Reference information only. Not medical, legal, or personal advice. Review our full disclaimer before relying on this page.
Harm Reduction

Harm Reduction Prep Checklist

A printable, checkbox-style prep list for anyone planning a psychedelic experience. Walk through it with your sitter before the day; revisit it if anything in the plan changes.

Substance Identity & Verification

Confirm what you actually have before you measure a dose.

  1. Reagent test the substance. A reagent kit (Marquis, Mecke, Ehrlich, Hofmann) tells you which family of compound is present and flags common substitutes.
  2. Run a fentanyl test strip. The opioid supply chain crosses into other drug markets far more often than people expect, and a strip takes two minutes.
  3. Confirm the weight on a milligram scale. A 10 mg error on a 50 mg dose is a 20 percent swing in effect; do not eyeball powders or crystals.
  4. Verify source reputation. A trusted supplier with consistent feedback reduces surprise; a new or anonymous source warrants the lowest end of any range.

Dose by Experience Level

Pick the floor of the range that fits your history, not the ceiling.

  1. First experience: start at light or threshold. A new substance should be explored at the low end of any reference range; you can scale up next time, you cannot scale down mid-experience.
  2. Second or third experience: step into the common range. After one or two sessions with a substance, the common band is the place most reference data is anchored.
  3. Run a scale-up test dose. Use a quarter or half portion and wait the full onset window (often 60-90 minutes) before deciding whether to take more.
  4. Strong and heavy ranges come with longer recovery. Heavy ranges demand a clearer day, a longer window of integration, and a sober sitter you have briefed.

Set & Setting

Mind state, body state, and physical space all stack on the dose.

  1. Set a clear intention. A simple, honest goal (curiosity, grief work, creative block) orients the experience better than no frame at all.
  2. Choose a calm, intentional environment. A familiar room with control over light, sound, and interruptions is the safer frame; public or unfamiliar spaces add ambient risk.
  3. Sleep and food on a normal rhythm the day before. Skipping sleep or running on an empty stomach amplifies intensity and nausea; a normal night and a light meal beforehand is the safer baseline.
  4. Curate a playlist and a phone plan. A prepared playlist removes decisions in the moment; silencing non-essential notifications prevents accidental stressors.

Contraindicated Medications & Health Conditions

Some combinations are not "risky," they are contraindicated.

  1. Review SSRIs and SNRIs. Selective serotonin reuptake inhibitors blunt or destabilize the effect of classical psychedelics and combine poorly with MDMA.
  2. Review MAOIs. Monoamine oxidase inhibitors dramatically amplify serotonergic risk and are a hard contraindication for several substances, especially oral DMT forms.
  3. Review lithium and stimulants. Lithium with psychedelics and stimulants with MDMA are both flagged for serious adverse events in clinical guidance.
  4. Honest screen on cardiac and psychotic history. A personal or close-family history of psychosis, or any cardiac condition worth a clinic visit, is a reason to pause and consult a clinician where lawful.
  5. Pregnancy and active mental health crises. Pregnancy, current suicidal ideation, or an acute unmanaged condition all warrant deferring the experience and finding professional support first.

Sober Sitter Presence

A calm, sober person on call is the single biggest safety upgrade.

  1. Choose a sitter you trust. Someone with harm-reduction fluency is better than a well-meaning friend who has not read the same literature.
  2. Agree on the protocol in advance. Talk through when the sitter speaks, what they will redirect, and how they handle a difficult loop or a panic loop.
  3. Brief on anchoring techniques. Slow breathing, eye contact, a hand on the shoulder, naming five things in the room, and changing the music are the standard moves.
  4. Plan transport and a quiet return. A ride home, a calm place to land, and a no-obligations next morning are part of the sitter role, not extra.

Integration Planning

The days after the experience do most of the long-term work.

  1. Hold a clear aftercare window. Plan for a low-stakes day or two with no major decisions or commitments immediately after the experience.
  2. Journal within 24 hours. Notes taken the same day preserve details the rationalizing mind starts to overwrite by day three.
  3. Schedule a follow-up conversation. A planned talk with the sitter or a trusted friend turns a private insight into something you can act on.
  4. Read one integration source before acting on any conclusion. The MAPS integration workbook, an ICEERS guide, or a vetted local integration circle gives you a frame before you make big changes.

If Something Goes Wrong

A short list of moves, kept in muscle memory, beats improvisation.

  1. Reorient to the room. Slow breaths, name five things you can see, change the music or the lighting, drink water, and sit or lie down on a safe surface.
  2. Use the sober sitter. A grounded voice describing the room is the single most reliable reset during a difficult loop.
  3. Call a peer support line. The Fireside Project line (1-623-473-7433) is free, confidential, and staffed by trained psychedelic peer-support volunteers.
  4. Escalate only if a real symptom appears. Chest pain, sustained loss of consciousness, seizures, or hyperthermia are medical emergencies; call local emergency services and disclose what was taken.

Compiled from the standing harm-reduction literature at Erowid, MAPS, DanceSafe, and the Zendo Project. Use this as a starting point, not a substitute for medical advice; review our /disclaimer. Read the full disclaimer.

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