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Taking both these drugs should not be harmful. The effects of both drugs are likely to be reduced.

Combining these drugs should not be harmful. However, they will mask each other’s effects, which might increase the risk of overdosing either drug. This combination is also hard on the heart due to each drug’s opposing action (7).

The combination is unlikely to cause any adverse or undesirable reactions beyond those that might ordinarily be expected from taking these drugs individually. Users have reported diminished experiences, thus care should be taken with dosage.

This combination carries a low risk. Aspirin and cannabis are unlikely to cause an adverse or undesirable reaction when used carefully and within the recommended dose.

Cannabis and DMT is not usually a harmful combination, but cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics so beware when mixing these drugs.

There is no evidence to date showing interactions between paracetamol and 2C-B.

This combination is unlikely to cause an adverse or undesirable reaction when used carefully and within the recommended dose.

Taking both these drugs together is likely to cause an effect stronger than taking them individually. If used with care they are unlikely to cause an adverse or undesirable reaction.

We strongly recommend you avoid taking these drugs together, reactions are highly unpredictable and can be fatal. You will likely come to some degree of harm even if you take strong precautions.

Taking the combined oral contraceptive pill and cocaine together is not usually any more harmful than taking them individually. The drugs are not known to interact with each other, each positively or negatively46,47.

Taking both of these drugs together is not usually any more harmful than taking them individually. The drugs are not known to interact with each other, each positively or negatively.

Alcohol and GHB is an unsafe combination. Even in very low doses this rapidly leads to memory loss, severe ataxia and unconsciousness. There is a high risk of vomit aspiration while unconscious.

Be careful when mixing amphetamines and GHB. Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

Avoid benzos if you are taking allergy medicines. benzos and allergy medicines such as Benadryl, Piriton and Clarityn are depressants and both slow down your central nervous system. This can produce heightened side effects such as drowsiness, sedation and poor concentration. In extreme cases, loss of consciousness and may occur.

These two drugs potentiate each other strongly and unpredictably which might lead to memory loss, blackout and respiratory depression.

Using these drugs together can cause an effect stronger than taking them individually, and they aren't likely to cause an adverse or undesirable reaction when used carefully. Additional research should always be done before mixing drugs.

Effects will be stronger than taking either drug alone, however, it’s unlikely that there will be any adverse health reactions to this combination.

The combination is unlikely to cause any adverse or undesirable reactions beyond those that might ordinarily be expected from taking these drugs individually. Users have reported diminished experiences thus care should be taken with dosage.

There is no evidence to date showing interactions between contraceptive pills and cannabis and generally this combination carries a low risk. However, cannabis will often intensify and alter your mood. If your contraception is causing significant changes in your mood, it is advisable to avoid cannabis as it may intensify mood swings.

This combination carries a low risk. Paracetamol and cannabis are unlikely to cause an adverse or undesirable reaction when used carefully and within the recommended dose.

There is no evidence to date showing interactions between paracetamol and LSD. This combination is unlikely to cause an adverse or undesirable reaction when used carefully.

There is no evidence to date showing interactions between allergy medicines and LSD. This combination is unlikely to cause an adverse or undesirable reaction when used carefully.

There is no evidence to date showing interactions between ibuprofen and 2C-B. This combination is unlikely to cause an adverse or undesirable reaction when used carefully.

There is no evidence to date showing interactions between ibuprofen and benzos. This combination is unlikely to cause an adverse or undesirable reaction when used carefully and within the recommended dose.

Using these drugs together can cause an effect stronger than taking them individually, and they aren't likely to cause an adverse or undesirable reaction when used carefully. Additional research should always be done before mixing drugs.

The effects of these two drugs are similar and synergistic, therefore mixing MDMA with 2C-B may increase the intensity of the experience.

Combining kratom with such depressants is contraindicated.Depressants have the same general effects as opiates. Therefore, combining them with kratom can cause a synergy effect of severe sedation, which can feel like overdosing. More sedation and respiratory depression can occur as a result. Memory blackouts are also likely to occur.

_Users report that the two herbs go well with each other, however, moderation is important when combining them. Keeping both doses low helps ensuring that you derive the highest possible positive effects without crossing the line to negative side-effects. You should go particularly light on cannabis dosage. Although rarely, some users report mild effects, such as feeling nauseous, sick and uncomfortable. Stronger side effects include anxiety and dizziness._

Be careful when taking paracetamol and cocaine. Paracetamol may increase the harmful effects of cocaine on the liver4.

Taking both these drugs together may produce unpleasant effects such as physical discomfort or overstimulation. High doses put you at risk. If you mix, start low and go slow

_Kratom leaves produce complex opioid-like analgesic effects, which could be potentiated with the use of ibuprofen._

Amphetamines and DMT is not usually a harmful combination but stimulants generally increase anxiety levels and the risk of thought loops which can lead to negative experiences.

Tricyclics (Amitriptyline, Anafranil, Asendin, Aventyl, Elavil, Endep, Norfranil, Norpramin, Pamelor, Sinequan, Surmontil, Tipramine, Tofranil, and Vivactil) is consistently reported as being very bad in combination with LSD. People attempting this combination are unable to communicate with others, they go into a fugue state where they wander away from home and don't know how they got there, and they are generally in a terrible state psychologically. Life-threatening seizures and at least one death have been reported to be triggered by the combination of LSD and tricyclics. If you are prescribed tricyclics for mental health problems, it is not a good idea to try LSD outside of a supervised medical setting, as it might worsen the symptoms.

Effects are additive. The combination is unlikely to cause any adverse or undesirable reactions beyond those that might ordinarily be expected from taking these drugs individually.

This drug can have anxiogenic (anxiety-creating) effects which may create an unpleasant thoughts and discomfort.

Using these drugs together can cause an effect stronger than desired though they aren't likely to cause a serious adverse reaction if used carefully. Additional research should always be done before mixing drugs.

Using these drugs together can cause an effect stronger than taking them individually, and they aren't likely to cause an adverse or undesirable reaction when used carefully. Additional research should always be done before mixing drugs.

This combination is relatively safe and is unlikely to cause any unwanted effects.

Stimulants should not be combined with kratom, as they further increase the level of stimulation provided by the kratom. This results in the development of potentially severe side effects: anxiety, heart palpitations, excessive sweating, and general agitation. More life-threatening side effects that may result include: increased blood pressure. The lowering of the seizure threshold may also be observed.

Cannabis and mushrooms is not usually a harmful combination, but cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics so beware when mixing these drugs.

The combination is unlikely to cause any adverse or undesirable reactions beyond those that might ordinarily be expected from taking these drugs individually. Benzos lessen the effects of nitrous oxide due to both drugs acting on common receptors.

This combination carries a low risk. Ibuprofen and cannabis are unlikely to cause an adverse or undesirable reaction when used carefully and within the recommended dose.

Cannabis and LSD is not usually a harmful combination, but cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics so beware when mixing these drugs.

These combinations are not usually physically harmful, but may produce undesirable effects, such as physical discomfort or overstimulation. Extreme use may cause physical health issues. Be careful when mixing these drugs.

The effects of mixing these two drugs together can be unpredictable.

There is no evidence to date showing interactions between aspirin and benzos. This combination is unlikely to cause an adverse or undesirable reaction when used carefully and within the recommended dose.

There is a low risk when drinking a moderate amount of alcohol when using the recommended dose of aspirin.

Avoid alcohol if you are taking aspirin for a headache. Alcohol is likely to make a headache worse as it causes dehydration.

2C-X and GHB is not usually a harmful combination, it will tend to decrease the effects of both drugs.

_Reactions and side effects are rare, but using these drugs together can cause an effect stronger than taking them individually, and they aren't likely to cause an adverse or undesirable reaction when used carefully. Kratom’s effects are due primarily to its interaction with mu-receptors in the brain, while SSRIs produce their effects by interacting with the serotonin receptors. It is hypothesized that, since both act on receptors that can sometimes be involved with each other in certain processes, an interaction may or may not occur. Interactions include risks such as_ [_serotonin syndrome_](https://www.mdedge.com/ccjm/article/120386/neurology/serotonin-syndrome-preventing-recognizing-and-treating-it)_. Additional research should always be done before mixing drugs._

[**Tramadol**](https://www.drugs.com/tramadol.html) can result in seizures when taken with LSD, as Tromadol lowers the seizure threshold.

There is no evidence to date showing interactions between ibuprofen and modafinil. This combination is unlikely to cause an adverse or undesirable reaction when used carefully.

Taking aspirin and cocaine together is not usually any more harmful than taking them individually. Aspirin is sometimes [used](https://www.the-hospitalist.org/hospitalist/article/125897/how-should-patient-cocaine-associated-chest-pain-be-treated) by doctors in response to cocaine associated chest pains51,52.

There is no evidence to date showing interactions between ibuprofen and ketamine. This combination is unlikely to cause an adverse or undesirable reaction when used carefully.

Caffeine and GHB have low risk and decreased synergy. Caffeine will mildly hide the depressant effects of GHB leading to a slightly increased risk of overdose.

### Alcohol overdose

-   Vomiting
-   Cold, clammy skin (hypothermia)
-   Loss of gag reflex
-   Seizures
-   Slow heart rate and breathing
-   Loss of coordination
-   Loss of/impaired consciousness

### Depressant (excluding alcohol) overdose

-   Slow shallow breathing
-   Not breathing
-   Barely conscious or unconscious
-   Blue lips or fingertips
-   Gurgling sounds/snoring
-   Impaired coordination
-   Muscle weakness

### Dissociative overdose

-   Slow shallow breathing
-   Stopping breathing
-   Low blood pressure
-   Low heart rate
-   Seizures
-   Loss of consciousness
-   Paranoia
-   Delusions
-   Shivering

### Opioid overdose

-   Slow shallow breathing
-   Not breathing
-   Barely conscious or unconscious
-   Blue lips or fingertips
-   Gurgling sounds/snoring
-   Pinpoint pupils
-   Very slow heartbeat
-   Very low blood pressure

### Stimulant overdose

-   Anxiety
-   Psychosis
-   Racing heart
-   Overheating
-   Dehydration
-   High blood pressure
-   Tremors
-   Seizures
-   Loss of consciousness

**References:** [Signs and symptoms of overdose](https://drugabuse.com/library/drug-overdose/); [Ketamine toxicity](https://www.ncbi.nlm.nih.gov/books/NBK541087/); [PCP](https://www.drugrehab.com/addiction/drugs/pcp/effects/)

A drug overdose simply means taking too much of a drug, resulting in negative side effects. Overdosing is never pleasant, but it can be a vastly different experience from one drug to the next. With some drugs, overdosing may be life-threatening, while with others it may simply be very uncomfortable due to a difficult psychological experience, and with some it can be both. The best way to get a general understanding of what an overdose might be like for a certain type of drug is to take into account what drug class it falls into. Read on below to find out more....

**References:** [Definitions archive](https://web.archive.org/web/20110227202513/http:/www.treatment-now.com/resources/definitions/)

### Depressants

Depressants, such as alcohol and benzodiazepines (e.g. Xanax and Valium), can be incredibly dangerous when taken in excessive doses, and especially when [mixed together](https://www.ncbi.nlm.nih.gov/pubmed/12170103). Having too much alcohol can cause severe complications which include: [asphyxiation](https://www.merriam-webster.com/dictionary/asphyxiation), [dehydration](https://www.webmd.com/a-to-z-guides/dehydration-adults#1), [irregular heartbeat](https://www.webmd.com/heart-disease/arrhythmia-directory), and in severe cases, [death](https://www.mayoclinic.org/diseases-conditions/alcohol-poisoning/symptoms-causes/syc-20354386). Similarly, benzodiazepines can induce a coma, reduced ability to breathe, and even heart attacks in some situations.

### Dissociatives

Dissociative anaesthetics such as ketamine are reasonably well tolerated at low doses. However, they can cause changes in heart rate and blood pressure which can be dangerous. DXM can also cause greatly reduced or even complete cessation of breathing, and [disturbing psychological effects](https://www.msdmanuals.com/en-gb/professional/special-subjects/recreational-drugs-and-intoxicants/ketamine-and-phencyclidine-pcp).

### Opioids

Opioids, such as heroin and fentanyl, can very easily, and often accidentally, be taken in quantities that cause an overdose. Like depressants, opioids can cause [respiratory depression, coma and death](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227310/). With very strong opioids like fentanyl, which is approximately 100 times more potent than liquid morphine, overdose can occur with [extremely small amounts](https://en.wikipedia.org/wiki/Equianalgesic).

Overdoses on fentanyl have even occurred unknowingly, as small quantities are sometimes accidentally pressed into [fake Xanax pills](https://drugabuse.com/fake-xanax-is-here-and-its-deadly/). This had [fatal consequences](https://www.oxfordtreatment.com/fentanyl/lethal-dose/) for the individuals who took the tainted pills. Only a tiny dose of fentanyl is required to cause death. As little as 2mg.

### Psychedelics

Psychedelics such as LSD or psilocybin can have very unpleasant side effects. These include: anxiety, vomiting, and hyperthermia. They've also been known to trigger [onset of acute psychosis](https://onlinelibrary.wiley.com/doi/abs/10.1002/ajmg.b.32177) in people with a family history of schizophrenia. Unlike drugs like fentanyl and heroin, psychedelics have rarely been known to directly cause death themselves. Deaths as a result of psychedelic ingestion are typically the result of risky behaviour while on the drug.

### Stimulants

Overdoses on stimulants such as amphetamine or cocaine put the cardiovascular system at great risk. They can easily cause heart attacks, dangerously high blood pressure, cerebral haemorrhage (bleeding in the brain), as well as involuntary movements and other hazardous symptoms. However, there is also a risk of [developing psychosis](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3554477/), which is especially prevalent with amphetamine and methamphetamine.

Empathogens, such as MDMA (ecstasy), can cause [serotonin syndrome](https://www.webmd.com/depression/guide/serotonin-syndrome-causes-symptoms-treatments#1) when taken in either, excessive quantities or when taken alongside certain antidepressants, such as [MAOIs](https://www.drugs.com/drug-class/monoamine-oxidase-inhibitors.html). There is also a risk of overheating and dehydration. However, the biggest risk associated with MDMA is pills cut with other dangerous chemicals, which have been known to [kill unsuspecting clubbers](https://volteface.me/feature/fired-ecstasy-related-deaths-rising-uk/).

**References:** [Fatal alcohol and benzo poisoning](https://www.ncbi.nlm.nih.gov/pubmed/12170103); [Serotonin syndrome](https://www.webmd.com/depression/guide/serotonin-syndrome-causes-symptoms-treatments#1); [MAOIs](https://www.drugs.com/drug-class/monoamine-oxidase-inhibitors.html); [Volteface](https://volteface.me/feature/fired-ecstasy-related-deaths-rising-uk/); [Fentanyl lethal dose](https://www.oxfordtreatment.com/fentanyl/lethal-dose/); [Amphetamine induced psychosis](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3554477/); [Ketamine and PCP](https://www.msdmanuals.com/en-gb/professional/special-subjects/recreational-drugs-and-intoxicants/ketamine-and-phencyclidine-pcp); [Drug induced psychosis](https://onlinelibrary.wiley.com/doi/abs/10.1002/ajmg.b.32177)

### Move fast

-   Ambulance. Call one immediately if they are struggling to breathe or are unconscious.

### While you wait

-   Check their [responsiveness](https://www.cprcertified.com/blog/first-aid-for-drug-overdoses). Shake them gently and shout their name. If they don't respond, the muscle between the shoulder and the neck (trapeze) firmly.
-   Stay with them. If they're awake, keep them calm through reassurance and by encouraging deep breaths.
-   Breathing. If they don't respond to any of the above, they are most likely unconscious → *watch their breathing*.
-   Airways. If they're unconscious, make sure nothing is obstructing their breathing.
-   Recovery position. If they're unconscious but breathing, flip them on the side so they don't choke if they vomit.
-   CPR. If they're unconscious and not breathing, it's time to start [basic life support](https://www.resus.org.uk/resuscitation-guidelines/adult-basic-life-support-and-automated-external-defibrillation/#sequence) → 30 chest compressions (to the beat of "Staying alive") then two rescue breaths (make sure to pinch the nose).

### Once help has arrived

-   Cooperate with medics. You are guilty of nothing, they simply want to help.
-   What drug and how much. If you know this, it's crucial to tell the medical team so that they can give the correct care and potentially save their life!
-   Hand it over. If you don't know what the person has been using, consider collecting the pills or powder and give it to the medical team. The more they know the better.

-   Avoid mixing drugs. This is the cause of many overdoses. For example, drugs like benzodiazepines can have a deadly additive effect when taken with opioids or alcohol. Additionally, taking several different drugs makes it more difficult to keep track of how much of each drug has been taken.
-   Test, test, test. Drug testing kits are readily available for purchase online. In the UK you can go to [Reagent Tests](https://www.reagent-tests.uk/). They can be used to determine whether a pill or powder contains any harmful drugs that may lead to an overdose.
-   Get clued up. Research typical doses - these are present on all the drug guides that we have. If it is legal in your country, consider investing in an electronic weighing scale.
-   Be aware of your tolerance. If you use a drug regularly, you will develop a tolerance to it (needing more to achieve the same effect). If you suddenly stop using it for a significant amount of time (even just a couple of weeks), your body will stop being used to it and your normal dose may suddenly become too much for you. Lower your doses accordingly.
-   Avoid strong drugs. The stronger the drug, the more likely the overdose. The recreational dose window becomes very small and it can be easy to go over.
-   Know your source. Consuming any drug bought illegally comes with risks, but does your source seem particularly unsafe or unreliable? It is always wise to take a small test dose of any drug before taking a larger dose. If it doesn't feel right, get rid of it.
-   Have a buddy. Having friends you trust to help you out if an accident were to happen is crucial. If you must be alone when taking a drug, consider letting a trusted friend know and determine how they can check up on you in advance.
-   Put your health first. Poor nutrition, unhealthy sleep habits, and overall health condition can contribute to increased risk of overdose. Find a doctor that you can be honest with and remember the importance of getting regular check-ups, especially if using substances.

Overdose

{Keep yourself and your friends safe}

Signs and symptoms

Alcohol overdose

Depressant (excluding alcohol) overdose

Dissociative overdose

Opioid overdose

Stimulant overdose