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First Aid for Alcohol and Drugs (EHBDD)
The EHBDD (First Aid for Alcohol and Drugs) course offers essential knowledge and skills that are of great importance to anyone involved in guiding psychedelic experiences, such as trip sitters and psychedelic therapists.
One of the most important aspects of the EHBDD course is understanding the effects of various types of drugs, including psychedelics such as psilocybin and MDMA. Supervisors must be able to recognize and understand the effects of these substances so that they can respond adequately to the needs of the person tripping. This insight helps them create a safe and supportive environment.
The course teaches tripsitters to recognize potential risks and complications that may occur during a psychedelic experience. This includes identifying symptoms of a bad trip, panic attacks, or other acute reactions. By recognizing these signals in a timely manner, the tripsitter can intervene quickly and effectively to stabilize the situation.
An important part of the EHBDD course is the first aid techniques that participants learn. This includes basic life-saving actions, such as dealing with unconsciousness, breathing difficulties, or other medical emergencies. It is crucial for a tripsitter to master these skills so that they can respond appropriately in the event of an emergency.
The tripsitters and therapists working at Triptherapie are required to complete First Aid and the Alcohol and Drugs module. In this blog, we list the various techniques for different types of drugs, including drugs other than psychedelics.
Posted : 1 October 2024 13:36
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MDMA
Ecstasy, also known as XTC, is the street name for pills or powders that contain the substance MDMA, among others. These tablets may sometimes contain other substances besides MDMA. Since 1988, MDMA has been on List 1 of the Dutch Opium Act, which means that it is classified as a hard drug.
Use of MDMA
Ecstasy, also known as XTC, is the street name for pills or powders containing, among other substances, MDMA. These tablets can sometimes contain other substances besides MDMA, such as speed. MDMA is one of the most widely used synthetic drugs, particularly within the subculture of electronic music, such as techno, trance, house, and hardcore. Users of MDMA typically do not experience physical addiction or psychological dependence. However, the use of MDMA is often associated with specific events, such as dance parties.
A trip can be a very intense experience and can sometimes be accompanied by feelings of panic and anxiety. This is often caused by the user feeling like they are losing touch with reality, or by resisting the influence of the substance and being unable to fully surrender to the experience.
Effects
Desired effects
- Feeling of euphoria
- Accompanied by a relaxed feeling
- Empathy and energy
- Contacts are easily made
- Sensory experiences are enhanced
- Sexual desire increases due to the use of MDMA.
- Strong feeling of being in love and a strong emotional bond with other users
Unwanted effects
- Fatigue and insomnia
- Cramps, nausea and vomiting
- Dry throat and mouth
- Tight jaws
- Heart palpitations
- Increase in blood pressure and body temperature
- Sweating
- Headache or dizziness and trembling
Risks
Water intoxication
Appetite and the need for sleep are suppressed by the use of MDMA, while the feeling of thirst increases; even when the body is not dehydrated. This can lead to the consumption of excessive amounts of water, which can ultimately result in a reduced sodium concentration in the blood, potentially causing cerebral edema or death.
Appetite and the need for sleep are suppressed by the use of MDMA, while the feeling of thirst increases; even when the body is not dehydrated. This can lead to the consumption of excessive amounts of water, which can ultimately result in a reduced sodium concentration in the blood, potentially causing cerebral edema or death.
Body temperature
An increase in body temperature as a direct result of MDMA and serotonin stimulation, facilitated by a warm environment and prolonged physical activity (such as moving and dancing), can cause overheating and dehydration. The consequence of this can be that important organ functions are affected or fail.
Overdose
An overdose of MDMA can be fatal (in relatively rare cases). It is difficult to predict which dose of MDMA is lethal, or conversely which dose is safe. The use of alcohol dampens the effect of MDMA, making you inclined to consume more. Furthermore, its use places an additional strain on your cardiovascular system.
An overdose of MDMA can be fatal (in relatively rare cases). It is difficult to predict which dose of MDMA is lethal, or conversely which dose is safe. The use of alcohol dampens the effect of MDMA, making you inclined to consume more. Furthermore, its use places an additional strain on your cardiovascular system.
Combination hazard
The rise in body temperature is greater when MDMA is combined with cannabis. To reduce the risk of overheating, it is advisable to drink plenty of isotonic beverages. No water, to avoid water intoxication! Furthermore, it is recommended to regularly rest and seek a cool environment.
Posted : 1 October 2024 14:42
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Amphetamine
Amphetamine, commonly referred to as speed, pep, or fast, is a synthetic substance. Its use can cause both physical and psychological addiction. Furthermore, amphetamine has a stimulating effect and can promote insomnia. Additionally, the use of amphetamine leads to a reduced appetite and appetite.
Use of Amphetamine
Amphetamine can be taken in the form of a pill or powder. The most common method is snorting, but it is also possible to swallow or inject it. When amphetamine is swallowed, the effects begin after about 20 minutes. In the case that it is taken in a 'bomb,' where a rolling paper is folded into a kind of container, the effect may take longer to kick in. Due to the presence of the paper, it then takes about 30 minutes to an hour before the effects are felt.
When injected into a vein, the effect of the drug occurs almost immediately.
The duration of the effects of amphetamine varies and typically ranges between 4 and 8 hours, depending on the amount ingested and the strength of the amphetamine. When smoking the substance, the effects are felt after just a few inhalations. However, smoking applies exclusively to methamphetamine, which is known in the illegal circuit as 'crystal meth' or simply 'meth', and is primarily used in the United States. Amphetamine, which is sold under the name 'speed' in most EU countries, cannot, on the other hand, be smoked.
Effects
Desired effects
- Lots of energy
- Reduced appetite
- Reduced sense of sleep
- Stimulating effect
Unwanted effects
- Anxiety and restlessness
- Involuntary movements of the body
- Sweat more
- Getting a headache
Risks
Psychological complaints
Psychological symptoms, such as paranoid delusions, have also been described. Depression may develop after cessation of (long-term) amphetamine use.
Psychological symptoms, such as paranoid delusions, have also been described. Depression may develop after cessation of (long-term) amphetamine use.
Heart rhythm disorders
In the long term, you can develop heart rhythm disorders, a heart attack, or a stroke.
Dry mouth
The use of amphetamine can lead to a dry mouth and you also produce less saliva (this is bad for your teeth because saliva is a natural cleanser for your teeth).
Overheating
Your body temperature rises due to use, and you can overheat.
Your body temperature rises due to use, and you can overheat.
Motor restlessness
After use, you may become motorically or physically restless (for example, you may make more jaw movements). You may also start grinding your teeth, which is bad for your teeth in the long term, and it is also possible that you may develop jaw clenching.
Exhaustion
You may become physically exhausted and suffer from insomnia. After use, you may feel tired and depressed for some time.
Posted : 1 October 2024 14:48
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Cocaine
Cocaine is a chemical substance extracted from the leaves of the coca plant and subsequently further processed. This substance has a stimulating effect on the central nervous system and reduces the feeling of hunger.
Cocaine use:
Cocaine is typically taken through the nose. The powder is laid out in a line and then snorted using a special snorting tube, a cut-off straw, or a rolled-up banknote.
When cocaine is snorted, it comes into contact with the nasal mucous membranes, where it enters the bloodstream through these membranes. It is important to note that the cocaine does not reach the brain directly; it must first be absorbed into the circulation.
When snorting cocaine, a small tip or a thin line is often taken. During an evening, users may take multiple doses. Users often share a 1-gram package (also known as a 'snow seal'). Usually, intake per evening varies between a quarter and half a gram. Higher doses are primarily seen among experienced or dependent users.
Effects
Desired effects
- Active, clear-headed, eager to do things
- Feeling of well-being, cheerful and happy
- Full of self-confidence
- At low doses and with occasional use, it can be sexually stimulating.
Unwanted effects
- Heart palpitations, rapid breathing
- Restless, anxious, agitated
- Undesirable psychological effects can occur after prolonged and heavy use, even with small amounts.
- At higher doses and frequent use: loss of libido, impotence
- Reduced menstruation
- Fatigue afterwards, sleep disturbances
Risks
Short-term risks
Strain on your heart and blood vessels
Cocaine puts a strain on your heart and blood vessels. This is because cocaine stimulates the heart rate. The heart needs more oxygen. At the same time, cocaine constricts the blood vessels, causing the heart to receive less oxygen.
Exhaustion
Cocaine exhausts the user. Fatigue is suppressed, causing one to cross the line.
Irritated nasal mucosa
Snorting cocaine irritates and inflames the nasal mucosa. Cocaine can also enter the frontal sinuses, causing blockages and headaches.
Take more cocaine
With regular use, the same dose has less of the desired effect, causing more to be taken often.
Depressed
In the days after using cocaine, you may feel very tired, burnt out, or depressed.
Long-term risks
Agitation and irritation
Frequent use of cocaine changes how you interact with people. It can make you agitated and irritated. Often, people are extremely self-centered.
Weight loss
Cocaine stimulates the central nervous system and suppresses the feeling of hunger.
Depression
After stopping, depression may occur that can be severe and last for several weeks (or sometimes even longer).
Addiction
Coke makes you greedy; you quickly want more. If you use a lot and often, you feel exhausted and down when sober. This can lead to a strong craving for cocaine.
Damage to cavities
Prolonged and heavy use often causes severe damage to the nose and sinuses. This can lead to chronic inflammation, which is painful and debilitating.
Posted : 1 October 2024 14:53
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LSD
What makes LSD so special is that it exhibits a psychoactive and hallucinogenic effect even when ingested in extremely small amounts (25 micrograms).
The use of LSD
An LSD trip is typically highly dependent on the user's inner state, including expectations, fantasies, and fears (set), as well as the immediate environment in which the experience takes place (setting). These factors can lead to a very positive or a very negative experience, also known as a bad trip. Therefore, a careful assessment of both the set and the setting is of crucial importance.
The effects of LSD usually begin 30 to 60 minutes after oral ingestion. Depending on the user's genetic predisposition and metabolic rate, the effects of LSD can last up to 12 hours on average.
Given the unpredictability of the effects of LSD, it is advisable to have a sober person in the vicinity of someone who is under the influence. This person can prevent destructive actions by the user during a bad trip.
Taking a very high dose (which can vary from person to person) does not affect the intensity of the trip, but it does affect its duration. It is possible that it takes 4 to 14 days for taking LSD again to be just as effective due to tolerance. LSD offers an intense experience that most users do not want to (re)experience daily. After a strong LSD trip, some users experience confusion for a few days, which is related to processing the experiences gained.
Effects
Desired effects
- Strong trip
- Strong visual hallucinations
- Deep thoughts
- Change in time perception
- Emergence of forgotten memories
- New interpretation based on previous (life) experiences
Unwanted effects
- Severe panic
- (Death)fear
- Acute psychoses
- Loss of sense of one's own personality
- Afraid that the bad trip is real and won't go away
- The feeling that time stands still
- Seeing small and large critters
- Intensifying unpleasant feelings
- Less or no control over emotions and behavior
Risks
Psychosis, depression and panic attacks
For people with a predisposition, the drug can trigger psychosis. LSD is therefore considered dangerous for people with mental health issues. If you already have a tendency to be anxious or depressed, using LSD can exacerbate the feelings associated with this (psychosis, panic attack, slump). The hallucinogenic trip effect can be frightening and cause a panic attack, which can lead to you 'flipping out' or having a 'bad trip'.
For people with a predisposition, the drug can trigger psychosis. LSD is therefore considered dangerous for people with mental health issues. If you already have a tendency to be anxious or depressed, using LSD can exacerbate the feelings associated with this (psychosis, panic attack, slump). The hallucinogenic trip effect can be frightening and cause a panic attack, which can lead to you 'flipping out' or having a 'bad trip'.
- Alternating emotions and sense of time.
- Emotions alternate (from positive to negative and vice versa).
- Your sense of time changes and you may experience 'flashbacks' (reliving trip experiences).
- Panic and fear.
A trip can be a very intense experience and can sometimes be accompanied by panic and anxiety. This is often caused by the user feeling like they are losing touch with reality, or trying to resist the influence of the product and being unable to surrender to it completely.
Posted : 1 October 2024 14:59
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Magic mushrooms
The term "magic mushroom" refers to mushrooms of the genus Psilocybe and related species. These mushrooms primarily contain the active substances psilocybin and psilocin.
Use of magic mushrooms
Magic mushrooms can be consumed in various ways. Below is an overview of the most common methods:
- Eating directly (in their pure form, magic mushrooms are often perceived as having an unpleasant taste)
- By brewing tea
- In combination with a sauce
- Incorporated into a chocolate bar
- In broth
The strength of the effects depends on the amount of mushrooms ingested. Additionally, the effect of different types of magic mushrooms varies depending on the context in which they are used and the user's state of mind. While one person may experience a pleasant, calm trip with the psilocybin mushrooms, another may undergo an intense experience. Moreover, the effect is generally stronger when the mushrooms are taken on an empty stomach.
Effects
Desired effects
- Strengthening of feelings and senses
- Laughing
- Music and colors are more intense
- Distortions of objects
- Lost in thought
- A relaxed, cheerful, energetic, high feeling
- Experiencing feelings you are normally not aware of
- Visual hallucinations
Unwanted effects
- Restless and confused
- Nausea
- Headache
- Thirst, dry mouth
- Warm or cold feeling
- Stomach and intestinal complaints
- Reinforcing unpleasant feelings
- Reduced control over emotions and behavior
Risks
Falling incorrectly
A magic mushroom can have an adverse effect, resulting in a bad trip for the user. This is often due to the physical or mental state the user is in at that moment. It may also be that the user does not feel comfortable at the location where the mushrooms are being consumed. Usually, there are pre-existing psychological problems involving a combination of various drugs and/or alcohol, or sleep deprivation. There are also often instances of excessively high doses of mushrooms or strong strains of mushrooms.
A magic mushroom can have an adverse effect, resulting in a bad trip for the user. This is often due to the physical or mental state the user is in at that moment. It may also be that the user does not feel comfortable at the location where the mushrooms are being consumed. Usually, there are pre-existing psychological problems involving a combination of various drugs and/or alcohol, or sleep deprivation. There are also often instances of excessively high doses of mushrooms or strong strains of mushrooms.
Panic attacks and depression
If you already have a predisposition to anxiety or depression, using magic mushrooms can trigger the feelings associated with this (psychosis, panic attack, slump). It is also possible that you will experience 'flashbacks' (reliving trip experiences).
If you already have a predisposition to anxiety or depression, using magic mushrooms can trigger the feelings associated with this (psychosis, panic attack, slump). It is also possible that you will experience 'flashbacks' (reliving trip experiences).
Posted : 1 October 2024 15:04
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First aid for alcohol and drugs in action
Step 1: Initial assessment of the severity of the situation
When you come into contact with someone who has used substances, it is possible to gather valuable information from the very first moment. The environment in which you find the person can already provide important clues for the correct approach and treatment. Additionally, the person's attitude and behavior can provide indications of possible alcohol and drug use. You can assess the severity of the situation based on the three situations below:
- Mild health disturbance: Easy to approach, noticeable use.
- Moderate health disturbance: Unresponsive, clearly under the influence.
- Serious health disturbance: Unresponsive due to (sub)comatose state.
Step 2: Assessing safety
Ensure the surroundings are safe. An individual who has taken an overdose may exhibit unpredictable behavior in certain circumstances. Do not hesitate to call emergency services (112) in such a situation.
Step 3: What are the acute life-threatening problems?
The following health disturbances are immediately life-threatening, except for acute psychosis (which can be indirectly life-threatening). The causes of the mentioned health disturbances are focused on substance use, but many other causes are possible. In the life-threatening situations listed below, you should call 112 for professional help.
- Airway obstruction
- Cardiovascular disorders
- Unconsciousness
- Insult
- Excitement delirium
- Hypothermia
- Overheating
- Acute psychosis (indirect)
1 - Airway obstruction (especially with narcotics)
An airway obstruction involves a blockage of the route of oxygen-rich (outside) air from outside the mouth deep into the lungs. Among the target group within the nightlife scene, this problem is usually caused by a combination of vomiting and drowsiness. Diagnose this by looking, listening, and feeling, and then initiate any necessary assistance.
Lockjaw in a person with decreased consciousness is always an emergency! Vomiting creates a high risk of suffocation. A rapid and complete 112 call ("threatened airway due to lockjaw") is vital!
2- Cardiovascular disorders (especially with stimulants)
As a result of high pressure in the vessels, problems can arise in the heart and brain. Myocardial infarction and cerebral hemorrhage have been described primarily in relation to cocaine use and 4FMP (a hybrid of MDMA and amphetamine). Palpitations are also reported with the use of other stimulants. Sometimes 'jaw clenching' occurs (with stimulants).
3 - Unconsciousness
In cases of unconsciousness, the victim is no longer responsive and does not react to verbal stimuli or pain. Unconsciousness related to substance use can have various causes, such as airway obstruction, severe hypothermia or hyperthermia, a seizure, and the use of sedatives such as alcohol or GHB.
4 - Seizure (especially with stimulants)
A seizure is the loss of consciousness. A seizure is usually accompanied by a jerky spasm of all the muscles in the body. This can be a manifestation of the disease epilepsy, but also due to substance use or strong visual stimulation. This is a dangerous situation, as the cause can also be the chemical effect of the drug.
During a seizure, the victim may turn blue as a result of inadequate breathing or airway obstruction. Incontinence (loss of urine and/or stool) may also occur, and the victim often bites their tongue. In many cases, a seizure ends spontaneously, but there is a risk that it may persist for longer than five minutes. This is referred to as 'status epilepticus', which can be fatal within a short time without professional help.
5 - Excitation delirium (especially with stimulants)
Excited delirium is a relatively unknown phenomenon. It is a condition in which the victim is motorically restless. The victim behaves almost animalistically and lashes out wildly.
A characteristic feature is that it is not targeted aggression. The victim will not surrender during fixation or overpowering. Nor does he or she make contact. This manifests itself in the fact that the victim looks right through you, as it were, and it is impossible to establish verbal contact.
Research has shown that excessive restraint affects the mortality risk of victims with agitated delirium. Cardiac overload occurs. Often, there is a combination of agitated delirium and improper care. The victim's agitation, in particular, is frequently perceived as the problem, causing security or the police to be the first to arrive on the scene. It is precisely among these professionals that there is still a great deal of unfamiliarity with agitated delirium, which sometimes leads them to fail to deal with it adequately.
6 - Hypothermia (especially with sedatives)
Hypothermia is a condition in which body temperature drops below 35 degrees. Different degrees of severity can be distinguished:
- A temperature between 33 and 36 degrees is considered mild hypothermia. The symptoms are often subtle. The victim is alert and well-oriented but complains of the cold. The skin is pale and cold, and shivering is usually present.
- Between 30 and 32 degrees, it is referred to as moderate hypothermia. The victim is absent-minded and disoriented. Below 30 degrees, unconsciousness may occur. The skin is pale and cold, and shivering is less pronounced than with mild hypothermia.
- Below 28 degrees, it is considered severe hypothermia. The victim is deeply unconscious and the muscles are stiff. There is a high risk of spontaneous cardiac arrest.
The above criteria are medical criteria. Outside the hospital, mild hypothermia can quickly progress to moderate and then severe hypothermia without proper assistance. It is therefore necessary to diagnose mild hypothermia in a timely manner. Hypothermia primarily occurs with the use of sedatives, but also due to stimulants (as a result of heavy sweating or wet clothing from dancing).
7 - Life-threatening overheating (with stimulants)
Overheating is a condition in which body temperature rises above 40 degrees. The condition is characterized by reduced consciousness to unconsciousness. Sometimes there is disorientation or aggression. The skin is pale, warm, and clammy or even dry.
The cause of life-threatening overheating is usually a combination of factors including intense muscle activity, insufficient fluid intake, non-breathable clothing, poor diet, stimulant use, high ambient temperature, and high humidity. Above 40 degrees, various processes in the body become disrupted, which can lead to irreversible damage to the brain and heart muscle. Above 42 degrees, the body's thermostat becomes dysregulated and can no longer regulate body temperature.
Unconsciousness upon the use of stimulants, severe overheating, seizures, and/or excited delirium are considered symptoms of a severe (sometimes life-threatening) brain disorder.
8 - Acute psychosis (especially with perception-altering and stimulant substances)
In acute psychosis, there are delusions (a disorder of thinking) and usually also hallucinations (a disorder of perception). The victim also experiences fear and aggression in response to the environment. The delusions cannot be corrected. The victim feels misunderstood, and together with the content of the delusions, this makes him or her anxious. It is this intense fear that makes the acute psychosis indirectly life-threatening. The victim feels anxious and threatened and will do everything to protect themselves.
Step 4: What are the non-acute severe symptoms?
If there are no acute life-threatening problems, look at the less problematic complaints that usually do not require help or for which there is often no request for help; these are the ones listed below and can be resolved by means of:
- Headache: Drink water to combat fluid loss
- Nausea: Sometimes vomiting helps, but be aware of the risk of suffocation.
- Dizziness: If you have low blood pressure, eat something with some salt or an isotonic drink.
- Drowsiness
- Abnormal body temperature or perception: Measure temperature and adjust clothing accordingly, or cool with wet cloths.
- Mild anxiety: Acceptance of the effect of the drug
- Discomfort
Posted : 1 October 2024 15:44
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