What to do in case of an MDMA overdose?

I tried to find some information on what one should do in the case of an overdose and I couldn't really find anything... Anyone know? Obviously keep body temperature down whilst making sure not to give them too much water (I've read cases were people on mdma died from water toxicity), but what do you do other than that? Also in the UK if you call an ambulance will the hospital call the police? Will you get arrested or charged with anything? I'm asking because although I personally, am sensible, however I know people who really really really aren't despite me telling them not to be so reckless. I know one guy that often takes 250mgs or relatively pure stuff whilst drinking and always gets to the point where he is completely incoherent and no fun to be around and has passed out a couple of times. He also took half a gram at a festival. He's a dick in short. But it would be nice to know what to do when he finally goes to far.

Drink a fair amount of water depending on how much you're excreting, I was drinking about a 600ml (extreme sweats) bottle an hour when I bombed 360mg at once whilst already peaking on a 180mg dose. Make sure he pisses every couple hours to so there is not to much fluid build up (can be difficult but I usually try to have a piss mid-roll if I've drunk a lot of water). He'll be fine as long as he keeps cool and drinks some cold water. If he's not visibly sweating much, a cup (250~ml) an hour should be plenty.

And no you wont be arrested if you call an ambulance, if someones life is in danger the first thing to do is call ambulance, just make sure that they absolutely need the ambulance and you're not just panicking, 250mg isn't going to be killing anyone IMO (if MDMA is all they took).

MDMA overdose: first thing is to take them somewhere very cold right away to prevent hyperthermia. place a cold rag on their forehead right away, give them some room to breathe. If this does not help things right away I would call emergency medical services right away. Drinking water can actually make things worse causing hyponatremia which is the #1 cause of MDMA-related death. If you give them water, make sure it's saline (salt/water mix).

severely etarded said:

If you give them water, make sure it's saline (salt/water mix).

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What if there is nowhere you can get salt from like at a club? Are there any alternatives that may be sold at the bar like fruit juices or sports drinks?

And how much salt ideally for a pint of water, would it something like one teaspoon for 500ml?

Chesh said:

What if there is nowhere you can get salt from like at a club? Are there any alternatives that may be sold at the bar like fruit juices or sports drinks?

And how much salt ideally for a pint of water, would it something like one teaspoon for 500ml?

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could try a virgin bloody mary. That should be loaded with sodium. and a few sips of straight water. not more than that though.

Most sports drinks have electrolytes. Gatorade, Powerade etc

In oral rehydration therapy, electrolyte drinks containing sodium and potassium salts replenish the body's water and electrolyte levels after dehydration caused by exercise, excessive alcohol consumption, diaphoresis, diarrhea, vomiting, intoxication or starvation. Athletes exercising in extreme conditions (for three or more hours continuously e.g. marathon or triathlon) who do not consume electrolytes risk dehydration (or hyponatremia).[1]
A simple electrolyte drink can be home-made by using the correct proportions of water, sugar, salt, salt substitute for potassium, and baking soda.[2]
Electrolytes are commonly found in fruit juices, coconut water, sports drinks, milk, and many fruits and vegetables (whole or in juice form) (e.g. potatoes, avocados).

So, I'm having one of those "Ok, someone's gotta say it." moments so I figured it may as well be me. . .

While it's unlikely 250 mg would cause an OD I understand your OP to basically mean what/if and when this guy eventually just get's ridiculous and does some real damage. That being the case there's been plenty of good advice here but I just wouldn't feel right without adding the following. . .

Please don't hesitate to call for help and emergency services if you are truly feeling over your head and there's something very wrong. As mentioned earlier it's pretty important not to over react needlessly as lots of people (myself included) like to enjoy MDMA to the point where we're pretty messed up for a while but if you and your friends truly feel like something is going very wrong DO NOT HESITATE to call for help. I can't (of course) guarantee you won't be arrested but the chances are exceedingly remote. The bottom line is someone's life just isn't worth risking. It's MUCH better to be err on the side of caution than not to anything and put someone's health in jeopardy.

Might I add 1 thing though. . . PLEASE PLEASE PLEASE make sure you go through his pockets / bags / whatever while you're waiting for help to arrive. While I'm nearly certain no one get into trouble (legal that is) for getting him medical help all bets are off is he's admitted and he's got a bag of rolls or pouch of molly in his pocket.

OK yeah, I know I'm the Old Foggie that had to be the worry wort but just felt it needed to be said

Nottamous said:

So, I'm having one of those "Ok, someone's gotta say it." moments so I figured it may as well be me. . .

While it's unlikely 250 mg would cause an OD I understand your OP to basically mean what/if and when this guy eventually just get's ridiculous and does some real damage. That being the case there's been plenty of good advice here but I just wouldn't feel right without adding the following. . .

Please don't hesitate to call for help and emergency services if you are truly feeling over your head and there's something very wrong. As mentioned earlier it's pretty important not to over react needlessly as lots of people (myself included) like to enjoy MDMA to the point where we're pretty messed up for a while but if you and your friends truly feel like something is going very wrong DO NOT HESITATE to call for help. I can't (of course) guarantee you won't be arrested but the chances are exceedingly remote. The bottom line is someone's life just isn't worth risking. It's MUCH better to be err on the side of caution than not to anything and put someone's health in jeopardy.

Might I add 1 thing though. . . PLEASE PLEASE PLEASE make sure you go through his pockets / bags / whatever while you're waiting for help to arrive. While I'm nearly certain no one get into trouble (legal that is) for getting him medical help all bets are off is he's admitted and he's got a bag of rolls or pouch of molly in his pocket.

OK yeah, I know I'm the Old Foggie that had to be the worry wort but just felt it needed to be said

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Well said!

While calling an ambulance is a reasonable option, it is important to know that the treatment they are going to offer is exactly what has been said in this thread.
The first approach is to lower body temperature, regardless of the presence of hyperthermia.
Remove all clothing and put cold rags on the face, head, neck, back, abdomen...
We are talking aggressive cooling techniques - not just stepping outside for cool air.

This method is remarkably effective all on its own.
Many people have reported that it abolishes their roll!
And rodent and primate research that uses highly toxic doses of MDMA PROVES that lowering temperature directly attenuates toxicity.

Since hyponatremia, or water intoxication, is a sign of advanced Serotonin Syndrome or MDMA toxicity - it normally occurs only after a severe episode of panic/anxiety.
If swelling in the face, hands, and abdomen should occur in the absence of urination - this is a bad sign.
Anyone with hyponatremia should already be in the hospital.
By this time, hyperthermia has normally begun - so EARLY and AGGRESSIVE cooling should prevent hyponatremia.

After aggressive cooling the next step in SUPPORTIVE care is saline IV.
The equivalent of this is a salty drink, or even gatorade.
Anything with salt and potassium in it would work.
If you are at a bar and cannot find a salty drink anywhere, or a damn saltshaker, it is time to run to the nearest gas station or wherever you can find a source.
No, licking other party members would not provide enough salt.
Perhaps if all the women lined up and took their shirts off for you...:D

This concludes the PRIMARY response seen in a hospital setting - and BOTH can be done prior to calling an ambulance.
It is unfortunate that this isn't well known among MDMA users, because it would save some of the lives that are lost or damaged.
Spread the word to all your rolling friends.

If anxiety and esp. hyperreflexia/tight muscles are seen after these two treatments, the next step is a benzodiazapene.
Valium, klonopin, or xanax are all good options.
Relaxing the muscles throughout the body help prevent myoglobin release from cell death and possible kidney damage!
But they also shut down glutamate, the primary excitatory neurotransmitter in the brain.

It is possible that cooling, saline IV, and benzo treatment will not fix the problem in a real acute reaction.
These people are normally VERY sensitive to ANY stimuli, and must be removed to a quiet, dark room.
And they have to be convinced that the cooling treatment really works.
They may be unable to speak or understand commands, and the inability to describe what they are experiencing can make it very difficult for friends to recognize the need for immediate intervention. Aphasia is a very bad sign.

If cooling, saline, benzos, and isolation does not calm the pantient....or if body temperature remains elevated...
The next step is a serotonin antagonist.
It is also the last step, aside from treating acidosis, kidney failure, liver failure..

If this does not resolve the symptoms, there is no other treatment available.
MDMA 'overdose' is a vague term, because acute MDMA reactions can happen at 'safe' recreational doses.
But most people who experience serotonin syndrome normally survive - and the dose required to cause death in most people is absurd.
Like 40 tabs!

MDMA causes neurotoxicity long before death.
Cooling, salt, and isolation are effective for most ER visits.
Tell your friends.

Make the distinction between panic attack and obvious physical danger.

If your vital signs are worrying you, go to a hospital.

Best advice? Don't overdose on MDMA. It's not hard. It's not as though it's an opiate where a fraction of a dose in some people can mean the difference between 'sweet spot' and death.

I'm not firmiliar with the laws in your district as I'm an American citizen, but as long as you've nothing on you and your house is clean, I wouldn't worry about prosecution. If you've drugs in the house, flush them before even THINKING about calling an ambulance.

In the spirit of harm reduction I've a duty to encourage you to have someone drive you to a hospital, but this doesn't mean necessarily that I believe that's the only way. I believe it will be uncomfortable and costly and there's in quite a few cases 99 percent chance that it was unnecessary and if you'd a mind for nursing you could have taken care of yourself at home. But you don't, and there's not, and if you value your life:

HOSPITAL.

HOSPITAL. HOSPITAL. HOSPITAL.

What is an overdose to you....?

500mgs at once? In that case I would just say sit back, relax and enjoy the ride!!!!!!

1000mgs? Get yourself some sitters who could watch over you in case things go bad and do the above

2000+, even spread out, is fucking retarded, and at that point Im pretty sure youd be seizing up and have pretty severe brain damage, a hospital would be almost required.

IF you suspect an OD and your wasted / paranoid and don't want to give your mobile / location etc - locate your nearest Phone box, give the location of the person (if you need to take them out side /leave them in the street then so be it) - you phone the emergency services and say, I have found a person Unconscious in xyz street and hang up. If you can / are willing then say this person has taken x y z drug (the person answering your call does not care and can not find you).

If that all seems too much then, write a note and leave it on the OD'ing person - what they have taken etc - leave them in the street and leave (if you can phone for 911 then +)

Folley said:

What is an overdose to you....?

500mgs at once? In that case I would just say sit back, relax and enjoy the ride!!!!!!

1000mgs? Get yourself some sitters who could watch over you in case things go bad and do the above

2000+, even spread out, is fucking retarded, and at that point Im pretty sure youd be seizing up and have pretty severe brain damage, a hospital would be almost required.

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Some people are very senstive to MDMA. Overdose is highly subjective and varies drastically from individual.

Signs to look for would be seizures/convulsions/hyperthermia(overheating)/foamy mouth/unresponsiveness etc.Those are bad signs at any dosage.

Folley said:

What is an overdose to you....?

500mgs at once? In that case I would just say sit back, relax and enjoy the ride!!!!!!

1000mgs? Get yourself some sitters who could watch over you in case things go bad and do the above

2000+, even spread out, is fucking retarded, and at that point Im pretty sure youd be seizing up and have pretty severe brain damage, a hospital would be almost required.

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500mgs really? As in the largest does I've taken waas about 180mg and I don't remember anything from that night. At 250mg this guy is incoherent and just wanders about shouting and hugging people, you can't hold a conversation with him because he'll say 5 words of which one will sound like its a real word but your not sure which of the many it could have been, if you try to question him further he'll get bored and wander off. At 500mg he said he was high for more than 10 hours. Sit back and enjoy, really?

Personally I try to always remember to write what I've taken and what dosage in my hand, in case something like that does happen for the friendly people that try to save me.

Yes really lol

theres not much else you can do... at that point you can pretty much assume some brain damage will occur, but unless you start seizing up, going to the hospital wont be of any more help than an educated friend

500mgs is THAT much, I mean obviously your going to have a fucking INTENSE roll that probably wont be all that pleasant, but its no where near enough to kill you (although seizures and dehydration still could)


IDK how you could really OVER dose on MDMA, I mean its not like you can really accidently just eat up a gram of MDMA

Here's a trip report on a 500mg dose if anyone is interested http://www.bluelight.ru/vb/threads/604334-(MDMA-500mg)-6th-roll-Crazy
Most of it is a blur but I seen some trippy shit.

I had a mate who did one bomb of MDMA (no idea on the dose because all my mates just buy a gram and split into 4-5 "equal" bombs, a gram usually weighs up at 0.7 so 1/4 of that is around 175mg I suppose. I'm guessing this bomb must have been like 200+ though) after he'd drunk a bit of alcohol, not much but he was drunk. It was at a rave and about an hour after he did the bomb he was sitting on a sofa, his lower jaw pushed out as far as possible while he was gurning up a fucking storm. His arms were contracted, so he looked like someone doing an impression of a retard where you spaz your arms. And he was just there on the sofa looking like an absolute retard, he was hallucinating at points cus he said shit about the taxi being outside. I sat with him for a bit and made sure he was sipping water and stroked his hair (sounds gay but it helped him), I figured this was my duty as the only sober one. He had no idea what was going on around him and he couldn't speak properly.

Unfortunately he doesn't remember anything so we don't know if he had a good time or not.

So yeah some people are sensitive to MDMA.

Please do not get too caught up on the number of mg's = overdose as it varies massively depending on person / quality / tolerance etc. 500mgs / a gram does not always equate to an overdose!

^ Yeah, those were just examples obviously


I consider an "overdose" to be a dose of a drug so large, that your body can no longer handle it, usually sending you into shock. If your not seizing, foaming at the mouth and unable to walk or form a single word, your still OK in my mind


theres a difference between an overdose, and a dose that is over what you wanted, thats just you not being able to handle your shit...