If something is going wrong right now

Call 911 first if any of these are true

Do not read the rest of this page. Do not call anyone else first. Call now if someone is:

• Not breathing, or breathing slowly, irregularly or noisily
• Unconscious, or cannot be woken
• Having a seizure
• Blue or grey around the lips or fingertips
• Confused and does not know where they are
• Very hot to the touch, or rigid
• Having chest pain, or has collapsed
• Someone who has taken something in order to harm themselves

911 Emergency services. Stay on the line — the dispatcher will tell you what to do while help is coming.

What to do while you wait

• If they are unconscious but breathing, roll them onto their side, head tilted back and chin lifted. If they vomit while on their back they can choke on it. This is the single most useful thing an untrained person can do.
• If they are not breathing normally, start chest compressions and let the dispatcher talk you through it. Get an AED if there is one.
• If you think it involves an opioid, give naloxone if you have it — follow the instructions on the device. Then still call 911. It can wear off before the drug does, so they can go back under; they need to be watched even if they wake up and feel fine.
• If they are having a seizure, move hard objects away, put something soft under their head, and let it happen. Do not hold them down and do not put anything in their mouth.
• Do not make them vomit.
• Do not give food, drink, alcohol, coffee or any medication to someone who is drowsy, confused or unconscious.
• Do not leave them alone, and do not let them drive or "walk it off". Do not let them sleep it off unwatched.

If you are not sure how bad it is

1-800-222-1222 Poison Control. Free, 24 hours. Answered by specialists in poison information — nurses and pharmacists — with medical toxicologists on call behind them. They advise the public and clinicians alike. They are a clinical service, not law enforcement, and they are not going to report you for taking something. Calling them early, before things get worse, is exactly what they are for.

If you are thinking about ending your life

988 Suicide & Crisis Lifeline. Call or text, free, 24 hours.

If you have already taken something to harm yourself, call 911 instead, now. 988 is for talking to someone. It is not treatment for something already in you, and the two are not interchangeable. You can call 988 afterwards.

Outside the United States

Call your local emergency number. Many countries also have a poison centre, though hours, staffing and whether they take calls from the public vary — the emergency number is the reliable route everywhere.

If you are going to an emergency department, this is what to tell them

Most staff will not have heard of what you took. That is not a failure on their part — these compounds are new, obscure, and there are hundreds of them. You can give them what they need in about thirty seconds. Read this out, or hand them your phone.

They will also want to know, so have it ready: anything you are prescribed, any conditions you have, any allergies, whether you could be pregnant, and where the product came from.

Say the real amounts. People routinely understate them, and it is understandable — but it hands the team a wrong picture, and they cannot treat you from a wrong picture. They are there to work out what is in you and fix it, not to investigate you.

Bring the container if you safely can. The order confirmation or product page on your phone works too. Do not delay leaving to hunt for it, do not handle loose powder, and seal it if it is open. The label and the vendor tell them more than the name alone.

If it was phenibut, say this as well

These three facts change what a clinician considers and what they treat you with:

A negative drug screen does not rule phenibut out — it is not on the panel. Clinicians have been misled by reading a clean screen as an all-clear. See also stopping phenibut.

If it was something sold as a supplement, say this

Several things sold in shops and online as supplements are pharmacologically something else. Tianeptine — sold as Zaza, Tianaa, Neptune's Fix and other names — is a full opioid agonist, and naloxone can reverse it. Say that out loud. It will not appear on a routine drug screen either.

If they do not recognise the name

Ask them to call the regional poison centre. Toxicologists take calls from clinicians around the clock, and it is a completely normal request — it is what the service is for. Staff make these calls routinely and will not take it as a slight.

You can say: “Would you be able to call poison control about this one? It's pretty obscure.”

If you are the family member and they cannot speak

Then you say all of the above. Bring whatever you found — the packet, the vial, the powder, the phone with the order on it. Do not worry about getting anyone into trouble; that is not what is happening in the room.

If you are trying to work out what you have found rather than dealing with an emergency, start here instead.

One thing not to do

If someone is physically dependent on something, do not confiscate their supply and leave them to it. With alcohol, benzodiazepines and phenibut, sudden withdrawal is itself a medical emergency and can cause seizures.

That is not a reason to help someone take more, and it is not a reason to wait. It is a reason to get clinical advice — from Poison Control, an urgent care, or an emergency department — rather than improvising the withdrawal yourself.

This page deliberately contains no doses, no amounts and no taper information. It exists to get you to people who can treat this, and to make sure they understand you when you arrive.