Managing a synthetic cannabinoid overdose (Dealing with “the fear”)
“The fear” is a term commonly used to refer to the anxiogenic (anxiety producing) effects of a synthetic cannabinoid overdose. Just as when one drinks too much alcohol and gets “the spins”, overconsumption of synthetic cannabinoids results in a very unpleasant and often downright terrifying experience in which the user often thinks that they are dying, or have suffered some permanent damage. If you ever experience a synthetic cannabinoid overdose it is important to remember that this fear is not based in reality, and is in fact you are merely experiencing a very severe panic attack. As long as you do not have any underlying cardiovascular condition it is extremely unlikely that you will experience any permanent damage from the overdose and you it is transient (it will pass). Just like a bad trip caused by psychedelic substances, you will eventually come down. Most synthetic cannabinoids currently on the market are very short acting which means that the effects will not last long.
Sometimes a person experiencing a synthetic cannabinoid overdose will have delirium like hallucinations, and loose contact with reality. It is important to remember that what you are experiencing is merely a sensation and is not real. Back when I was smoking synthetic cannabinoids I had hundreds of these mild overdoses, the sensations experienced can be very frightening and can surpass anything one can experience from traditional psychedelic and dissociative drugs. I have had times where I was sure I was trapped in hell and reliving every terrible thing I have ever done in graphic detail only to get the end of it and the loop to restart. The dissociation experienced from some of these chemicals can be extremely severe, surpassing the dissociation of drugs like ketamine and phencyclidine. 5-fur-144 is an example of one of the extremely dissociative cannabinoids and I suspect it has some action on N-methyl-D-aspartate similar to classical dissociative drugs in addition to cannabimimetic effects.
I recall one specific incident on 5-fur-144 (xlr-11) in which I saw myself separate from my body and was launched into space at lightning speed. This was not like classical psychedelics or dissociative however and the experience was primarily dark and the ego would not fully let go, very anxiety inducing. I did not know who I was, what I was, only that I did not want to be wherever I was. A hallucinatory phenomenon ensued in which I was assaulted with demonic voices screaming in my head, and dark shadow like “entities” reaching into my body (mind you “I” was out of my body, watching helplessly from above but feeling everything) while they were reaching through my chest and pulling my heart out of me like that scene from Indiana Jones and the temple of doom.
If you ever experience these schizophrenic like hallucinations (psychosis) from a synthetic cannabinoid overdose it is important to try your best to keep calm (as difficult as that can be) and remember it is merely a drug induced “trip”, you bought the ticket, you take the ride. Synthetic cannabinoids induce extreme tachycardia and panicking will only raise your heart rate and blood pressure further. The most important thing to do in the event of a synthetic cannabinoid overdose (assuming you still have enough control) is to keep your heart rate down any way possible as to minimize the chance of a cardiovascular accident (heart attack or stroke).
---Tips and tricks to lower heart rate in an emergency----
1. Lie down. Anxiously pacing around will only raise your heart rate higher, making you more anxious which will land you in a negative feedback loop of anxiety reinforcing tachycardia which reinforces anxiety and the irrational fear that you are dying.
2. Try to meditate or focus on pleasant mental imagery to take your mind off the anxiety, your heart rate will come down when you stop thinking about it thereby ending the negative feedback loop which is reinforcing the anxiety and tachycardia.
3. Practice breathing exercised. Take a deep full breath and hold it for a few seconds, then fully expel the breath and repeat. Keep breathing slow, one of the causes of cannabinoid induced anxiety and tachycardia is actually hyperventilating. Breathing into a paper bag can help as well
4. Do the Valsalva maneuver.
Hold your breath and bear down in a strain (like if you’re constipated and straining to have a bowel movement). Do these for five seconds, then breathe. This fools your body into thinking your heart should slow down. If the pulse hasn’t slowed, try again.
5. Do the carotid maneuver.
Find your carotid pulse just below your jaw. The vagus nerve runs next to it. Massage very firmly for five seconds. Warning: In rare cases this could knock off a piece of a blood clot lodged in this area and cause a stroke. Don’t do this in elderly people or anyone with a history of a stroke.
6. Do an Ice-water facial.
If you have cold water (preferably ice water,) dip your face in it a few seconds. This stimulates your vagus nerve to slow your heart by causing what’s known as the dive reflex. It’s the same reflex that helps some people survive for a long time under cold water by slowing the body’s metabolism down.
When experiencing a synthetic cannabinoid overdose try your hardest to think about something else besides how unpleasant the effects are. Just like with a bad trip caused by classical psychedelics you may find that if you can get your mind off the negativity you may find that it is actually pleasant (In very minor ODs at least.) Do not focus on your pulse, it reinforces the anxiety and makes the tachycardia much worse. You would be surprised at how well the body handles tachycardia, and you are extremely unlikely (assuming you are healthy) to have a heart attack from your heart beating too fast. For a mild overdose, while it is hard to realize it at the time, your heart really isn’t beating much faster than if you where to run a mile or engage in any heavy exercise.
Symptoms and sensations you may experience during a synthetic cannabinoid overdose
• Tachycardia (racing heart beat)
• Auditory hallucinations (hearing voices)
• Tactile hallucinations (touch hallucinations)
• Feeling as though you have pissed yourself
• Nausea and vomiting
• Severe anxiety and feeling of immanent doom
• Visual hallucinations (both open and closed eye visuals)
• Severe dissociation of mind and body (feeling as though you are “outside yourself”)
• Fluctuations in blood pressure (either high or low)
• Agitation and aggression
• Sensation that you or objects around you are melting (similar but different to the feeling of psychedelics)
• Audio and visual flanging effect (very similar to nitrous, ketamine, or DXM)
• Phantom pains in various areas of the body (likely a hallucination)
• Severe paranoia (like pot times ten)
• Seizures (rare, extreme overdose)
• Cardiovascular accidents (rare, extreme overdose)
• Loss of motor control
• Unresponsiveness (extreme overdose)
• Looping thoughts or actions
• Ego death/loss (rare, wish it was more common)
• Seizures (rare, extreme overdose)
• Cardiovascular accidents (rare, extreme overdose)
• Loss of motor control
• Unresponsiveness (extreme overdose)
• Looping thoughts or actions
• Ego death/loss (rare, wish it was more common)
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---Some other things you can do to take your mind off of the anxiety---
• Watch TV, preferably a program that is easy to follow and not a lot of shooting or cop car noises (nothing is worse while on any intoxicating substance than hearing the sound of cop cars.)
• As mentioned before in the how to slow your heart rate section, meditation can be a great way to take your mind off of the negativity
• Turn on all the lights in the house, darkness can bring on a negative mindstate in some people (this goes for psychedelics as well.)
• If you are experiencing dissociation or hallucinations try to avoid closing your eyes, as the CEVs produced by cannabinoids are often more intense than the OEVs
• Get something to eat, you will feel better quickly once you get some food in you. As with marijuana, eating something will quickly bring you down
• Sing a song out loud or listen to positive, uplifting music preferably without words, I find psybient to be great (but not the dark stuff).
• Drink plenty of water, you may be dehydrated and not know it
• Take a shower
• Try to introspect and determine the source of the anxiety (only recommended for mild overdoses or for those experienced with psychedelic substances)
• If you are not too far gone and it is still possible (ie: mild OD) try to read, it can really help to take your mind off the negativity
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-----------------------------What is and is not a medical emergency from SC use------------------------------
----------Medical emergency requiring immediate care (call 911 or drive to hospital)---------
-Seizures and convulsions
-Anaphylactic shock (allergic reaction)
-serious hives or perceivable swelling
-Severe flank pain persisting after intoxication has worn off (may indicate AKI)
-Signs of stroke or heart attack persisting after the typical duration of intoxication (SC’s cause panic attacks which have many symptoms consistent with stroke or heart attack so differentiating them during the intoxication is difficult)
-Person an immediate threat to self or others, severe psychotic break
-Person not breathing
*Remember that a panic attack can mimic the symptoms of many serious problems so it can be hard to distinguish between them, you should familiarize yourself with the symptoms of a panic attack which are listed below*
-Panic Attack Symptoms-
• Sense of impending doom or danger
• Fear of loss of control or death
• Rapid heart rate
• Sweating
• Trembling
• Shortness of breath
• Hyperventilation
• Chills
• Hot flashes
• Nausea
• Abdominal cramping
• Chest pain
• Headache
• Dizziness
• Faintness