Harm Reduction
Practical, life-saving information. Drug testing kits, dangerous combinations, overdose recognition and response, and naloxone access.
Harm Reduction Notice: This site does not promote drug use. It provides evidence-based information to reduce harm. If you or someone you know is struggling with substance use, call SAMHSA: 1-800-662-4357 (free, confidential, 24/7). In an emergency, call 911. Naloxone saves lives — carry it.
Drug Testing Kits
| Kit | Color | Detects | Primary Use | Limitations |
|---|---|---|---|---|
| Marquis | Purple/black | MDMA/MDA, amphetamines, opioids (heroin, morphine) | First-line test for MDMA, amphetamines, and opioids | Cannot distinguish between MDMA and MDA. Does not detect fentanyl. |
| Mecke | Dark blue/green | MDMA/MDA, opioids, 2C-B, DXM | Confirmatory test for MDMA (use alongside Marquis) | Limited specificity for novel psychoactive substances |
| Mandelin | Varies widely | Ketamine, PMA/PMMA, amphetamines, opioids | Best test for ketamine identification | Color changes can be subtle and hard to interpret |
| Ehrlich | Purple | LSD, psilocybin, DMT (any indole-containing compound) | Essential test for LSD blotter (rules out NBOMe) | Only confirms presence of an indole; does NOT identify specific compound or dose. NBOMe (dangerous LSD substitute) does NOT react. |
| Simon's | Blue | Distinguishes MDMA from MDA (secondary amines vs primary) | Confirmatory: MDMA (blue) vs MDA (no reaction) | Must be used after positive Marquis test. Not useful alone. |
| Fentanyl Test Strips (FTS) | Line-based (pregnancy test style) | Fentanyl and most fentanyl analogs | Critical harm reduction tool for any street drug | Cannot detect xylazine, nitazenes, or novel synthetic opioids. False negatives possible with uneven distribution in pressed pills ("chocolate chip cookie effect"). Dissolve ENTIRE pill/dose in water and test the solution. |
| Xylazine Test Strips | Line-based | Xylazine (tranq) | Supplementary to fentanyl test strips for opioid supply | Only 49% sensitivity (misses about half of xylazine-positive samples). Newer strips improving but not yet widely available. |
Dangerous Drug Combinations
| Combination | Risk Level | Action |
|---|---|---|
| Opioids + Benzodiazepines | FATAL | Avoid completely. Additive respiratory depression. |
| Opioids + Alcohol | FATAL | Never combine. Even moderate alcohol + opioids can be lethal. |
| MAOI + SSRI/SNRI | FATAL | Serotonin syndrome. 2-week washout between drugs. |
| Alcohol + Benzodiazepines | FATAL | Both enhance GABA-A. Synergistic respiratory depression. |
| GHB + Alcohol or Benzos | FATAL | GHB has narrow therapeutic window. Never combine with CNS depressants. |
| Stimulants + MAOIs | FATAL | Hypertensive crisis. Avoid all stimulants if on MAOIs including ayahuasca. |
| Cocaine + Alcohol | DANGEROUS | Forms cocaethylene. More cardiotoxic than either alone. |
| Psychedelics + Lithium | RISKY | Seizure risk. Do not take psychedelics while on lithium. |
Overdose Response
- Call 911 immediately — Good Samaritan laws protect you in most states
- Administer naloxone if opioid overdose suspected — nasal spray (Narcan) or intramuscular
- Perform rescue breathing — 1 breath every 5 seconds if not breathing
- Place in recovery position — on their side to prevent aspiration
- Stay with them — naloxone wears off in 30-90 min; the opioid may outlast it
- Give second naloxone dose if no response after 2-3 minutes
Where to Get Naloxone
- Pharmacies: Available without prescription in most US states (Narcan nasal spray)
- NEXT Distro: nextdistro.org — free naloxone by mail
- Harm reduction orgs: Local syringe exchanges, community health centers
- Cost: Free-$50 depending on insurance and source
Emergency Numbers
- Emergency: 911
- SAMHSA Helpline: 1-800-662-4357 (free, confidential, 24/7)
- Poison Control: 1-800-222-1222
- Crisis Text Line: Text HOME to 741741
- Suicide & Crisis Lifeline: 988