Harm Reduction at Oxy

Opioids: Safer Use and Overdose Prevention

Opioids are a class of drugs that include prescription painkillers (like oxycodone, hydrocodone, and morphine), as well as illicit substances like heroin and fentanyl. They work by binding to receptors in the brain and body to relieve pain and create feelings of relaxation or euphoria. While they can be helpful when prescribed and used correctly, opioids carry a high risk of overdose, addiction, and death—especially when mixed with other substances or used in unpredictable doses.

If you choose to use opioids, here are some ways to reduce your risk:

• Never use alone. Have someone with you or use a service like the Never Use Alone hotline (1-800-484-3731).
• Start small. Even a small amount can be potent, especially if the drug is laced with fentanyl.
• Use fentanyl test strips to check any pill, powder, or drug before taking it.
• Avoid mixing drugs, especially with alcohol, benzos, or other depressants—they drastically increase overdose risk.
• Keep naloxone (Narcan) on hand. It can reverse an opioid overdose and save a life.

What You Need to Know About Fentanyl

Fentanyl is a powerful synthetic opioid used medically for pain relief—but it's also driving a deadly wave of overdoses due to its illegal use.

• Extremely potent: Fentanyl is about 100x stronger than morphine and 50x stronger than heroin.
• Illicitly manufactured: It's often mixed into other drugs—like party drugs or pills sold as study aids—without users knowing.
• Lethal in small doses: Just 2 mg (about the size of a sesame seed) can be fatal.
• One-time use can be deadly: Overdose can happen the first time someone tries a drug unknowingly laced with fentanyl.
• It’s very prevalent: In a recent DEA study, 60% of fake pills seized and tested contained a potentially lethal dose of fentanyl.

Test Before You Use: Fentanyl Test Strips

Using fentanyl test strips can reduce your risk of accidental overdose.

How to use a fentanyl test strip:

• Add at least 15 ml of water to a clean container (a bottle cap, small cup, or the test strip package works).
• Dissolve a small amount of the drug in the water (such as residue from the bag or a crushed portion of a pill). Test one substance and/or pill at a time.
• Hold the blue end of the strip and dip the other end in the water for 10 seconds.
• Remove and wait 60 seconds.
• Results: 1 line = fentanyl is present. 2 lines = no fentanyl detected.

Recognizing an Opioid Overdose

Signs to watch for:

• Pinpoint pupils (very small, unresponsive to light)
• Slow or stopped breathing (normal is 12–20 breaths per minute)
• Unconsciousness (won’t respond to shouting or pain)

If you see these signs:

Call 911 and Campus Safety: (323) 259-2599

Campus Safety responders typically arrive within 3 minutes.

How to Respond: Administering Naloxone

1. Call for help: Dial 911 and/or Campus Safety, or designate someone nearby to call.
2. Check responsiveness: Yell the person’s name or apply a firm painful stimulus (like a sternum rub).
3. Check breathing and pulse: Look for chest movement. Check for a pulse at the neck.
4. Give naloxone (Narcan):
   • Lay person on their back.
   • Insert spray into one nostril and press firmly until it clicks.
   • If no response in 2–3 minutes, give another dose if available.
5. Recovery position: Turn them on their left side in case they vomit.
6. Rescue breathing: If unconscious, give rescue breaths (watch this short video to learn how).
7. Stay with them: They may feel fine after waking, but must go to the hospital. Naloxone wears off in 60–90 minutes, and overdose can return.

After an Overdose: Support Matters

Witnessing or responding to an overdose is intense. Take care of yourself and seek support.

Mental Health Resources

• Emmons Counseling:
  • Walk-in hours: Weekdays 1–3 pm
  • Schedule on your student health portal or call (323) 259-2657
• 24/7 Mental Health Crisis Line: (323) 341-4141
• TimelyCare App: Free, 24/7 mental health support for Oxy students (download at timelycare.com/oxy)

Other Confidential Resources:

• Project SAFE Advocates
• Susan Young, Office of Religious & Spiritual Life

Substance Use Support

If you're concerned about your substance use or want to explore your options, Emmons Counseling can help connect you to supportive resources. Schedule an appointment on your student health portal, call (323) 259-2657, or walk in on weekdays between 1 pm and 3 pm.

If you’re concerned about a friend in the moment, aren’t sure how to handle a substance-use related emergency, or need help after hours, call the 24/7 Crisis Line: (323) 341-4141. Emmons will follow up with the caller the next business day.

Help Improve Safety On Campus

If you’ve used naloxone to reverse an overdose, please consider anonymously reporting it via this form. This helps the college meet state reporting requirements and improve prevention efforts. No identifying information is collected.

Alcohol: Safer Use and Harm Reduction Tips

Drinking doesn’t have to be part of your college experience if you don’t want it to. Many Oxy students don’t drink, or, if they do, they drink infrequently. In a Spring 2025 survey, 41% of students reported not drinking at all in the last 2 weeks, and among those who did drink, 33% reported that they did not binge drink. (Source: Healthy Minds Study.) If you choose to drink, there are actions you can take to keep yourself and your friends safe.

Understanding a Standard Drink

Knowing what counts as one standard drink helps you track how much alcohol you’re really consuming. In the U.S., a standard drink contains about 14 grams of pure alcohol, which equals:

• 12 oz. of beer (5% alcohol)
• 5 oz. of wine (12% alcohol)
• 1.5 oz. of liquor (40% alcohol, such as vodka, rum, or whiskey)

Keep in mind that cocktails and mixed drinks often contain more than one standard drink.

General Tips for Safer Drinking

• Set Limits: Know your limit and stick to it—no more than one standard drink per hour is a good pace.
• Avoid Drinking Games: Games encourage rapid consumption and make it easier to lose track of how much you’re drinking.
• Eat First: A full stomach slows alcohol absorption.
• Hydrate: Alternate alcoholic drinks with water or non-alcoholic beverages.
• Track Your Intake: Use an app or mental notes to stay aware of how much you’ve had.
• Watch Out for Each Other: Go out with friends, stay together, and speak up if something seems off.
• Plan Ahead: Arrange a safe ride, use a rideshare app, or plan to stay nearby. Campus Safety will pick students up within ~1 mile of campus.

Tracking Intoxication: What to Look For and What to Do

Blood Alcohol Concentration (BAC) rises with each drink, and changes in behavior and decision-making happen along the way. Here’s what different stages of intoxication in a friend may look like and how you can respond:

Stage 1 – Non-Use (0.00 BAC)

What You See: No drinking-related problems. People may choose not to drink for personal, religious, or social reasons.
What You Do: Support their choice. Make sure non-alcoholic beverages are available when planning gatherings or parties.

Stage 2 – Feeling Buzzed (~0.02–0.04 BAC)

What You See: People feel relaxed, talk more easily, may act more social or uninhibited.
What You Do: Encourage spacing drinks, eating between drinks, switching to water or soda, and giving calm feedback if behavior starts to shift.

Stage 3 – Questionable Decisions (~0.05–0.07 BAC)

What You See: Risky behavior like flirting more aggressively, thinking it’s okay to drive or walk home alone, losing belongings, mood swings.
What You Do: Take keys away, offer a safe way home, don’t encourage risky jokes or behavior, and speak up with calm, assertive support.

Stage 4 – Talking Loud / Getting Injured (~0.07–0.10 BAC)

What You See: People get louder, react slower, misjudge distances, feel less pain, or stumble.
What You Do: Prioritize safety—yours and theirs. Encourage them to slow down or stop drinking. Get help if anyone is hurt or showing signs of serious impairment.

Stage 5 – Staggering / Slurring (~0.11–0.15 BAC)

What You See: Slurred speech, poor balance, spills, frequent bathroom trips, possible aggression, or loss of bladder control.
What You Do: Remove access to alcohol, do not leave them alone, and get help from sober friends or professionals if needed.

Stage 6 – Life-Threatening / Passing Out (~0.20–0.40 BAC)

What You See: Loss of consciousness, slow or irregular breathing (fewer than 12 breaths per minute), inability to wake up.
What You Do: Call 911 immediately. Monitor breathing and consciousness continuously. Do not leave them alone.

Substance Use Support

If you're concerned about your substance use or want to explore your options, Emmons Counseling can help connect you to supportive resources. Schedule an appointment on your student health portal, call (323) 259-2657, or walk in on weekdays between 1 pm and 3 pm. You can also try our confidential self-assessment, which will help you explore your relationship with alcohol and options if you want to reduce or stop drinking, by clicking here.

If you’re concerned about a friend in the moment, aren’t sure how to handle a substance-use related emergency, or need help after hours, call the 24/7 Crisis Line: (323) 341-4141. Emmons will follow up with the caller the next business day.

Cannabis: Safer Use and Harm Reduction Tips

Cannabis is legal in many states for adults 21 and over, including California. It’s important to understand how to reduce risks to your health, safety, and academic success if you choose to smoke or ingest cannabis.

Things to Know Before You Use

• Start Low, Go Slow: Especially with edibles—effects can take 1–2 hours to kick in. Start with 2.5–5 mg THC and wait before taking more.
• Potency Matters: Cannabis today is much stronger than in past decades. THC levels in products can exceed 40%, which increases the risk for negative effects and cannabis use disorder.
• Know Your Body: Effects vary based on dose, potency, ingestion method, underlying health, and personal factors like sex, age, and experience with cannabis.

Possible Short-Term Effects

• Relaxation, increased sociability, or a euphoric “high”
• But also: anxiety, paranoia, panic, distorted time perception, memory issues, increased heart rate
• These effects are more likely with high doses, high-THC products, or when someone is inexperienced.

Long-Term and Physical Risks

• Lung health: Smoking cannabis can lead to chronic bronchitis and other respiratory issues, similar to tobacco use.
• Heart health: Cannabis can raise heart rate and blood pressure; heavy use may be linked to higher risk of stroke or heart attack.
• Gastrointestinal issues: Long-term heavy use can lead to cannabinoid hyperemesis syndrome (CHS)—persistent nausea and vomiting.
• Cognitive effects: Frequent use may impair attention, memory, and learning—especially in teens and young adults.

Mental Health Considerations

• Cannabis use has been linked to increased risk of anxiety, depression, and psychosis, particularly at high doses or in people with a family history of mental health disorders.
• Some research suggests cannabis may worsen symptoms in people already living with mental illness.

Addiction and Withdrawal

• Cannabis Use Disorder affects an estimated 22–30% of users. Risk is highest with daily or near-daily use.
• Withdrawal symptoms may include irritability, sleep issues, anxiety, low appetite, and mood swings. They can occur even without a formal disorder diagnosis.

Safer Use Strategies

• Use in a safe, familiar environment with people you trust.
• Obtain cannabis from a dispensary so you can control the potency of what you’re consuming.
• Avoid driving for at least 6–8 hours after use—or longer for edibles.
• Don’t mix with alcohol or other substances.
• Take breaks from use to reassess how it affects your body and mind.
• Seek help if cannabis use is interfering with your academics, relationships, health, or mental health, or if you begin to feel like you “need” it to function.

Substance Use Support

If you're concerned about your substance use or want to explore your options, Emmons Counseling can help connect you to supportive resources. Schedule an appointment on your student health portal, call (323) 259-2657, or walk in on weekdays between 1 pm and 3 pm. You can also try our confidential self-assessment, which will help you explore your relationship with cannabis and options if you want to reduce or stop consuming it, by clicking here.

If you’re concerned about a friend in the moment, aren’t sure how to handle a substance-use related emergency, or need help after hours, call the 24/7 Crisis Line: (323) 341-4141. Emmons will follow up with the caller the next business day.

Source: NIDA. 2024, September 24. Cannabis (Marijuana). Retrieved from https://nida.nih.gov/research-topics/cannabis-marijuana on 2025, July 9.

For more information about cannabis and cannabis safety, click here.

Psychedelics, MDMA, and Ketamine: Safer Use and Harm Reduction Tips

Psychedelics and other mind-altering substances like MDMA and ketamine are used by many people for exploration, connection, healing, creativity, or simply fun. While these substances carry risks, they can also be meaningful and impactful experiences when approached thoughtfully.

Prepare Before You Trip

The outcome of a psychedelic or altered-state experience depends heavily on set (your mindset, mental health, and expectations) and setting (your physical and social environment). Being intentional about both can make the difference between a safe, meaningful experience and a frightening one.

Before taking any substance, think about:

• Who you're with—are they supportive and trustworthy?
• Where you are—is it a calm, comfortable place?
• What you're bringing into the experience—are you feeling emotionally steady?

Even with the best preparation, bad trips or intense experiences can still happen. Plan ahead by having a sober sitter if possible, or letting someone know what you're taking, where you’ll be, and how to check in on you. Have blankets, water, calming music, and a plan for grounding yourself if things get overwhelming.

If you're taking prescription medications, it's also important to know how they may interact with psychedelics, stimulants, or dissociatives. Many students are prescribed antidepressants (like SSRIs) or stimulants (like Adderall), which can affect how a substance works—or make it riskier.

Resources for checking interactions:

• Psychedelic Interaction Checker – A $5–$10 service that checks psilocybin safety with your specific medications
• TripSit Combo Chart – A free chart showing how drugs interact with each other, including common prescriptions like SSRIs and Adderall (an amphetamine)
• As always, talk to your doctor about what substances to avoid if you’re taking prescription medications or have a medical condition. 

If you need peer support during a during or after a psychedelic experience, use the Fireside Project hotline: 623-473-7433. 

Psilocybin Mushrooms (Magic Mushrooms)

“Magic mushrooms” are fungi containing psilocybin, a compound that converts in the body to psilocin, producing altered states of consciousness. The most common species is Psilocybe cubensis. They’re usually consumed dried, brewed into tea, or mixed with citrus in a “lemon tek.”

Effects

• Duration: about 4 to 6 hours
• May include visuals, time distortion, emotional openness, and spiritual or introspective experiences
• Some people report contact with “entities” or a deep connection to nature
• Experiences can be beautiful, unpredictable, or intense

Harm Reduction Tips

• Start with a small amount, especially if it’s your first time or you’re unsure about the potency
• Avoid redosing early—effects can take over an hour to fully develop
• Confirm your source—some mushrooms are toxic and look similar to psilocybin species
• Choose a calm, familiar environment with trusted people
• Consider having a sober sitter
• Be mindful of your mental health—those with a history of psychosis or mood disorders may be more vulnerable

LSD (Acid)

LSD is a potent psychedelic first synthesized in 1938. It produces long-lasting shifts in perception, mood, and cognition, often accompanied by visual distortions and profound emotional experiences. Most LSD is taken via blotter paper placed on or under the tongue.

Effects

• Duration: about 8 to 12 hours
• May include visuals, time distortion, deep introspection, and a sense of altered reality
• Experiences often unfold in “chapters,” with changes in emotional tone or mental clarity
• Social or solitary—experiences vary based on personality and environment

Harm Reduction Tips

• Start low and go slow, especially with new sources
• LSD has no strong taste—a bitter or metallic taste may indicate a different, potentially riskier substance
• Know where it’s from, and don’t trust assumptions about strength
• Avoid redosing too early
• Prepare your set and setting carefully
• LSD is not recommended for those with personal or family histories of psychotic disorders

MDMA (Molly / Ecstasy)

MDMA is known for its emotional warmth, openness, and sensory enhancement. It’s used both recreationally and in therapeutic settings, and is currently being studied as a treatment for PTSD. MDMA is typically swallowed as a tablet, capsule, or powder.

Effects

• Duration: about 3 to 5 hours
• Includes euphoria, increased empathy, tactile sensitivity, and sociability
• Can also cause jaw clenching, dehydration, and temporary emotional depletion afterward

Harm Reduction Tips

• Start low and go slow—MDMA’s effects vary widely between people and batches
• Don’t redose more than once, and avoid stacking doses early on
• Stay hydrated, but don’t overdo it—aim for about 1 to 3 cups of water per hour
• Pair with salty snacks or electrolyte drinks to maintain proper balance
• Take long breaks between use to prevent serotonin depletion and emotional burnout
• Confirm your source—MDMA is often adulterated or misrepresented
• Test your drugs! (see Opioid section)

Ketamine

Ketamine is a dissociative anesthetic used in medicine and mental health treatment. In non-medical settings, it's often snorted in powder form. It creates a floaty or detached sensation and, at higher doses, can cause full dissociation or out-of-body experiences. Ketamine is being studied and used in clinical settings for treatment-resistant depression and suicidal ideation.

Effects

• Duration: about 45 to 60 minutes, with return to baseline in 1.5 to 2 hours
• Low doses feel dreamy or mildly euphoric
• Higher doses may produce a “k-hole”—a state of deep dissociation, often described as spiritual or surreal

Harm Reduction Tips

• Start low and go slow—accidentally entering a k-hole can be intense or frightening
• Avoid using high doses alone—ketamine reduces motor control and increases risk of injury or choking
• Stay seated or lying down if using moderate to high amounts
• Avoid mixing with alcohol, benzos, or other depressants
• Long-term frequent use can lead to ketamine cystitis, a painful and sometimes irreversible bladder condition
• Be skeptical of claims about “special isomers”—most ketamine on the street is racemic and unverified

General Harm Reduction Tips for All Substances

• Start low and go slow
• Test and verify your substances when possible
• Set and setting matter—prepare your mindset and physical space
• Don’t mix substances unless you’re confident in the risks
• Plan for recovery—allow time to rest and reflect afterward
• Trip with trusted people, and consider a sober sitter
• Talk about the experience afterward—journaling or integration can be helpful

If You or a Friend Is in Crisis

• Don’t hesitate to ask for help. Let someone know where you are and what you’ve taken
• Call the 24/7 Crisis Line: (323) 341-4141. They will first assess for safety and can activate emergency services if needed. Emmons will follow up with the caller the next business day to see if additional services are wanted or needed.
• For peer support during or after a psychedelic experience, use the Fireside Project hotline: 623-473-7433
• If someone is unresponsive, vomiting heavily, overheating, or having a seizure, call emergency services immediately

Learn More

• PsychedelicInteraction.com – medication and psilocybin interaction checker
• TripSit Combo Chart – check interactions between substances and common prescriptions. As always, talk to your doctor about what substances to avoid if you’re taking prescription medications or have a medical condition. 
• DanceSafe – trusted harm reduction nonprofit and the source for the drug information in this guide

Substance Use Support

If you're concerned about your substance use or want to explore your options, Emmons Counseling can help connect you to supportive resources. Schedule an appointment on your student health portal, call (323) 259-2657, or walk in on weekdays between 1 pm and 3 pm.

Nicotine: Harm Reduction Tips

Nicotine is a fast-acting stimulant and the main psychoactive ingredient in tobacco. It enhances focus, suppresses appetite, and can cause feelings of mild euphoria or relaxation. While nicotine itself isn’t carcinogenic, smoking tobacco significantly increases the risk of cancer, heart disease, and lung damage.

Common forms of nicotine use include:

• Smoked tobacco (cigarettes, cigars, hookah)
• Smokeless tobacco (chew, snuff, Zyn pouches)
• Vapes (devices that heat and inhale nicotine liquid)
• Nicotine replacement (gum, lozenges, patches)

Nicotine is highly addictive. First-time users often feel dizzy or nauseous, and frequent use may lead to dependence, anxiety when not using, and withdrawal symptoms like irritability or cravings.

Harm Reduction Tips:

• Use low-dose products and avoid daily use to reduce dependence.
• Avoid indoor smoking or vaping to protect others (and pets) from secondhand exposure.
• Store nicotine products securely—especially vape liquids, which can be toxic if ingested.
• Track your use. Vaping often leads to higher nicotine intake than smoking.

Environmental Impact

Nicotine use doesn’t just affect your health—it also harms the environment:

• Cigarette butts are the most littered item worldwide and leach toxic chemicals into soil and waterways.
• Zyn and other nicotine pouches are non-biodegradable and often discarded improperly.
  Vape pens and pods contain batteries, metals, and plastics that contribute to electronic waste.

Substance Use Support

If you're concerned about your substance use or want to explore your options, Emmons Counseling can help connect you to supportive resources. Schedule an appointment on your student health portal, call (323) 259-2657, or walk in on weekdays between 1 pm and 3 pm. You can try our confidential self-assessment if you’re interested in exploring your relationship with nicotine or learning how to quit.

Stimulants: Safer Use & Harm Reduction Tips

Stimulants—including methamphetamine (meth), cocaine, and nicotine—can increase energy, focus, sociability, and euphoria. They also pose health risks, especially with higher doses, lack of sleep or food, or unsafe routes like smoking or injecting. While illicit use of meth and cocaine carries high risk, it’s important to know that certain prescription medications for ADHD, such as Desoxyn, contain methamphetamine, and others (like Adderall or Vyvanse) contain amphetamine. These substances can interact with other drugs and stimulants in dangerous ways.

Whether you’re using prescribed stimulants, recreational ones, or both, here’s how to reduce harm:

Harm Reduction Tips for Stimulants

• Start with a low dose, especially if it’s your first time, you're unsure of the purity, or you’re using a new route (snorting, smoking, injecting).
• Test your drugs. See the Opioids section for how to test for fentanyl.
• Check for interactions. If you're using stimulants alongside medications (especially ADHD meds or antidepressants), consult the TripSit Combo Chart to check for unsafe combinations. As always, talk to your doctor about what substances to avoid if you’re taking prescription medications or have a medical condition. 
• Avoid mixing stimulants with other drugs, particularly other uppers like caffeine, pre-workouts, or other ADHD meds, which increase the risk of heart strain, overheating, and panic.
• Stay hydrated, but don’t overhydrate. Sip ~500ml of water per hour, especially if you’re active or dancing.
• Eat and rest before and after use. Stimulants can suppress appetite and interfere with sleep, leading to exhaustion, mood issues, and poor decision-making.
• Take breaks. Avoid daily use and space out sessions to reduce the risk of tolerance, dependency, and long-term health impacts.
• Plan for the comedown. Have food, hydration, and time to decompress in a calming space. Crashes can feel depressing and lead to compulsive redosing.
• Use in a familiar, safe setting with people you trust. Avoid driving or engaging in risky activities while under the influence.
• If someone is overheating, paranoid, or unresponsive, get medical help immediately. You won’t get in trouble—your safety or theirs is the top priority.

Cocaine (including Crack)

• Cocaine is short-acting. Expect cravings to redose every 15–30 minutes if snorted—or even sooner if smoked. Plan accordingly to avoid binge cycles.
• Use saline spray before and after snorting to protect nasal passages. Switch nostrils and use your own straw or rolled paper to prevent disease transmission.
• Crack hits harder and faster than snorted cocaine, making compulsive redosing more likely. Smoke in moderation and take breaks.
• Avoid combining with alcohol or stimulants. Cocaine and alcohol create cocaethylene, a toxic compound that stresses the heart and liver.
• Watch your heart. Even small doses can raise blood pressure and heart rate. Anyone with a heart condition should avoid use entirely.
• Take breaks between sessions to let your body recover and reduce tolerance.

Methamphetamine (Meth)

• Route matters: Oral use is the least risky. Smoking or injecting dramatically increases the rush—and the risk of addiction and overamping.
• Avoid multi-day binges. Meth lasts a long time and can keep you awake for days, increasing the risk of psychosis, paranoia, and delusional thinking.
• “Meth mouth” is mostly due to dry mouth, jaw clenching, and poor hygiene. Stay hydrated, avoid sugary drinks, and brush/floss after use.
• High doses and frequent redosing increase risks of twitching, stuttering, and long-term nerve damage.
• Use in moderation if you’re feeling anxious, depressed, or burned out—meth can be more psychologically addictive in these states.
• Know the signs of overamping: chest pain, overheating, seizures, intense anxiety, or paranoia. Seek emergency help if needed.

Adapted from DanceSafe.org

Substance Use Support

If you're concerned about your substance use or want to explore your options, Emmons Counseling can help connect you to supportive resources. Schedule an appointment on your student health portal, call (323) 259-2657, or walk in on weekdays between 1 pm and 3 pm.