Medical Disclaimer
This page provides first-aid guidance for drug-related emergencies. It is not a substitute for professional medical advice, diagnosis, or treatment. Always call emergency services in a life-threatening situation. The information here is compiled from public health sources and harm reduction organizations. It has not been reviewed by a licensed physician. Use at your own risk.
Stimulant Overdose: Cocaine, Meth, and Amphetamine
Overheating, cardiac distress, seizures — recognition and cooling
Recognition
- •Extreme body temperature (hot to the touch, not sweating appropriately)
- •Chest pain or tightness, rapid or irregular heartbeat
- •Seizures or convulsions
- •Confusion, aggression, or psychosis (not the expected drug effect)
- •Difficulty breathing or gasping for air
- •Unresponsive after a period of agitation
What to Do
Call emergency services immediately
Stimulant overdose can cause cardiac arrest within minutes. Do not wait. Tell the dispatcher the person is overheating, having chest pain, or seizing — paramedics need to know the symptoms, not necessarily the substance.
Cool the person down
Move them out of direct sunlight or heat. Remove excess clothing. Apply cool (not ice-cold) water to the neck, armpits, and groin — these are the body's heat exchange points. Fan them. If conscious, give small sips of cool water. Ice packs wrapped in cloth on the neck and armpits help.
If seizing, protect from injury
Clear the area of sharp or hard objects. Do not restrain them or put anything in their mouth. Cushion the head with something soft. Time the seizure — if it lasts more than 5 minutes or they have multiple seizures without regaining consciousness, tell the paramedics immediately.
Monitor breathing and pulse
If breathing stops, begin CPR. Stimulant overdose can cause sudden cardiac arrest. Check for a pulse at the neck. If no pulse, start chest compressions at 100-120 per minute.
Stay calm and keep them calm if conscious
Panic increases heart rate and body temperature. Speak in a low, steady voice. Reassure them that help is coming. Do not leave them alone.
When to Call Emergency Services
- →Chest pain of any kind — do not assume it is anxiety, assume it is cardiac
- →Seizure lasting more than 2 minutes, or multiple seizures
- →Body temperature feels dangerously hot to the touch and the person is confused
- →Person collapses or loses consciousness
- →Heart rate over 150 bpm sustained for more than a few minutes
What NOT to Do
Myth: Give them a sedative or alcohol to 'come down'
Truth: Never mix drugs during a medical emergency. Adding a sedative to a stimulant overdose increases cardiac stress and can cause respiratory failure. This is how people die.
Myth: Force them to drink a lot of water
Truth: Small sips if conscious and overheating. Large amounts of water during a stimulant overdose can cause hyponatremia (water intoxication), which is itself life-threatening.
Myth: Put ice directly on their skin
Truth: Ice causes vasoconstriction, which traps heat in the body's core. Use cool water and indirect cold applications instead.
Prevention
- ✓Test for fentanyl. Stimulant supplies are increasingly contaminated with fentanyl. A fentanyl test strip on every batch is non-negotiable.
- ✓Dose low and wait. Stimulant overdose is often cumulative — multiple small doses stack into a crisis.
- ✓Stay cool and hydrated. MDMA and stimulants impair the body's temperature regulation. Take breaks from dancing. Drink 500ml of water per hour — not more.
- ✓Avoid mixing with other stimulants, alcohol, or MAOIs. Combined stimulant load on the heart is multiplicative, not additive.
Testing & Resources
IMPORTANT: This guide is for informational purposes only and does not constitute medical advice. Drug use carries inherent risks. No substance use is completely safe. Always call emergency services (911 in the US/Canada, 999 in the UK, 000 in Australia, 112 in the EU) in a life-threatening situation. TestSubstances.com is not responsible for any actions taken based on this information. If you or someone you know is struggling with substance use, contact SAMHSA (1-800-662-4357) or your local health authority.