the temple of harm reduction

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Knowledge That Keeps People Alive

The accumulated practice of a movement that has spent decades
refusing to let the drug war write the eulogies.

Start Here  ·  The Supply  ·  Drug Checking  ·  Naloxone  ·  Safer Use  ·  For Loved Ones  ·  Where to Get Help

If this is urgent

Someone is not breathing

Call 911. Give naloxone if opioids may be involved. Begin rescue breathing or CPR if you are trained.

Using alone

Call Never Use Alone at 1-800-484-3731. Tell someone where you are before you use.

Need naloxone

Get naloxone through a local syringe-service program, pharmacy access, or mail-order programs such as NEXT Distro.

This page is education, not emergency response, medical care, or legal advice.

Section One

Start Here

This page exists because the official channels failed.

The drug war has been losing for fifty years. The body count keeps climbing. More than one hundred thousand Americans now die of drug poisoning every year. That number is not the result of personal weakness. It is the predictable outcome of a policy that drove the supply underground, replaced familiar substances with research chemicals nobody can dose correctly, and then criminalized the people who tried to help.

Harm reduction is the tradition that refused to look away.

Before it had a name, it was nurses keeping naloxone in their cars without telling the hospital. It was people who use drugs teaching each other how to test their supply. It was sex workers handing each other sterile syringes in the back of vans in the 1980s. It was every person who decided that staying alive was worth more than staying legal.

the temple of harm reduction inherits that practice and names it for what it is. Sacred work.

What Harm Reduction Is

Harm reduction is a practical, evidence-based approach to drug use that meets people where they are. It does not require abstinence. It does not require recovery. It does not require that you stop being who you are in order to deserve help.

The core principles are simple. People will use substances. Some of them will be ours. Some of them will be our family. Whether the use is recreational, ceremonial, medicinal, or compulsive, the response is the same. Keep the person alive. Reduce the harm. Let the rest unfold in the time and the way that the person chooses.

What Harm Reduction Is Not

It is not encouragement to use drugs. People who never come into contact with a single harm-reduction worker still use drugs. The question is not whether the use happens. The question is whether the person survives it.

It is not the opposite of recovery. Many people in long-term recovery first walked through a harm-reduction door. Drug checking, naloxone training, syringe access, and drug-poisoning response education are how a lot of people stay alive long enough to choose recovery if and when they want it. The two practices are not enemies. They are the same hand at different moments of the same life.

It is not soft. Harm reduction asks you to look directly at what is happening, to name the substances by their actual chemistry, to learn the protocols that will save the person in front of you. That is the opposite of soft.

Section Two

The Contaminated Supply

Before anything else, understand this. The drug supply in the United States is contaminated. Not occasionally. Continuously.

Fentanyl and other unexpected compounds are present in parts of the unregulated drug supply. You cannot know the contents of a substance by appearance alone. This is not a moral problem. It is a chemistry problem. And the chemistry has a cause.

The Iron Law of Prohibition

The Iron Law of Prohibition is a principle articulated by Richard Cowan in 1986. When a substance is prohibited, the supply moves toward higher potency. The reason is simple economics. Smaller volumes are easier to hide, easier to smuggle, easier to move past the people enforcing the ban. So the supply does not get safer when it is prohibited. It gets more concentrated.

This is how we got from heroin to fentanyl. It is how we got from fentanyl to nitazenes that are several times more potent than fentanyl. It is how a person who used the same dose every day for a decade can suddenly die, because the powder in their hand this week contains something that did not exist last month.

The Iron Law of Prohibition is not a theory. It is a body count.

What Is Actually in the Supply

  • Fentanyl. Roughly 50 to 100 times more potent than morphine. Present in the vast majority of opioid samples and in a growing share of stimulant, benzodiazepine, and counterfeit pill samples. Doses are measured in micrograms. A few grains of salt-sized particles can be fatal.
  • Nitazenes. A class of synthetic opioids more potent than fentanyl. Some analogs require multiple doses of naloxone to reverse a poisoning. Showing up nationally in 2024 and 2025.
  • Xylazine, also called tranq. A veterinary sedative. Not an opioid, so naloxone does not reverse its sedation. Causes serious wounds when injected. Often mixed with fentanyl and may extend the duration of a drug poisoning.
  • Medetomidine. Another veterinary sedative being detected in 2024 and 2025. Even more potent than xylazine in some respects. Naloxone does not reverse it.
  • Counterfeit pills. Counterfeit oxycodone, Xanax, and Adderall pressed with fentanyl. Many people who die were not seeking opioids at all. They thought they were taking a benzodiazepine or a stimulant.

Assume nothing about what is in the substance in front of you. Assume nothing about what your unregulated drug supply source knows. They may be several steps removed from the chemistry and several thousand miles removed from the lab. The only way to know what is in something is to test it.

Section Three

Drug Checking

Drug checking is the practice of testing a substance before it enters a body. It is the single most important survival tool of the contaminated-supply era. It is not perfect. It is dramatically better than nothing.

Fentanyl Test Strips

Fentanyl test strips, sometimes called FTS, are small immunoassay strips originally developed for urine drug screening. Harm-reduction workers figured out that you can dissolve a small sample of a substance in water and dip a strip to see whether fentanyl is present.

Two lines means no fentanyl detected. One line means fentanyl detected. The strip is a yes-or-no answer, not a measurement. It will not tell you how much fentanyl is present. It will not catch every analog. It is the cheapest, fastest, most accessible drug check available, and it has saved many thousands of lives.

How to use one. Dissolve a small amount of the substance in clean water. The dilution matters. For powders, roughly a quarter teaspoon of water per small bump of substance is a reasonable starting point. For pills, crush and dissolve. Dip the strip for fifteen seconds. Lay it flat. Read the result at two to five minutes. Discard after.

Fentanyl test strips are legal in most states and decriminalized as drug-checking equipment in a growing number of others. The Temple distributes them as sacramental items.

Reagent Kits

Reagent kits are sets of chemical solutions that change color when they contact specific substances. They are the standard tool for checking substances expected to be MDMA, methamphetamine, cocaine, ketamine, LSD, and psychedelics. They identify the presence of an expected compound and flag the presence of common adulterants.

The common reagents are Marquis, Mecke, Mandelin, Simon’s, Folin, Hofmann, and Liebermann. Different reagents detect different compounds. Many people who use reagent tests keep at least Marquis and one or two complements. A drop of reagent on a tiny scraping of substance gives a color reaction within seconds. The color is compared against a published chart.

Reagent testing tells you what your substance probably is. It does not tell you the purity. It does not detect fentanyl reliably. For substances where fentanyl contamination is possible, reagent test first, then fentanyl-strip test the same sample.

A Word on Negative Results

A negative fentanyl test does not mean the substance is safe. It means that the part of the sample you tested did not contain detectable fentanyl. Powders mix unevenly. A pill may have a fentanyl hot spot that your sample missed. Treat every result as information, not as a guarantee.

The protocol is the same either way. Test. Start with a smaller dose than you think you need. Have naloxone in the room. Have a person who can call for help if something goes wrong.

Section Four

Naloxone and Drug-Poisoning Response

Naloxone is the medication that reverses opioid drug poisoning. It binds to opioid receptors and displaces opioids. The person wakes up. They breathe again. They get to live.

If you do not already carry naloxone, get it. If you have it, learn to use it. If you have used it, talk about it. The taboo around naloxone is what kills people. Carry the medicine. Tell someone you have it.

How to Recognize a Drug Poisoning

The signs of an opioid drug poisoning are specific.

  • Slow, shallow, or stopped breathing. Fewer than ten breaths per minute is dangerous.
  • Lips, fingernails, or skin turning blue or gray. In darker skin, look at the lips and the gums.
  • Pinpoint pupils.
  • Unresponsive to a sternal rub or to their own name shouted loudly.
  • A choking, snoring, or gurgling sound. This is the death rattle of the throat closing. Do not assume the person is sleeping.

If you are unsure whether someone is poisoned or asleep, treat it as a poisoning. Naloxone does nothing to a person who has no opioids in their system. There is no downside to using it. The downside is waiting.

The Response Protocol

  1. Try to wake them. Shout their name. Rub your knuckles hard up and down their sternum. If they do not respond, move to step two.
  2. Call 911. Most states have Good Samaritan laws that protect both the caller and the person poisoned from drug-possession charges. Tell the dispatcher “someone is not breathing.” You do not have to mention drugs.
  3. Give naloxone. Spray one dose of nasal naloxone in one nostril. If using an injectable kit, inject into the outer thigh muscle through clothing if needed.
  4. Give rescue breaths if you can. Tilt the head back, lift the chin, pinch the nose, and give one breath every five seconds. The breathing is what keeps the brain alive. Naloxone works in two to five minutes. The breathing has to happen now.
  5. If no response in two to three minutes, give a second dose. Contaminated-supply poisonings often require two, three, or four doses. Do not stop because the first one did not work.
  6. Once they are breathing, put them in the recovery position. On their side, top knee bent forward, head tilted back slightly to keep the airway open. People can vomit after being revived. The recovery position keeps them from choking.
  7. Stay with them. Naloxone wears off in thirty to ninety minutes. The opioid in their system may outlast it. The person can re-poison. Stay until medical help arrives or until you are certain they are safe.

Good Samaritan Laws

Most states protect people who call 911 for a drug poisoning from being charged with simple drug possession or paraphernalia possession. The specifics vary by state. The protections do not cover dealing, weapons charges, or outstanding warrants.

Call anyway. A life is worth more than a charge. The Temple believes this without reservation.

Section Five

Safer Use

There is no entirely safe way to use a substance from the unregulated market. There are practices that dramatically reduce the risk. They are the practices of people with lived experience, harm-reduction outreach workers, and clinicians who have been honest with themselves about the world we actually live in.

Never Use Alone

The single most important safer-use practice is to never use alone. Most fatal drug poisonings happen when there is no one in the room to call for help. If you cannot have another person physically present, use a virtual companion. The Never Use Alone Hotline at 1-800-484-3731 stays on the line during a session and dispatches help if you stop responding. It is free. It is anonymous. It works.

Start Low. Go Slow.

Take a smaller dose than you think you need, especially from a new batch or a new supplier. Wait. The supply variability between batches is enormous. The dose that was fine last week may not be fine today.

If you have not used for a while, your tolerance is gone. People die in the first weeks after release from incarceration or treatment because they returned to their old dose. Their body could no longer absorb it. Start low. Lower than that.

Mixing Is the Biggest Risk

Most fatal drug poisonings involve more than one substance. The combination that kills more people than any other is opioids plus benzodiazepines. Both depress breathing. Together they multiply. The same is true of opioids plus alcohol, opioids plus muscle relaxants, and benzodiazepines plus alcohol.

If you are mixing, reduce all doses. Know which combinations are the most dangerous. The standard reference is the drug combination chart from TripSit. It is online for free. Print a copy. Tape it to the wall.

Know Your Method

Smoking and injecting carry the highest poisoning risk because the substance reaches the brain fastest. Snorting is intermediate. Oral and rectal are slower and somewhat more forgiving, though absorbed dose still varies. If you can use a slower method, use the slower method.

If you inject, use sterile equipment every time. New syringe, new cooker, new water, new cotton. Rotate sites. Clean the skin. Never share. Sharing is how hepatitis C and HIV spread, and both are still spreading. Syringe-service programs are free and confidential in most cities. Find your local one.

Hydration, Temperature, Rest

For stimulants and for entactogens like MDMA, the failure modes are different. Hyperthermia, dehydration, and electrolyte imbalance can kill you. Drink water. About a pint per hour while active is a reasonable target. Do not drink so much that you dilute your electrolytes. Take breaks. Cool your body. Sleep when you can.

Journaling & Interaction-Checking Tools

Field Notes is a great tool developed by a long time fellow psychonaut and friend of the Temple. It is an offline, private harm-reduction journal and trip-sitting workstation for psychonauts and all other explorers. Everything stays on your own device. There is no account, no network, no tracking. It logs doses, keeps a live timeline of what is happening in your body, and warns you in advance about dangerous interactions across common substance classes: opioid plus benzo, MAOI plus serotonin releaser, lithium plus psychedelics, SSRI plus MDMA, and many more. It runs on Mac and Linux. Download it here: github.com/sparkly-quasar/field-notes.

Substance References

dose.wiki is a modern, open-source encyclopedia of psychoactive substances and their subjective effects. It currently documents 577 substances and 233 subjective effects, and every single article is reviewed by a human expert before publication. The full dataset is dedicated to the public domain under CC0, which means anyone can download it, build on it, and fork it. Use it to look up dose ranges, durations, interactions, and effect profiles before you use, and to check what other people are actually reporting. Browse it at dose.wiki.

Psilocybin Dosage Calculator

Our friends at the Church of Ambrosia maintain a detailed dosage calculator for magic mushrooms and psilocybin edibles. It personalizes the recommended dose based on your body weight, how long it has been since your last dose (tolerance), personal sensitivity, and the tested potency of the specific strain or product you have on hand. It is designed for lab-tested material with known psilocybin content, which is the only way to dose responsibly at any level above a microdose. If your mushrooms have not been tested, use traditional dosage standards instead and start low. Access the calculator at ambrosia.church/magic-mushrooms/dosage-calculator.

Section Six

For Loved Ones

If you are reading this because someone you love uses substances, this section is for you.

The first thing to understand is that you cannot save a person who does not want to be saved. You can only keep them alive long enough that they have the option of choosing to be saved later. That is not a defeat. That is the entire job.

The Rock Bottom Lie

You may have been told that the person has to hit rock bottom before they will change. This doctrine has killed more people than any drug. The contaminated supply does not allow for a long descent into hitting bottom. The bottom is now a coffin. Every drug-poisoning prevention practice exists to ensure the person has a chance to make a different choice tomorrow.

Withholding care does not motivate change. It accelerates death. The evidence on this is overwhelming. Love them anyway. Keep them alive anyway. The chance for change comes from being still here, not from the absence of help.

What to Say

You are not going to talk anyone out of using by repeating the cost. They know the cost. You are going to keep them tethered to the world by being a person who stays in their life without conditions.

Useful things to say. I love you. I am not going anywhere. I would rather have you alive and honest with me than isolated and at risk. Do you have naloxone. Do you want me to come over and just sit with you. Tell me what would help.

Things to avoid. You are killing yourself. You are killing me. If you really loved us. After everything we have done for you. These sentences are about your pain, not theirs. They will land as shame. Shame is the opposite of survival.

Practical Steps

  • Get naloxone. Multiple doses. Keep some in your bag, some in your car, some in their home. Tell them where it is.
  • Learn the response protocol above. Practice it out loud. Make sure other people in their life know it too.
  • Get fentanyl test strips into their hands without making them ask for them.
  • Save the Never Use Alone Hotline in their phone. 1-800-484-3731.
  • If they are willing, agree on a check-in time each day. A text. A call. A signal that they made it through the night.

Your Own Care

Loving someone who uses is exhausting. You will need your own people. SMART Recovery Family and Friends, Learn to Cope, and the harm-reduction parents network at Broken No More are organized for exactly this. Therapy with a clinician who understands harm reduction is invaluable. You cannot pour from an empty cup.

Section Seven

Where to Get Help

Crisis and Companion Lines

Naloxone Access

  • NEXT Distro. Mail-order naloxone, free, mailed in discreet packaging. nextdistro.org
  • Local syringe-service programs. Most provide free naloxone with training. Search the North American Syringe Exchange Network directory.
  • Pharmacy access. Naloxone is available over the counter in every state under the brand name Narcan. No prescription required.
  • State health department programs. Many states mail naloxone directly to residents at no cost. Check your state health department website.

Drug Checking

  • the temple of harm reduction. Drug-checking supplies offered as sacramental tools of care to anyone who asks, as availability allows.
  • Grassroots Harm Reduction. Low-cost reagent kits and fentanyl, xylazine, and amphetamine test strips for individuals, plus buyers’ club pricing for harm-reduction programs.
  • DanceSafe. Reagent kits, fentanyl test strips, educational materials. dancesafe.org
  • NEXT Distro. Fentanyl test strips by mail.
  • Bunk Police. Reagent test kits.

Harm-Reduction Organizations

For Loved Ones

If You Take One Thing From This Page

Carry naloxone. Tell someone you carry it. Test what you use. Use with someone, or call Never Use Alone at 1-800-484-3731. Keep yourself, and the people around you, alive long enough to choose what comes next.

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