Allergic reaction or unidentified bad product — Emergency

When When hives, swelling of the face, lips, or tongue, shortness of breath, circulatory collapse, or unusual poisoning symptoms appear within minutes to hours after use.

Immediate

1. Call 112 — anaphylactic reactions can be fatal within minutes.

2. Lay the person down, raise their legs (shock position). If they have trouble breathing: prefer an upright position.

3. If an adrenaline auto-injector (EpiPen, Jext, Emerade) is available and the reaction is clear: inject into the outer thigh.

Don't do

Don't leave the person alone — the course is unpredictable.

Don't self-medicate with antihistamines and 'wait it out' — with shortness of breath or circulatory problems, that isn't enough.

Don't throw away the leftover substance. Show it to the emergency doctor or photograph it — it helps with diagnosis and protects other users via drug checking.

Allergic reactions to pure substances are rare but documented (especially with cathinones, phenethylamines, synthetics). More common are reactions to:

Cutting agents (e.g. levamisole in cocaine, phenacetin)
Contaminations (pesticides in cannabis, heavy metals in cocaine)
False identity (something sold as “MDMA” contains PMMA, a cathinone, or a fentanyl admixture)

A suspected anaphylaxis is a medical emergency — hospital treatment is standardized (adrenaline, antihistamines, cortisone, circulatory stabilization).

Drug checking in Berlin (drugchecking.berlin: vista, Schwulenberatung, Fixpunkt; also Eclipse e.V.) tests anonymously for active-ingredient identity and common cutting agents. Having a sample tested before use protects against exactly this scenario.

For repeated reactions to certain substances or substance classes: get a medical evaluation afterward.