Bad trip in San Diego? Who to call and what to do right now

Who should you call right now?

Call 911 if the person:

• is unconscious or can't be woken⁸
• is having trouble breathing⁸
• is having a seizure or uncontrollable shaking⁸
• has collapsed or is extremely weak⁸
• is threatening to hurt themselves or someone else, or is in danger³⁹

For everything else, call or text one of these:

• 988 Suicide and Crisis Lifeline: call or text 988, 24/7, free and confidential. Counselors help with "alcohol or drug use concerns."⁷
• San Diego Access and Crisis Line: 888-724-7240, 24/7, free and confidential, with interpreters in over 200 languages. It's the county's local 988 crisis center.¹
• Poison Control: 1-800-222-1222, 24/7, free and confidential. Call it if you're unsure what was taken.⁸
• Fireside Project psychedelic peer support: 62-FIRESIDE (623-473-7433), call or text, every day from 11 a.m. to 11 p.m. Pacific, for support during and after trips. Fireside "is not a suicide hotline"; if you're considering suicide, call 988.⁹

When you call, say what was taken, how much time has passed and whether anything else was mixed in. Keep the package: products sold as mushrooms have turned out to contain other drugs (more on that below).

How do you help a friend through a bad trip?

Johns Hopkins researchers' safety guidelines call a "bad trip" the most likely risk in psychedelic studies, one that "could lead to potentially dangerous behavior such as leaving the study site."¹³ Those guidelines and a large survey point to the same basics:

• Stay with them. Don't leave them alone or let them wander off. Study protocols keep at least two monitors with a participant during sessions.¹³
• Move somewhere calm and safe. Get them somewhere quiet and physically safe. In a global survey, a poor "setting" was among the most reported reasons for incidents that ended in emergency care.¹⁴
• Reassure, don't argue. The guidelines call "strong personal support and reassurance" the right first response, and warn that trying to "talk down" someone may make it worse. Remind them they took a drug and that it will wear off.¹³
• Don't let them drive. Driving under the influence of any drug is a crime under Vehicle Code 23152(f).⁶

Not sure it's an emergency? Call Fireside during its hours or 988 any time, and call 911 if any warning sign above appears.⁷⁹

Will calling 911 get you in trouble?

California's 911 Good Samaritan law, Health and Safety Code 11376.5, protects people who seek help in good faith during a "drug-related overdose." In plain words:⁵

• If you call for someone else, it isn't a crime for you to be under the influence of, or to possess for personal use, the drugs or paraphernalia connected to that overdose, as long as you don't obstruct medical or police personnel.
• The person who overdosed gets the same protection when they, or someone at the scene, seek help.
• It doesn't cover selling, giving away or exchanging drugs, and it doesn't cover offenses like driving under the influence.
• An overdose is a condition a reasonable person would believe "may result in death, disability, or serious injury." Asking for help includes a call, a text or an alert from a smartwatch.

The law says "no other immunities" are intended.⁵ For what possession itself carries, see our guide to psilocybin penalties in California. None of this is legal advice.

What can San Diego County send besides an ambulance?

Mobile Crisis Response Teams. Call 988 or 888-724-7240 to request one. Teams work 24/7 and "can come to you anywhere in San Diego County." Each has a mental health clinician, a case manager and a peer support specialist, and "teams do not include law enforcement staff," though police may be called if there's a safety concern. They "cannot help if there are threats of violence or medical emergencies"; that's a 911 call.³

Psychiatric Emergency Response Teams (PERT). Dispatched through 911 from 6 a.m. to midnight, each pairs a licensed clinician with a specially trained officer.²

Walk-in crisis stabilization units. No appointment is needed, care lasts up to 24 hours, and admission can be voluntary.⁴ The county's own pages list different numbers of units, so check its current crisis stabilization unit list for addresses; it includes a unit in Hillcrest for people under 18.²⁴ The San Diego County Psychiatric Hospital also takes adult walk-ins, and county behavioral health clinics offer walk-in crisis care during business hours.²

What if it isn't psilocybin at all?

A trip that feels wrong may not be psilocybin. Three possibilities:

• Amanita. Some "mushroom" gummies contain Amanita muscaria. Its compound muscimol is a central nervous system depressant, and ibotenic acid is considered a neurotoxin that can cause nausea, vomiting, abdominal pain, diarrhea, agitation and headaches.¹²
• Synthetic analogues in candy. CDPH found 4-AcO-DET and 4-AcO-DMT in TRE House gummies, chocolate and syrup, and warned they "may cause severe illness, hospitalization, or even death."¹¹ In the 2024 Diamond Shruumz outbreak, severe symptoms included seizures, decreased consciousness and respiratory failure.¹⁰
• Mixing. Mixing substances was among the most reported reasons for magic mushroom emergencies in a global survey.¹⁴ A UC San Diego review of 232 psychedelic-related emergency visits found concurrent cannabis use was associated with higher odds of psychiatric hospitalization.¹⁵

Our comparison of what's sold as mushroom gummies in San Diego covers what testing has found in these products, and the parents' guide to mushroom edibles covers children who eat one by accident.

Which medications make it an emergency?

• Lithium. In an analysis of online experience reports, 47% of 62 reports of lithium combined with a classic psychedelic involved seizures, and 39% involved medical attention. These are uncontrolled self-reports, but the authors provisionally concluded psychedelics "may pose a significant seizure risk" for people on lithium.¹⁶ A seizure is a 911 call.
• MAOIs. Research guidelines note that MAO inhibitors have been shown to reduce sensitivity to psychedelics, but that giving ayahuasca, which contains MAOIs, to someone taking a serotonin reuptake inhibitor "may lead to a severe serotonin syndrome reaction."¹³ Tell responders about any MAOI or other antidepressant.
• SSRIs and SNRIs. The evidence conflicts. In a survey, people on SSRIs or SNRIs often reported weaker effects, and the dampening may last up to 3 months after stopping.¹⁷ A controlled study in healthy volunteers found escitalopram didn't change psilocybin's positive mood effects but reduced bad drug effects and anxiety.¹⁸ Don't stop or change a prescription on your own; that's a conversation for the prescriber.

Who should avoid psilocybin altogether?

The Johns Hopkins guidelines exclude research volunteers with a current or past psychotic disorder, such as schizophrenia, or bipolar I or II disorder, calling these "the most important conditions to exclude for ensuring safety," and also exclude people with a first- or second-degree relative who has them. The same guidelines note that prolonged psychoses triggered by psychedelics are less common than bad trips.¹³

The UC San Diego emergency-visit review points the same way: a history of bipolar disorder or of a primary psychotic disorder was associated with much higher odds of psychiatric hospitalization.¹⁵ People taking lithium face the seizure risk described above.¹⁶

What helps after the bad moment passes?

In a global survey, all but one of those who sought emergency care after magic mushrooms "returned back to normality within 24 h."¹⁴

• Peer support. Fireside Project's line takes calls and texts after trips as well as during them.⁹
• Integration. MAPS describes integration as "an intentional process to understand a psychedelic experience and bring the lessons into daily life," which can be "supported by peers, community, coaches, or therapists."²⁰
• A clinician. See a doctor or therapist if anxiety, low mood or visual changes linger. Research guidelines tell investigators to check for the relatively rare hallucinogen persisting perception disorder at follow-up.¹³ Our guide to psychedelic therapy costs in San Diego lists legal options and what they cost.

Terms on this page are defined in our magic mushroom glossary.