1. Remember It Isn't Real
Hallucinogenic drugs can make you see, feel and even hear things that are disorted or have no basis in reality. They can cause you to have thoughts which seem profound and real, but are extreme, out of proportion, or downight delusional. If nothing else, hold on to remembering that everything you are perceiving is influenced by the drug you have taken, and is probably not real.
Some of the hallucinations you see, hear or feel on drugs can seem very real, but they probably aren't. Some of the thoughts you have seem profound and true, but are not in perspective right now. Think about it this way -- if it is real, it will still be there tomorrow. If it is true, you will still believe it tomorrow. So don't act on anything that seems different or out of the ordinary, because the chances are, it won't even be there or seem that important after you come down. And if it is, you will be in a much better state to deal with it then.
2. Stay Safe
Try to stay in places where the risks of you hurting yourself are low. Stay in familiar territory, away from heights, traffic and other hazards. You may have unusual impulses, and want to try doing something that has seemed risky in the past, but doesn't seem risky now. Don't follow such impulses.
If you choose to go outside, make sure someone goes with you, ideally someone who has not taken any drugs. Stick to quiet places without too many people around, but make sure help is nearby if you need it. People who have been drinking alcohol are not the best company for you right now, so avoid drinking establishments such as bars and pubs.
3. Connect With Someone
Although talking might be difficult, and you could find it hard to put what you are feeling into words, try to let someone understanding know you are having a bad trip. Choose someone who is not going to over-react to your drug use, and ideally, someone who is not under the influence of alcohol or drugs. Even if you aren't able to talk, just having someone sit with you can be very calming.
Going off on your own is not a good idea when you are having a bad trip, but large groups of people can be overwhelming, too. If you are at an event such as a concert, festival, nightclub or rave, try and find a quieter area with another person or small group. Look for a chill-out room, or a DanceSafe booth or other supportive group.
If connecting with someone by phone is your best option, contacting a drug helpline could help, but they may not give you the support you need, as they are geared towards dealing with drug dependence rather than intoxication -- a better choice would be to call DanceSafe on 888-MDMA-411. They are a harm reduction organization and are very skilled at supporting people who are having negative drug experiences.
If you are feeling really out of control, you can always call 911 or go to the emergency room of your local hospital. Emergency rooms are not great places to be spending time when you are having a bad trip -- they are full of sick and injured people who are upset and frustrated -- so calling 911 might be a better choice. Be sure to tell the paramedic what you have taken.
4. Take Care of Your Physical Needs
If you haven't eaten for hours, and particularly if you have been overactive, your low blood sugar may be lowering your mood. Make sure you have had enough fluids -- although don't over-do it -- and try to eat something. The process of eating can be difficult while under the influence of hallucinogens, so if you can't handle chewing, choose something soft and easy to eat and digest, such as pudding or ice cream.
It is unlikely that you will be able to sleep, particularly if you are within the first few hours of the trip, but sitting or lying down and resting can help. Listening to soothing music is often very calming.
5. Don't Attempt to Self Medicate
There are many myths involving self medication when you are having a bad trip, but generally, taking more drugs will make you feel worse, not better. Adding any psychoactive substance, including alcohol, to a bad trip, will tend to increase your feelings of anxiety and being out of control, followed by the comedown while you are still feeling wide awake under the influence of the hallucinogen.
If you feel physically ill, if you are worried that the drug may have been contaminated, or that you need medication to help with your mental state, call 911 or go to your nearest emergency room -- ideally with an unintoxicated companion -- and let the professionals decide what the best treatment is for your current state. Be sure to tell the paramedic what you have taken, and bring a sample if possible. Do not handle LSD with your bare hands, as it can be absorbed through the skin and intensify the experience.
Fadiman, J. The Psychedelic Explorer's Guide: Safe, Therapeutic, and Sacred Journeys. Rochester, Vermont: Park Street Press. 2011.
Hayes, C. (editor). Tripping: An Anthology of True-Life Psychedelic Adventures. New York: Penguin. 2000.