How to stop a bad trip - or at least die trying

A bad trip, according to the definition in Wikipedia is a "disturbing experience associated with the use of a hallucinogen". The classical definition relates to a state of psychosis that may result in anguish, actual physical harm to self and to others, or risky behaviour as a result of a negative environment
(Timothy Leary's set and setting theory)

Sometimes you just have to hit the emergency button

These definitions stop short of exposing basic truths about a bad trip that a Psychedelic Dad has lived through. In my experiences:

• Every single mind-altering substance causes bad trips if mishandled. You name it. Even alcohol causes delirium tremens if abused for a long-enough period. One of my worst nightmares was a bad trip on methylone - a weaker relative of MDMA - in a domestic setting. Do not be fooled here.
• Bad trips can be "turned around". It takes a lot of experience, strength and willpower to do this, but it can be done -but sometimes bad trips can't be turned around. 
• Bad trips cannot be avoided. No, they cannot if the circumstances are negative, if you are worried, or in a harsh environment or have become entangled in a random negative event whilst high. "How do you think you will react if high in a house-party, and then suddenly the police come crashing though the door?"
• As a trip-sitter you must know how to react is someone else is having a hard time. This is why someone else is trusting you to look after them. Because you know your shit and they can't look after themselves. Sometimes, talking nice things and wrapping someone in a blanket does not work with psychotic people. 
• You are tripping solo, and things are not looking good. This is a hard one; not only you have no sitter to help you, but you must use whatever common sense is left in you to call a stop to the madness. If I feel that I'm coming up too fast, too soon, it's an indicator that something nasty is on the way and if I am not prepared to handle it, I do a run for the emergency button.

I always have Diazepam (generic Valium) around and I will stress the point of the post: you should have an emergency plan for responding to a bad trip situation -any other benzodiazepine or antipsychotic drug will do for stopping a bad trip, but if you don't have them before the trip starts your only other alternative is to contact the emergency services or ambulance in your locality. Or ride the bad trip out. With all the consequences these options may bring.

A bad trip can be stopped, you just need to know how.

If the patient is already manic and violent: unless you are lucky enough to have an anti-psychotic needle or you are able to calm the patient down to administer the Diazepam, the only viable option is to call for an ambulance.

If the patient is unresponsive or unconscious: place the patient on his / her side and ensure the airways are not obstructed and breathing can be maintained. Call for an ambulance *immediately*.

When ready to push the "stop button" take 20 milligrams of Diazepam with water - the hard part might be convincing the patient to do it as they might already be in a psychotic state. The pills can be crushed and mixed with water, or chewed before swallowing (they taste bad, but crushing them brings on the effects sooner...)

Tell the patient the truth and ask them to stay strong for 10 or 15 minutes - the Diazepam will start working very soon (you did crush the pills, right?) - in the meantime provide supportive care, blankets, fluids and a warm and caring environment. Turn off the lights and get rid of all noxious influences - this might be a good time for listening to Bach, and not Rage Against the Machine.

Do not go "how do you feel?" or "I told you it was too much" or "You scared me shit-less" every one minute or so: they will be feeling like survivors of a plane crash for the next couple of hours, so do not be an arse. There will be time for explanations later on.

After a couple of hours, serve something warm and nutritious to the victim - a chicken soup, a minestrone or something similar. Give plenty of fluids. Ask the patient to sleep until the next day, if possible.

That's all there is to it (in my experience); that's how you kill off a bad trip. Of course, others will have different experiences or may disagree with me, but that's what the Internet is for.