Emergency Info

Guidelines on when to call the Emergency Services 999 for unwell recreational drug users

Call 999 if ANY one of the following is present:

Unconsciousness – if the patient does not respond to vocal commands, requires painful stimulus (e.g. pressure across the fingernails) to respond or does not respond at all.

Significant agitation (e.g. pacing around the room) or aggression not settling within 15 minutes.

Seizures (e.g. a convulsion similar to an epileptic fit)

Breathing difficulties such as fast breathing rate which does not settle within 15 minutes.

Heart rate over 140 beats per minute not settling within 5 minutes.

Temperature over 38.5 not settling after about 5 minutes of rest, or if very flushed and feels very hot if no thermometer is available.

Blood pressure – Systolic (“upper pressure”) over 180mmHg, or Diastolic (“lower pressure”) over 110mmHg on two repeated blood pressure measurements.

Other concerns – if there are any other concerns (e.g. severe headache, chest pain).


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Dealing with drug-induced problems

License holders should be clear about how they will respond to drug and alcohol induced problems.

These problems may be of a medical or psychological nature and the assistance provided should be swiftly and easily accessible. The scale and type of medical interventions available will vary according to the type and scale of event being run.

The following section explores some of the key issues but does not attempt to prescribe definitive levels of medical cover.

Dedicated team

Larger clubs or festivals should employ a dedicated medical/welfare team who have received drug-specific training. These may be in-house employees or bought in from a number of companies who provide specialised services to dance events and festivals. Again, it is important that these companies have a track record of working with drug induced problems. It should not be assumed that such reputable organisations as the Red Cross or St. John Ambulance Service necessarily possess the requisite experience. Even highly experienced and skilled NHS trained doctors, nurses and paramedics should not be expected to work in this setting without the supervision of a colleague with experience of working with drug-induced problems. A list of specialist drug medical providers can be found here.


The training provided to such staff should include information about common drug induced problems, such as anxiety, paranoia, seizures, heart rate and blood pressure problems and elevated body temperature. These will vary depending on the pattern of drug use locally. Staff, who for the first time encounter clubbers who have used ketamine for example, may not recognise the symptoms of use. It is important that local drug agencies are used to keep staff up-to-date.

First Aiders

Smaller venues should ensure that sufficient employees are trained as First Aiders to ensure that a minimum of two such staff are present at all times during any event. It is advisable that all newly qualified First Aiders work with more experienced staff.
The venue should ensure that medical staff have regular training and ensure that staff are clear about lines of accountability for their work.

Briefing all staff

Medical/welfare staff should regularly brief door supervisors, bar staff and other club staff about common symptoms of drug induced distress to look out for. Bar staff should also have comprehensive server training to help them to deal appropriately with people who are intoxicated through alcohol, drugs or a combination of the two.


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