2C-T-2 Dosage Guide

## Recognizing a 2C-T-2 Emergency 2C-T-2 belongs to a family of compounds with documented fatalities. Any adverse reaction beyond expected psychedelic effects should be taken seriously and evaluated for escalation. The critical distinction is between a difficult psychedelic experience (unpleasant but not medically dangerous) and serotonin toxicity or cardiovascular crisis (potentially fatal). **Signs that indicate a medical emergency (call emergency services):** - Body temperature above 39°C (102°F) and rising - Sustained heart rate above 150 bpm, especially with chest pain or irregular rhythm - Muscle rigidity, sustained clonus (involuntary rhythmic jerking), or tremor that is worsening - Seizure of any duration - Confusion progressing to delirium -- the person cannot recognize where they are or who you are - Profuse sweating with hot, dry skin (indicates the body has lost the ability to thermoregulate) - Loss of consciousness **Signs of a difficult but non-emergency psychedelic experience:** - Severe anxiety and panic with intact awareness of surroundings - Nausea and vomiting (common during the come-up) - Heart rate elevated but below 130 bpm with no chest pain - Emotional distress with preserved reality testing ## Emergency Response Protocol 1. **Call emergency services.** State: "Possible serotonin syndrome from a serotonergic drug." Provide the substance name, dose, time of ingestion, and any other substances taken. Withholding information puts the patient at risk 2. **Cool the person aggressively.** Serotonin syndrome kills through hyperthermia. Remove clothing. Apply ice packs to armpits, groin, and neck. Mist skin with water and fan. Do not immerse in ice water (this can cause vasoconstriction and paradoxically trap heat) 3. **Benzodiazepines for agitation and seizures.** If available, diazepam or lorazepam can manage agitation and prevent seizure escalation. Do not use antipsychotics (chlorpromazine, haloperidol) -- these can worsen serotonergic crises 4. **Monitor airway.** If unconscious, place in recovery position. Be prepared for CPR 5. **Document everything.** Time of ingestion, dose, route, other substances, progression of symptoms. Paramedics and emergency physicians need this timeline ## Managing Psychological Distress If the person is physically stable but experiencing severe anxiety, panic, or frightening perceptual distortions: - Reduce environmental stimulation. Dim lights, lower volume, remove crowds - Speak slowly and calmly. Use their name. Make eye contact. Your composure is the most powerful tool available - Ground them with simple, concrete questions: "Can you tell me your name? Can you squeeze my hand?" - Remind them that the experience is temporary and caused by a substance with a known duration - Do not leave a distressed person alone - Benzodiazepines, if available and the person can swallow safely, can substantially reduce acute psychological distress Never hesitate to call emergency services because of legal concerns. Good Samaritan laws protect callers in most jurisdictions.