This is not an endorsement of drinking or taking drugs.
If you live with T1D and are choosing to drink alcohol, please check in with your diabetes care team and have support in place. This is not medical advice.
This section is an honest, experience-based look at how various substances may affect people living with T1D, physically, emotionally, and physiologically, in the context of partying. It is not a recommendation or an endorsement of using these substances, nor is it medical or clinical advice.
One key theme?
The inverted U-curve: a little may be pleasant; too much can be overwhelming or dangerous.
Let’s walk through them.
Cannabis (THC)
Psychoactive cannabinoid. Main active compound: THC (Tetrahydrocannabinol). THC interacts with CB1 receptors in the brain’s endocannabinoid system, modulating GABA, dopamine, and serotonin pathways leading to:
- Sedative, dreamy, often relaxing
- Intensified music, colours, taste
- Social disinhibition or quiet introspection
- Strong increase in appetite
- Time dilation
Time frames:
- Onset: 15–60 mins (inhaled); 30–90 mins (edibles)
- Duration: 2–4 hrs (inhaled); up to 6–8 hrs (edibles)
- Half-life: ~1.3 days (occasional use); up to 5–13 days (chronic use)
T1D considerations:
- No direct glucose effect, but the “munchies” can cause post-cannabis highs if insulin isn’t given
- Judgement may be impaired, reducing the chance of bolusing
- Closed-loop systems may misinterpret unannounced eating
- At high doses: paranoia, anxiety, and loss of control
Ketamine (Special K)
Dissociative anaesthetic / tranquiliser. Used medically, but often recreationally at much lower doses. Blocks NMDA glutamate receptors, disrupting normal sensory integration and inducing dissociation. Also boosts dopamine and serotonin in some brain regions.
What to expect:
- Altered perception of space, time, and body
- Disconnection from self and surroundings
- Visual and auditory distortion
- Risk of entering a “K-hole”, a deep, non-responsive mental space for what may seem like a very long time
- Wobbly, floaty physical state
Time frames:
- Onset: 5–15 mins (intranasal); 20–30 mins (oral)
- Duration: 45–90 mins
- Half-life: 2.5–3 hrs
T1D considerations:
- Not directly glucose-altering
- Biggest risk: loss of ability to self-manage
- May not recognise or treat a hypo while dissociated
- Co-use with alcohol is high risk due to dissacositation
- Always ensure someone sober knows you have T1D and what to do
LSD (Acid) & Psilocybin (Magic Mushrooms)
Classical psychedelics / hallucinogens. Selective serotonin 2A (5-HT2A) receptor agonists, disrupting the default mode network (DMN) and re-routing consciousness through new and novel neural pathways. They shift your entire mode of consciousness, altering how your brain processes perception, self, space, and time. Cannabis, while more common and milder in its effects, can also distort awareness, increase hunger, and impair judgment.
The result?
Your brain no longer runs along its usual pathways. New connections light up. Old boundaries dissolve. This can feel expansive or frightening. Beautiful or disorienting. For anyone with T1D, this altered mental landscape comes with important considerations around safety, glucose awareness, and self-care.
What to expect:
- Intense perceptual shifts in sound, colour, time, and emotion
- Sensory cross-over (seeing music, feeling colours)
- Euphoria, insight, or existential overwhelm
- Altered sense of self “ego dissolution”
- Emotional sensitivity or introspection
- Risk of panic or confusion at high doses
Time frames:
LSD
- Onset: 30–60 mins
- Peak: 2–4 hrs
- Duration: 8–12 hrs
- Half-life: ~3–5 hrs, but effects last far longer
Psilocybin
- Onset: 20–40 mins
- Peak: 1–2 hrs
- Duration: 4–6 hrs
- Half-life: ~1–3 hrs
T1D considerations:
- These are long-acting substances
- May impair all aspects of self-care: checking glucose, eating, bolusing
- Risk of forgetting you have diabetes
- Hypoglycaemia during a trip can be very hard to treat
- Strongly impacted by “set and setting” — environment and mental state
T1D safety points for all these substances
- Know your source. Home testing kits and weighing your dose reduce risk.
- Start low and go slow.
- Set and setting matter. These substances radically change perception. Being in an overstimulating, unfamiliar or unsafe space increases psychological risks.
- Be mindful of co-administration with alcohol. It amplifies sedation, impairs judgement, and increases the risk of unrecognised or untreated hypoglycaemia.
- The inverted U-curve is real. The right amount might feel expansive. Too much can feel terrifying or dangerous.
- After-effects are real. Sleep disruption, emotional sensitivity, and a general “come-down” can linger for a day or more. Plan for this.
- Safety first. Ensure you have your full diabetes kit, someone knows what you are taking and that you have T1D, and have CGM followers.
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