Living with type 1 diabetes (T1D) means learning how to navigate life with a body that doesn’t always play by the rules, and partying is no exception. Whether it’s nights out, festivals, afterparties, hookups, or house raves, these are real experiences that many people with T1D encounter.
Yet there’s a surprising lack of honest, relatable guidance on how to manage them. Most official resources stop at “don’t do it”, but that doesn’t help when you’re already in it, planning it, or curious about what others with diabetes have done to stay safe.
This guide exists to fill that gap. It’s written using the lived experience of people with T1D (me and my friends – not saying who has taken what) for people with T1D and is rooted in lived experience. It’s here to reduce harm, open conversation, and provide realistic strategies for managing diabetes in high-stakes, high-energy environments, without judgement or shame.
Let’s be clear right from the start:
- This is not medical advice.
- This is not a guide to using drugs or alcohol.
We’re not discussing legality, and here’s why.
Laws around drug use vary wildly by country, region, and context. Some of the most harmful substances, like alcohol and cigarettes, are legal and socially accepted. Others, which may carry lower physiological risk when used with care, are criminalised.
Take a look at the graphic from the landmark study that ranks drugs by objective harm. You’ll see that the most dangerous drug overall, by far, is alcohol. Not because it’s the most potent, but because it’s the most widely consumed, and carries real short and long-term health risks. That’s the reality.
This guide exists to inform, not to promote. It’s here so that people who do choose to party with T1D can do so with a greater awareness of the risks, and ideally, with better safety strategies. For some, reading this may lead to the decision not to take anything at all. For others, it may help reduce the risk of serious harm. Both outcomes are a win.
The Inverted U: Why Dose Matters More Than You Think
Every psychoactive substance, legal or illegal, works on an inverted U-curve.
- At the low end, the dose has little or no effect.
- At the peak of the curve, you may feel exactly what you hoped for: connected, confident, energised, euphoric, calm, or introspective.
- But go beyond that peak, and the same substance can cause distress, confusion, anxiety, paranoia, dysphoria, blackouts, or worse.
This “Optimal Arousal”, the Goldilocks zone, is what many people aim for when they use a substance. But it’s highly variable and depends on four key factors:
- The substance itself — alcohol, MDMA, cannabis, ketamine, etc.
- The dose — how much is taken and how quickly.
- The person — their weight, tolerance, mood, neurobiology, and diabetes status.
- The set and setting — who they’re with, where they are, and how safe they feel.
The problem is, with unregulated substances, you rarely know the exact dose or purity. That makes overshooting the peak of the U, and falling into the zone of harm, more likely, especially for those who are new or curious.
Take alcohol, for example:
- 2–10 units might help someone feel more relaxed, sociable, or connected.
- But 25–30 units will likely lead to vomiting, memory loss, or worse.
- And 300 units? That could be fatal.
With alcohol, the U-curve is easier to understand because it’s regulated and labelled, we generally know how much is in a drink. But for something like cocaine, you usually don’t know the purity, potency, or content. Taking a line from an unfamiliar batch could be the equivalent of drinking 20+ units of alcohol in one go, without knowing, that’s presuming the substance was Cocaine!
That’s why throughout this guide, two principles come up over and over again:
- Test it, don’t guess it.
- Start low and go slow.
If someone chooses to experiment, this is how they observe the effect of a small dose before taking more. It’s the best way to:
- Reduce the chance of overshooting the inverted U.
- Maintain some level of awareness and control, especially when managing T1D.
- Avoid combining substances that push the U-curve even further out of reach.
Remember: There is no universal safe dose.
No “just take this much.”
Because the U-curve is unique to everybody, every moment, and every mix of context.
This guide use neutral language, not slang, and always frame substance use through:
- Neurochemical effects (e.g., serotonin, dopamine, GABA)
- Behavioural changes (e.g., energy, inhibition, hunger)
- Perceptual shifts (e.g., visuals, altered time, ego loss)
When it comes to non-regulated substances, the people contributing to this guide emphasise, Test it, don’t guess it:
- Obtaining the substance ahead of time, not buying on the night.
- Using a reagent home test kit to verify content (e.g., MDMA, LSD, ketamine).
- Scales to weigh out the amount.
- Starting with a tiny dose, even smaller than “normal.”
- Never doing it alone, especially with T1D.
- Wearing a medical ID, keeping glucose visible, and sharing CGM data when possible.
- Carrying hypo treatments (glucose tabs, gels, Lucozade, sweets).
If someone does choose to use a substance, this mindset helps reduce the risk of panic, harm, or life-threatening situations, for themselves and for others around them.
One more time, this guide is:
- Not promoting substance use
- Not a how-to
- Not a legal guide
- And absolutely not a substitute for clinical or medical advice
It is a resource built from the reflections and experiences of people with T1D who’ve lived these realities, and want to offer others the chance to learn from what they’ve seen, felt, and learned.
Every person is wired differently, both psychologically and physiologically. What might feel like a magical, expansive experience for one person could be destabilising, overwhelming, or even dangerous for another. One person’s elixir can be another’s poison.
Some people have a natural “off switch”, an intuitive sense of when enough is enough. Others find it harder to stop, especially if the substance is tapping into deeper patterns of seeking, escape, or dysregulation. There are real, biological differences in how people respond to dopamine, serotonin, GABA, and other neurochemicals. Some brains are simply more prone to habit loops and compulsion. Some bodies carry trauma that alters how safe a high can feel. And some people, through genetics, history, or circumstance, carry a higher baseline risk for harm.
As you move through each section, keep the inverted U-curve, test it don’t guess it and start low/go slow. Here are the different categories