When is online counseling not enough and local help is needed?

Online counseling is enough for many concerns, but not for every situation. If you are in acute danger, or someone in your surroundings is acutely threatened, a reply by message is too slow. Then you need a service that can act immediately, that is, the emergency number 112 or a counseling service locally.

When a message is too slow

DigiSucht states that replies usually come within a few working days. At mindzone, requests should be answered within two working days where possible. That suits everyday questions, but it is too late for a crisis, because you need help now.

With appointments by video or chat, everything depends on the counselor's availability. If you need an appointment today, you cannot rely on hoping for a free slot.

Warning signs that mean you should not wait

There are situations in which you should act immediately. These include thoughts of harming yourself, or the suspicion that someone in your surroundings is putting themselves at risk. If someone hardly seems able to respond, call the emergency number straight away.

According to the BIÖG, people who use cannabis develop psychosis more often than people who do not. The link is statistical and does not prove that cannabis causes psychosis. Anyone who shows delusions, strong fear of being persecuted or a loss of contact with reality after using needs medical help quickly. This means calling the emergency number 112 or going to an emergency department.

What a local counseling service can do

A local counseling service can support you in person and arrange appointments that go beyond the screen. The platform DigiSucht explicitly recommends contacting the counseling service directly for urgent concerns.

You can find suitable services through the DHS addiction help directory. There you can search by postal code or town and filter for services that offer support on cannabis. An overview of the search is in the article Where do I find an addiction counseling service for cannabis?

The Sucht & Drogen Hotline as a bridge

If you cannot find a suitable service, DigiSucht names the Sucht & Drogen Hotline at 01806 313031. It is one way to reach a service quickly when searching online does not help. In an acute danger, however, the emergency number 112 takes priority.

Prevention: take warning signs seriously early

With ongoing use, psychological dependence can develop. According to the BIÖG, roughly one in eight people who use cannabis becomes dependent. If you notice changes in yourself or in someone close to you, do not wait for a crisis, and seek counseling early. A conversation in person can be the right next step.

An overview of signs of dependence is in the article How do I recognize cannabis dependence?

Terms: crisis, emergency and psychosis

• Crisis is a situation in which you can no longer cope well with daily life and decisions. It needs prompt support, though not every crisis is an emergency.
• Emergency means an acute danger to life and limb. In that case, call the emergency number 112 straight away.
• Psychosis is a state in which the perception of reality is markedly distorted, for example through delusions or voices that no one else hears.

What to write to the counselor in the first sentences

First say that it is urgent. In two or three sentences, describe what is happening right now and whether you feel safe at the moment. If you cannot log in or no reply comes, call the counseling service directly. In a danger to life and limb, do not wait for a message.

Help for relatives in a crisis

If someone in your surroundings shows warning signs, stay calm and speak to the person directly. Ask what is going on, and listen without judging. Do not leave the person alone if they are putting themselves at risk. In an acute danger, call the emergency number 112.

Relatives can also seek counseling. The offer anonymous counseling for relatives is aimed exactly at this situation.

Common misconceptions about cannabis and psychosis

• “Anyone who only uses occasionally is safe from it.” According to the BIÖG, the harm from cannabis depends on age and on how often it is used. For someone with an inborn tendency towards psychosis, even small amounts may be enough.
• “I will notice when things tip over.” During a psychosis, a person's own judgment can be impaired. That is why the view of other people matters.
• “Calling the emergency number is an overreaction.” When in doubt, a call is the right step. The service at the other end decides what happens next.

What helps after a crisis

After an emergency, it is worth writing down your use, sleep and mood in the days before. This helps the counselor recognize patterns. Ask there which offers suit the time afterwards, such as individual sessions, group offers or medical support. If you return to online counseling after a crisis, bring the results from the acute phase with you.

Having contacts ready in advance

While you wait for a reply, it is worth noting the most important contacts now. These include the emergency number 112, the telephone number of a local counseling service and the name of a person who can help you nearby. That way you do not have to search for them in a crisis.

Steps to begin with

Even when you are looking for help, you do not have to know the whole solution straight away. A counselor accompanies you step by step. For that reason, write down the problem and, in addition, the next small steps you can take, such as a phone call, an appointment or a conversation with a trusted person.

What you can do now

• In case of acute danger to yourself or others, call the emergency number 112.
• For urgent, non-acute concerns, call or visit a counseling service directly.
• If no service fits, use the Sucht & Drogen Hotline on 01806 313031.
• After a first crisis, use online counseling again to plan the next steps. The article Is there video counseling for addiction problems? shows how a video call works.