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A drug overdose occurs when a person uses a toxic amount of a drug that their body cannot handle properly. This can lead to life-threatening consequences, including hypoxia, coma, and death. A drug overdose is a medical emergency and requires immediate medical attention. If you think you or someone else has experienced an overdose, call 911 immediately.
In this article:
- What is a Drug Overdose?
- Signs of a Drug Overdose
- Who is at Risk of a Drug Overdose?
- What to Do if You Suspect an Overdose
- The Good Samaritan Law: Overdose Prevention
- Transitioning into Addiction Treatment
What is a Drug Overdose?
A drug overdose occurs when a person takes too much of a drug, interfering with the brain and body’s ability to function. A drug overdose is a medical emergency and can have potentially fatal consequences.1 And in cases of non-fatal overdose, the person may still experience harmful short-term and long-term effects.
Symptoms of a drug overdose vary between substances and it can sometimes be difficult to tell the difference between typical side effects of a substance and the signs of an overdose.
Many different drugs can cause an overdose, including:
- Alcohol (also known as alcohol poisoning)
- Opioids like heroin, fentanyl, prescription painkillers
- Sedatives like benzodiazepines and barbiturates
- Stimulants, such as cocaine, methamphetamine, and amphetamines
Signs of a Drug Overdose
The signs and symptoms of a drug overdose vary from substance to substance, but for many substances, such as alcohol, sedatives, and opioids, an overdose is most clearly indicated by slowed or stopped breathing. This is because they are central nervous system (CNS) depressants, which slow down brain activity. Taking a toxic dose of a CNS depressant is what leads to stopped breathing, coma, and death.
A stimulant overdose occurs when a stimulant drug causes toxic effects that overwhelm the body’s ability to function normally. Moreover, cocaine use is linked with an increased risk of sudden death, even in people as young as 19 years old.2
Opioids
Signs and symptoms of opioid overdose include:3
- Bluish lips and fingertips
- Pale face
- Limp body
- Unresponsiveness
- Slow, irregular, or stopped breathing
- Vomiting
- Choking or gurgling sounds
- Loss of consciousness
Between 64% and 97% of people who use opioids report that they’ve witnessed an overdose.3
Alcohol
Signs and symptoms of an alcohol overdose include:4
- Stupor
- Mental confusion
- Difficulty maintaining consciousness
- Vomiting
- Clammy skin
- Slow breathing
- Seizures
- Slow heart rate
- Bluish skin color
- Dangerously low body temperature
- No gag reflex
Sedatives
Sedatives include benzodiazepines like Xanax, Ativan, and Klonopin, and barbiturates like phenobarbital.
Signs and symptoms of a sedative overdose may include:5,6
- Confusion
- Labored breathing or stopped breathing
- Extremely impaired mental status
- Slurred speech
- Coma
Stimulants
Signs and symptoms of a stimulant overdose include:7
- Aggression
- Tremors
- Restlessness
- Rapid breathing
- Confusion
- Fever
- Hallucinations
- Dangerously high body temperature
- Heart attack
- Seizure
- Vomiting
- Coma
Who is at Risk of a Drug Overdose?
Risk factors increase the likelihood that someone may experience a drug overdose. These risk factors include:8,9
- Having a previous non-fatal overdose
- Having certain chronic health conditions, such as heart disease or lung disease
- Mixing stimulants and opioids
- Mixing opioid and alcohol or sedatives
- Not knowing the purity of illegal drugs, which could be cut with deadly opioids like fentanyl
- Reduced tolerance from not using drugs for a while
- Social deprivation
- Using substance alone
- Using drugs intravenously
Tolerance is one of the harder risk factors to gauge, and it helps to understand how cross tolerance between drugs works.
What to Do if You Suspect an Overdose
If someone is unresponsive or has abnormal, slow or stopped breathing, call 911 immediately. If an opioid overdose is possible, administer naloxone if it is available. Stay with the person and support their breathing until help arrives.
When you call 911, provide as much information as possible to the operator. Saving a short list of emergency phone numbers on your phone ahead of time makes that call easier. It is vital to have medical professionals on the scene to treat the person overdosing.
Recovery Position
If the person is breathing but is unconscious or cannot stay awake, place them in the recovery position This involves rolling them onto their side, supporting their body with a bent knee, and turning their face to the side. This will help to prevent them from choking.10
Perform Rescue Breathing or CPR
When someone has experienced a drug overdose, the greatest risk is a lack of oxygen. If the person is not breathing normally, provide rescue breathing if you are trained to do so. If the person is not breathing and also has no pulse, begin CPR if you are trained to do so. Follow the instructions given by the 911 dispatcher and continue until the person begins breathing normally or emergency responders take over.
Administer Naloxone (Narcan) if Available
If you think a person has overdosed on an opioid, you can administer naloxone (Narcan), a life-saving medication that rapidly reverses the life-threatening effects of an opioid overdose and temporarily restores breathing. Narcan is not meant to be a replacement for professional medical care—rather, it is intended to buy a person time while waiting for first responders to arrive.
Narcan is an easy-to-use nasal spray formulation that you can administer by:3
- Holding the device with your thumb on the bottom of the plunger
- Inserting the nozzle into either nostril
- Pressing the plunger firmly
If two to three minutes have passed and the person hasn’t begun breathing and first responders have not arrived, then administer a second dose of Narcan. If available, continue to give doses every two to three minutes until the person wakes up or first responders arrive.
The Good Samaritan Law: Overdose Prevention
Many fatal overdoses across the country could have been prevented if an onlooker had called 911 to get the person emergency medical care. But many people don’t call out of fear of legal repercussions related to drug possession.
Most states have laws that provide some legal protections to people who call for emergency help during an overdose. The protections vary by state and may cover certain drug possession or related offenses while excluding other offenses.
Transitioning into Addiction Treatment
The best overdose prevention is seeking out substance abuse treatment where you can learn the recovery skills you need to obtain and maintain sobriety in the long run. Treatment typically involves a combination of treatment modalities, such as:
- Individual therapy
- Group counseling
- Family therapy
- Support groups
- Addiction treatment medications, if applicable
Inpatient rehab may be beneficial for those with a severe addiction, dual diagnosis, or polysubstance addiction due to the 24/7 care and treatment. Outpatient rehab is the more flexible choice for those who want to continue meeting other responsibilities while in recovery.
And if you or someone you know has experienced a drug overdose, this may indicate the presence of a substance addiction. At the hospital, the medical team can refer you to an addiction treatment program once you’ve been stabilized.
If you are looking for a quality rehab, call our helpline at
800-914-7089
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Resources
1. U.S. National Library of Medicine. (2021). Overdose.
2. Benito Morentin, Javier Ballesteros, Luis F. Callado, J. Javier Meana. (2014). Recent cocaine use is a significant risk factor for sudden cardiovascular death in 15-49-year-old subjects: a forensic case-control study. Addiction 109 (12): 2071 DOI: 10.1111/add.12691
3. American Psychological Association. (2018). Recognizing and Responding to Opioid Overdose.
4. National Institute on Alcohol Abuse and Alcoholism. (2021, May). Understanding the dangers of alcohol overdose.
5. Centers for Disease Control and Prevention. (2021, August 20). A day to remember: international overdose awareness day.
6. Kang, M., Galuska, M.A., & Ghassemzadeh, S. (2021). Benzodiazepine toxicity. Treasure Island, FL: StatPearls Publishing.
7. National Institute on Drug Abuse. (2018, June). Prescription stimulants DrugFacts.
8. Commonwealth of Massachusetts. (2022). Opioid overdose risk factors.
9. Doggui, R., Adib, K., & Baldacchino, A. (2021). Understanding fatal and non-fatal drug overdose risk factors: Overdose risk questionnaire pilot study—validation. Frontiers in pharmacology, 12.
10. Overdose Prevention and Education Network. (2022). Responding to an Overdose.
