Opioids and Overdose

During an overdose, breathing can be dangerously slowed or stopped, causing brain damage or death. It’s important to act quickly.

Opioids act on a part of the brain that regulates breathing. So, when taken in high doses, opioids can cause someone to stop breathing or have dangerously slow breathing, causing death or brain damage.

Anyone who uses opioids can overdose. Overdose can take minutes or even hours to occur after taking opioids.

If you think someone may be overdosing, call 911. First Responders are equipped to administer naloxone (Narcan), which can reverse the symptoms of an overdose  if administered in time. Anyone can get naloxone to have on hand in case of an emergency. Naloxone can be obtained by following this link and taking a brief training.

It may be hard to tell if a person is high or experiencing an overdose. If you’re not sure, it’s best to treat it like an overdose–you can save a life.

• Call 911 immediately.
• Administer naloxone, if available.
• Try to keep the person awake and breathing.
• Lay the person on their side to prevent choking.
• Stay with them until emergency workers arrive.

If someone overdoses and is unconscious…Try waking them, yell their name, rub chest bone with your knuckles.

If they are not breathing or have very slow breathing:

• Start rescue breathing.
• Pinch nose, tilt head.
• 1 breath every 5 seconds
• Call 911 – say the person isn’t breathing.
• If you are alone, put the person in the Recover Position before calling 911.
• Use Narcan if you have it.
• Continue rescue breathing until help arrives. Tell paramedics what the person took, how much, and any information that could help save the victim’s life.

There were 4,669 EMS calls to probable drug overdose victims in the first six months of 2022. The Alabama 2022 Emergency Room visit drug overdose data accounted for 4,605 (or 33%) Opioid overdoses, 881 (or 6%) Stimulant overdoses and 8,456 (or 61%) of the reported drug overdoses were not specified.  An opioid overdose results in death when opioids interrupt the body’s drive to breathe.

Signs of an overdose include:

• Small, constricted “pinpoint pupils”
• Falling asleep or loss of consciousness
• Slow, shallow breathing
• Choking or gurgling sounds
• Limp body
• Pale, blue, or cold skin

A person experiencing an overdose can experience dangerously slowed breathing or stop breathing all together. This can cause brain damage or death; therefore, it is important to understand and quickly identify the signs of an overdose.

• Opioids sit on the brain receptors and decrease the ability to breathe.
• Overdose death can occur over time (several minutes to 3 hours)
• There is an opportunity to reverse the overdose, however, time is limited.

• DO support the person’s breathing by administering oxygen or performing rescue breathing
• DO administer naloxone
• DO put the person in the “recovery position” on the side, if he or she is breathing independently
• DO stay with the person and keep him/her warm
• DON’T slap or try to forcefully stimulate the person – it will only cause further injury. If you are unable to wake the person by shouting, rubbing your knuckles on the sternum (center of the chest or rib cage), or light pinching, he or she may be unconscious.
• DON’T put the person into a cold bath or shower. This increases the risk of falling, drowning or going into shock.
• DON’T inject the person with any substance (salt water, milk, “speed,” heroin, etc.). The only safe and appropriate treatment is naloxone.
• DON’T try to make the person vomit drugs that he or she may have swallowed. Choking or inhaling vomit into the lungs can cause a fatal injury.

Risk Factors of an Opioid Overdose:

• Having an opioid use disorder.
• Starting to use opioids again after not using.
• Tolerance falls in a few days.
• Using opioids at the same time with alcohol or sedating drugs like sleep aids and benzodiazepines (“benzos” like Valium and Xanax). Taken together, they can slow breathing even more.
• Taking prescription pain medicine more often or in higher doses than prescribed.
• Injecting opioids.
• ANY heroin use, due to its wide range or purity. Taking someone else’s pain medication.
• Using long-acting opioids (like methadone) or strong opioids (like fentanyl) when not monitored by a doctor or treatment program.
• Having certain medical conditions like liver, heart or lung disease, HIV, or mental health problems.
• If someone has overdosed before, they are more likely to overdose again.
• Older than 65 years old.

Signs of an Overdose:

• Small, constricted ‘pinpoint’ pupils
• Falling asleep or loss of cousciousness
• Slow, shallow breathing
• Choking or gurgling sounds
• Limp body
• Pale, blue, or cold skin

What to do if you think someone is overdosing:

It may be hard to tell if a person is high or experiencing an overdose. If you’re not sure, it’s best to treat it like an overdose–you can save a life.

• Call 911 immediately.
• Administer naloxone, if available.
• Try to keep the person awake and breathing.
• Lay the person on their side to prevent choking.
• Stay with them until emergency workers arrive.

If someone overdoses and is unconscious…

Try waking them, yell their name, rub chest bone with your knuckles.

If they are not breathing or have very slow breathing:

• Start rescue breathing.
• Pinch nose, tilt head.
• 1 breath every 5 seconds
• Call 911 – say the person isn’t breathing.
• If you are alone, put the person in the Recover Position before calling 911.
• Use Narcan if you have it.
• Continue rescue breathing until help arrives. Tell paramedics what the person took, how much, and any information that could help save the victim’s life.

So, you’ve overdosed… Now what?

In the next few hours…

• Stay with someone for at least 4 hours. They can call 911 if you pass out again, stop breathing, or have other health problems.
• Wait out the naloxone before you use again. If you’re “dope sick” after naloxone, wait to get well. With more opioids you can OD again when the naloxone wears off. See how you feel in 30 – 90 minutes (about 1 and a half hours).

In the next few days…

• Get a naloxone kit and tell others you have it. If you’ve OD’d once, you’re more likely to OD again. Find naloxone and learn more here.
• Talk to someone – To see or have an overdose can be upsetting. It can help to talk to someone you trust.
• Cut your chance of dying from overdose by 50% by taking the treatment medications methadone or buprenorphine under the care of a medical provider.