This article is intended for informational purposes only and should not be used as a substitute for professional medical advice or emergency treatment. If you suspect an overdose, call emergency services at 911 immediately.

The opioid crisis has become a major public health emergency, with overdoses involving substances like heroin, fentanyl, and prescription painkillers contributing to thousands of deaths annually. Over 100,000 Americans die each year from drug overdose, and the vast majority of these are due to opiates. Recognizing the signs of an opioid overdose can be life-saving. This article provides an in-depth look at the symptoms of opioid overdose and what actions to take if you suspect someone is experiencing one.

If you or a loved one is currently using or abusing opioids, knowing these overdose symptoms and what to do if someone is experiencing a heroin overdose or fentanyl overdose can save a life.

What Are Opiates and Opioids?

Opiates are naturally occurring substances derived from the opium poppy, including morphine and codeine. Opioids, a broader category, include both natural opiates and synthetic or semi-synthetic drugs like heroin, fentanyl, and prescription medications such as oxycodone, hydrocodone, and methadone. These drugs interact with opioid receptors in the brain, producing pain relief and euphoria, but they also depress the central nervous system, which can lead to overdose.

Risk Factors for Overdose

Several factors can increase the risk of an opioid overdose:

• High Doses: Taking a large dose of opioids, whether intentionally or accidentally, increases the risk of overdose.
• Potent Substances: Drugs like fentanyl are significantly more potent than heroin or morphine, making them more likely to cause overdose even in small amounts.
• Combining Substances: Mixing opioids with other depressants such as alcohol or benzodiazepines can amplify their effects, increasing the risk of overdose.
• Tolerance Levels: Individuals who have developed tolerance may take higher doses, while those with reduced tolerance (e.g., after a period of abstinence) are at greater risk of overdose.
• Health Conditions: Pre-existing health issues, particularly respiratory or cardiovascular problems, can exacerbate the depressant effects of opioids.

Signs and Symptoms of Opioid Overdose

Opioid overdose affects the body’s respiratory and central nervous systems, leading to life-threatening symptoms. Recognizing these signs quickly is crucial for providing timely help. With the rise of fentanyl, it’s very likely that knowing how to recognize the signs of a fentanyl overdose could lead to you saving someone’s life.

Below are the most common signs of fentanyl overdose, but these are also the most common signs of opioid overdose of any type of opiate. It’s extremely important to memorize and recognize these signs.

1. Respiratory Depression

One of the most dangerous effects of opioid overdose is respiratory depression, where breathing slows down or stops entirely. Look for:

• Slow, Shallow Breathing: Breaths may become extremely slow, irregular, or shallow. The person may appear to be gasping for air or struggling to breathe.
• No Breathing: In severe cases, breathing may stop completely, leading to unconsciousness or death if not addressed promptly.

2. Unresponsiveness or Unconsciousness

• Extreme Drowsiness: The person may be in a state of “nodding off,” with difficulty staying awake or maintaining consciousness.
• Unresponsiveness: If you try to wake them and they do not respond to verbal or physical stimuli, it’s a critical sign. Shouting their name, shaking them gently, or performing a sternum rub (rubbing the knuckles on their chest) are common methods to check responsiveness.

3. Pinpoint Pupils

• Constricted Pupils: One of the telltale signs of opioid use, especially during an overdose, is pinpoint pupils that are very small and do not respond to light.

4. Cyanosis (Blue Skin)

• Bluish or Pale Skin: Oxygen deprivation can cause a blue or grayish tint to the skin, lips, and fingernails, particularly in light-skinned individuals. In darker-skinned individuals, you may notice a gray or ashen appearance.

5. Choking or Gurgling Sounds

• Gurgling or Rattling Noises: Sometimes called the “death rattle,” these noises occur when a person’s airway is partially blocked. It can sound like choking or snoring.

6. Cold or Clammy Skin

• Cool to the Touch: The person’s skin may feel cold or clammy, indicating poor circulation and the body shutting down.

7. Weak Pulse or Low Blood Pressure

• Slow or Erratic Pulse: A very slow, weak, or irregular pulse is a serious sign of an opioid overdose. Blood pressure may also drop dangerously low.

What to Do If You Suspect an Overdose

An opioid overdose is a medical emergency. Immediate action can save a life. Here’s what to do if you suspect someone is overdosing:

1. Call for Emergency Help: Dial emergency services (911 in the U.S.) immediately. Provide as much information as possible, including the suspected substance involved.
   
2. Administer Naloxone (Narcan): If available, administer naloxone, a medication that can rapidly reverse the effects of opioid overdose. It can be given via nasal spray or injection. Multiple doses may be necessary for potent opioids like fentanyl.
   
   Read our entire guide on How to Use Naloxone.
   
3. Perform Rescue Breathing or CPR: If the person is not breathing or has a weak pulse, begin rescue breathing or CPR if you are trained. Rescue breathing involves giving breaths every 5 seconds to provide oxygen.
   
4. Stay with the Person: Do not leave the person alone. Monitor their breathing and be prepared to perform additional naloxone doses if needed. Stay until emergency responders arrive.
   
5. Provide Details to Paramedics: When help arrives, provide information on what substances were taken if known, how much, and any other relevant medical history.

If you or a loved one frequently uses opiates, make sure to read our guide on How to Use Naloxone. Naloxone is a life saving drug that can reverse an overdose when someone is exhibiting the symptoms of an opiate overdose. It is a cheap and over the counter drug that will literally bring people back from the dead.

Prevention and Education

Preventing opioid overdoses involves a multi-faceted approach:

• Education: Educate individuals on the risks of opioid use, especially the dangers of mixing substances and the potency of drugs like fentanyl.
• Safe Prescribing Practices: Healthcare providers should follow guidelines for prescribing opioids and consider alternatives for pain management when possible.
• Access to Naloxone: Making naloxone more accessible to individuals at risk of overdose, their friends, and family members can significantly reduce fatal outcomes.
• Substance Use Treatment: Providing access to addiction treatment services, including medication-assisted treatment (MAT) and counseling, is essential for those struggling with opioid use disorder.

Conclusion

Recognizing the signs and symptoms of an opioid overdose can be the difference between life and death. By understanding what to look for and how to respond, individuals can take quick action to potentially save lives. As the opioid crisis continues to impact communities worldwide, education, awareness, and access to life-saving resources like naloxone are crucial components in combating this epidemic.

For further reading and resources, consider consulting sources like the Centers for Disease Control and Prevention (CDC) and the National Institute on Drug Abuse (NIDA). These organizations provide extensive information on opioid overdose prevention, treatment, and support.

This article is intended for informational purposes only and should not be used as a substitute for professional medical advice or emergency treatment. If you suspect an overdose, call emergency services at 911 immediately.