Signs of a Drug Overdose (and What to Do When It Happens to Someone)

Michelle Rosenker

November 19, 2019

Drug overdoses accounted for more than 72,000 deaths in 2017 across the United States. More than half (68% to be exact) were caused by opioids such as heroin, fentanyl, and oxycodone. In places like West Virginia, Ohio, and Kentucky, drug overdoses are occurring at a record pace. 

The disease of addiction is extremely complex and often difficult to manage without professional help. Unfortunately, many people addicted to drugs like opioids, cocaine, meth, and benzodiazepines end up overdosing because of their compulsive substance abuse. People can survive an overdose, but usually experience some form of physical or psychological repercussions as a result. However, thousands of people do not live to tell their stories. 

Signs of a Drug Overdose

Drug addiction has become so pervasive in American society that one-third of all Americans know someone who has either died from, is in recovery from or is currently experiencing drug addiction. With millions of people abusing drugs more than ever before, it is not out of the realm of possibility to encounter someone who is overdosing. The person you find overdosing might be a friend, family member, or even a complete stranger that you see in town. Knowing what the signs of drug overdose are can put you in a position to save a life should it be necessary. 

Many signs associated with drug overdose can vary based on the type of drug that a person is abusing and each person has his or her own body chemistry that affects how drugs impact them. However, there are several baseline signs that denote any kind of drug overdose is occurring. They include the following:

  • Dilated pupils
  • Problems breathing
  • Nausea
  • Vomiting
  • Dizziness 
  • Confusion
  • Seizures
  • Increased body temperature
  • Abnormal pulse (either high or low)
  • Unconsciousness
  • Chest pain
  • Abdominal pain
  • Diarrhea
  • Bluish tint around lips or fingertips
  • Excessive sleepiness

Specific symptoms of a drug overdose can turn deadly, too. A common example of this is vomiting. People who are overdosing on drugs and who vomit can aspirate or choke and die as a result. Another example is when a person experiences a fatal fall during a drug-induced seizure. 

How Long Until Signs of a Drug Overdose Occur?

There is no set period of time that it takes for drug overdose symptoms to develop. Some of the factors that can help determine this include the following:

  • What type of drug is being abused? Certain drugs are more potent than others, meaning that it takes smaller amounts for someone to overdose. For example, two milligrams is the lethal amount of fentanyl (one teaspoon is 5 milligrams). Someone who uses fentanyl is more likely to start displaying symptoms of overdose quicker than someone who took one hit off a crack pipe or took a Xanax. 
  • Is the drug user tolerant to the drug? Someone who is tolerant to a drug is accustomed to consuming a specific amount on a regular basis. Because of this tolerance, it takes more of that substance to produce symptoms of overdose. So, you might not see someone who is a regular meth abuser experience overdose symptoms as easily as you would someone who has never abused this drug before.
  • Is there more than one drug being abused simultaneously? When drugs are mixed, the risk of overdose increases. The faster the use of more than one drug at a time, the quicker signs of an overdose will develop.

It cannot be stressed enough that each and every drug user is unique in his or her own way. It should never be assumed that someone who is a long-time user of a drug isn’t going to show any symptoms of an overdose even if he or she is using a lot at one time. It also should not be assumed that someone who has never used drugs before will not overdose on his or her first go around. Overdose can happen at any time to anyone, regardless of their history with drugs. The factors listed above help explain common risk factors that lend themselves to producing signs of overdose.

drug overdose

What to Do When Someone is Overdosing

There is a stereotype of what a drug overdose looks like. Many people think that someone who is overdosing on drugs is unconscious, unable to move, or experiencing a severe physical issue like a seizure. And while that is descriptive of several overdoses, it does not always look like that. Someone could be overdosing on drugs but still be able to walk, talk, and breathe. The most important thing you can do to be ready for what to do when someone is overdosing is to know what the signs of overdose are (see above). When you see that someone is overdosing, it is critical to get them the appropriate help.

If you suspect someone is overdosing, call 911 immediately. Studies show that the most common reason why people do not call 911 when someone is overdosing is out of fear that they will get in trouble with the police. Good Samaritan laws (which are in effect in all 50 states) protect people who call in overdoses from suffering criminal charges. While each state has different specifics to that law, the goal of implementing it is to remove the fear of getting into trouble so that those who are able to call in an overdose actually do so. Therefore, no matter what the situation is, if you are with someone who is overdosing, call 911 as quickly as possible. 

Depending on what symptoms the individual is experiencing, your next steps will likely include performing rescue breathing and/or CPR while you wait for emergency medical personnel to arrive. If the individual is overdosing on opioids and you or someone else at the scene have Narcan, administer it right away. If the person does not begin breathing again and you do not have another dose of Narcan, begin CPR until help arrives. 

Narcan: What is it?

Narcan, which is also known by the generic name naloxone, is a full opioid antagonist. This means that when it is administered, it stops the effects of opioids in the body by binding to and blocking opioid receptors in the brain. When successful, this effect restores a person’s breathing, heart rate, and other vital signs that might have been lost due to the overdose. 

How to Administer Narcan Nasal Spray

The most popular form of Narcan comes in an intranasal spray. If you are in a position to administer Narcan in the hopes of reversing an overdose, it is important that you know how to do it. 

Narcan comes in a package that requires you to peel the back of it off in order to open it. Once you open it, you will see the spray, which is comparable in appearance to other nasal sprays like Nasacort or Xyzal. DO NOT test the spray. There is only one dose. From there, do the following:

  • Tilt the individual’s head back and support the back of their neck with your hand 
  • Hold the spray by putting your thumb on the bottom and your two fingers on the nozzle
  • Place the tip of the nozzle into either nostril until your fingers are touching the bottom of the individual’s nose
  • Push the spray (or “plunger”) firmly to release the dose of Narcan into the nose
  • Remove the nozzle from the individual’s nose

Once Narcan has been administered, complete the following steps:

  • Place the individual on his or her side to prevent choking or aspiration
  • Wait 2-3 minutes to see if the dose has worked (if effective, the person will wake up or there will be an improvement in his or her breathing)
  • If after 2-3 minutes there is no change, administer a second dose of Narcan (follow the same steps as above BUT administer the second dose in the opposite nostril as the first)
  • Continue to administer Narcan every 2-3 minutes if there is no improvement in the person’s condition

In between doses of Narcan, be sure to place the individual on his or her side. And remember, prior to administering Narcan, call 911 for help. Narcan is NOT a substitute for emergency medical care. 

What Happens After Administering Narcan?

Typically, someone who was administered Narcan is brought to a local emergency room. Once admitted to the emergency room, overdose patients are usually seen as quickly as possible to help determine their stability. If the patient is awake and able to make decisions for him/herself, he or she can leave at any time. The law states that overdose patients must be monitored for one hour before being able to be discharged. However, most emergency room staff will not discharge an opioid overdose patient that quickly, as they will want to spend time running vitals and ensuring that the patient is physically stable. 

narcan and naloxone dispensing pharmacy

Narcan Side Effects

Narcan can do amazing things in regards to opioid overdose, but its use does not come without effects. 

The most common side effects associated with Narcan include the following:

  • Swelling and/or dryness in the nose 
  • Congested or runny nose
  • High blood pressure
  • Increased heart rate
  • Nausea
  • Vomiting
  • Diarrhea
  • Abdominal pain
  • Excessive yawning
  • Chills and sweats
  • Tremors
  • Fever
  • Weakness
  • Seizures
  • Muscle spasms
  • Dizziness
  • Headache
  • Aggressive behavior
  • Restlessness
  • Irritability

The majority of Narcan’s side effects are the exact same as opioid withdrawal symptoms. That is because Narcan throws the body right into full-on withdrawal. So, after a person has been administered Narcan, being hospitalized can be beneficial in order to tend to some of the more pressing symptoms of this life-saving drug. 

Unfortunately, opioid addiction is an insidious disease, therefore it is not uncommon for those hooked on this type of drug to leave the hospital and go right back to using. This is extremely dangerous because Narcan only remains active in the system for about one hour. Other opioids like heroin and prescription opioids often remain active for up to 12 hours.  This is why hospitals have to monitor a patient for at least one hour because there is a possibility that when the Narcan wears off, he or she may need another dose. Since the opioids that the individual overdosed on are still active, abusing more can make it much easier to overdose again. Many overdose patients leave the hospital and return shortly thereafter because of this. 

Cost of Narcan

The brand name medication Narcan is fairly expensive in comparison to many other brand name drugs. It is usually priced between $130-$140 for a kit containing two doses. However, the generic of Narcan, naloxone, is available at a much lower price. Each dose can cost anywhere between $10-$20, making it much more cost-effective for those who need it most. 

How You Can Get Narcan for Free

Most major insurance plans cover the cost of Narcan, so if you have insurance, there is a chance that you do not need to pay for it. Because the opioid crisis has reached epidemic proportions, countless communities throughout the United States have distribution centers that hand out Narcan for free or hold events where the public can get theirs. Simply conducting an online search for free Narcan in your state can connect you to the places where you can obtain this medication at no cost.

If You Are Addicted to Opioids, Now is the Time to Get Help.

Between 1999 and 2017, overdose deaths involving opioids increased six times. The opioid epidemic is broken down in waves. The first wave of opioid overdose deaths occurred in the late 1990s after opioid-based medications started being prescribed at a high rate. Around 2010, the second wave hit. Heroin was now a part of countless opioid overdoses. Just a mere three years later, the third wave hit in 2013 when fentanyl hit the scene. 

Today, 130 people will die from opioid overdose. Tomorrow, another 130 will die. By the time 2019 comes to a close, more than 47,000 people will have lost their lives to opioids like heroin, fentanyl, oxycodone, and hydrocodone. You do not need to be one of those people. 

Addiction is a treatable disease. With the proper diagnosis and therapeutic care, you can stop your active drug addiction and begin living a life free of substance abuse for good. Do not wait a minute longer. Call us right now to get the help you deserve.