How to Spot an Overdose?

Learn the Symptoms of Overdose to Save a Life

Why Is It Important To Spot An Overdose Quickly?

A Growing Problem

Drug overdose deaths in the United States have seen a steady increase so far this century. From 1999 to 2018, the number of drug overdose deaths increased four times.¹ Because of the rising frequency of drug overdoses, chances are you may encounter a person experiencing a drug overdose. But how will you know if this is the case? We’ll review the symptoms so you can spot an overdose and discuss what should be done to help in cases of an overdose.

Why Overdoses are Increasing

People take all kinds of substances for all sorts of reasons. Prescription drugs, over the counter medications, illegal street drugs, and even alcohol all affect the body. When too much of a substance is taken, the effects of that substance overwhelm bodily functions, causing an overdose. An overdose can result in serious, permanent medical problems or even death. The more quickly an overdose is spotted and action is taken, the more likely it is to survive and recover from the overdose without serious medical complications.

If action is not taken quickly when an overdose is suspected, the large amount of substance in the body will overwhelm the brain. Learning to spot and overdose is important because, if left untreated, brain damage may result. If the brain is severely compromised, it may stop sending signals to the lungs and heart. Breathing and heartbeat may stop, and death may occur.

How To Prevent An Overdose

The best way to prevent an overdose is to remove the risks that may lead to overdose.

Take medication according to a doctor’s prescription
Never mix medications with alcohol or illicit drugs
Reduce substance abuse in society because anyone who abuses drugs is at high risk for overdose
Use caution if injecting substances because injection increases the chance of an overdose.²

Let’s look at some signs and symptoms of overdose-related to specific substances and how to provide emergency assistance.

Opioid Overdose

Opioids act to slow down the body’s systems. When the effects are mild, they produce the “high” that frequently can result in addiction. If too much of an opioid is taken, the risk of overdose is relatively high. Opioids have many symptoms of overdose in common. You can spot and overdose by looking for these symptoms:³

Extreme drowsiness or loss of consciousness
Slow or shallow breathing
Pale or bluish skin that is cold to the touch
Limp body
Constricted or "pinpoint" pupils
Choking or gurglings sounds, often referred to as the "death rattle"

The three combined symptoms of pinpoint pupils, unconsciousness, and difficulty breathing are considered an opioid overdose’s most common symptoms. Here are some additional ways to spot an overdose of specific opioids:

Heroin Overdose

Sudden unresponsiveness is a key sign of overdose.

May fall asleep standing up or sitting in a chair
May appear to fall asleep while speaking
Head will droop or loll backward
If not unresponsive, the person may be incoherent with stumbling and slurred speech⁴

Hydrocodone Overdose

Often misused as a sleep aid, signs of a hydrocodone overdose include:

Extreme drowsiness or tiredness
Weakness
Nausea and vomiting
Dangerously low blood pressure and heart rate⁵

Percocet Overdose

This drug combines Oxycodone, an opioid, and acetaminophen. Overdose symptoms include:

Stomach pain and loss of appetite
Itching
Dark-colored urine
Jaundice (yellow color to the skin and eyes)⁶

Tramadol Overdose

This opioid is usually considered to have a lower risk for overdose than other opioids. Overdose can occur in some people, with short-lived seizures being a symptom.⁷

Reversing an Opioid Overdose

If you spot an overdose and think it is opioids, call 911 immediately to obtain emergency medical help. Do not try to treat the overdose alone at home. While waiting for help to arrive, do the following:⁸

Attempt to wake the person
If the person is partially awake, walk them around to keep them from losing consciousness
If they are lying down or unconscious, lay them on their side to facilitate breathing and prevent choking

Anyone with an opioid prescription may also have a prescription for Naloxone HCL, commonly known by the brand name Narcan®. This drug is used to temporarily reverse the effects of opioids in the event of an overdose. It does not replace emergency medical treatment, so the steps listed above should also be followed. If there is Naloxone, help administer it while waiting for emergency medical help. Naloxone should be strictly administered as prescribed.⁹

Stimulants Overdose

Stimulants speed up the body functions, hence the nickname “speed.” Stimulant drugs include cocaine, methamphetamine (crystal meth), MDMA (ecstasy), and most medications used to treat attention deficit hyperactivity disorder (ADHD), such as Adderall® or Ritalin®. The symptoms of a stimulant overdose include:¹⁰

Rapid heartbeat
Chest pains
Sweating
Severe headaches
Anxiety, agitation, or panic attacks
Hallucinations
Paranoia
Confusion
In and out of consciousness
Seizures
Jerking, rigid arms and legs
Fever

Look for these signs and symptoms to spot an overdose from using specific stimulants:

Adderall Overdose

This common ADHD medication is often misused by people wanting to get more work done. It is sometimes abused in a misguided effort to counteract the effects of opioids or alcohol. In addition to the above, signs of overdose may include:

Hyperactivity
Overactive reflexes
Nausea and vomiting
Diarrhea
Dilated pupils¹¹

Cocaine Overdose

Using cocaine when the weather is hot can increase susceptibility to overdose, also called cocaine intoxication. Symptoms can include:

Dehydration
Excitedness, talking in a rambling manner
Lightheadedness
Dilated pupils
Pale skin
Loss of urine control
High blood pressure¹²

Methamphetamine Overdose

Because the potency of meth varies from batch to batch, two doses that appear to be the same may be very different, leading to a possible overdose. The early symptoms of overdose on meth look very similar to meth high. Here’s how to tell the difference:

More intense “high” than usual
Rapid or irregular heartbeat
Changes in personality or level of alertness¹³

Over-Amping

A person who has overdosed on stimulants may experience over-amping, a term used when a stimulant overdose’s psychological effects all appear at once. This includes anxiety, paranoia, “crashing,” and confusion. Take these steps if over-amping occurs:

Stay with the person, remain calm, and encourage them to stop taking any substances
Move the person to a calm, quiet area
Keep them hydrated with water. Be careful not to over-hydrate
Place cool, wet cloths on the forehead, back of the neck, or armpits

If a stimulant overdose is suspected, call 911 immediately. Unlike an opioid overdose, Naloxone will not help a stimulant overdose. However, it will counteract any opioids that may have been combined with stimulants, so it may still be used. Other steps to take include:

Avoid giving the person water if they lose consciousness
In cases of a seizure, make space and clear room of furniture or objects that may hurt them. Do not restrain them or put anything in their mouth¹⁴

Benzodiazepine Overdose

Benzodiazepine medications are tranquilizers used to relieve anxiety, control seizures, treat insomnia, or relax painful muscles. They include brand name medications like Valium, Ativan, and Xanax. Overdosing on benzodiazepines alone rarely results in death. The primary symptoms used to spot an overdose of a benzodiazepine are:¹⁴

When very large doses are taken, difficulty breathing and coma can result, but the size of the dose that results in these symptoms depends on many factors. More often, benzodiazepine overdoses result from combining benzodiazepines with alcohol or other drugs.¹⁵

When an overdose occurs from a combination of drugs, primary attention should be paid to the overdose symptoms caused by alcohol or other drugs, as these symptoms may be more severe. Xanax (alprazolam) is the benzodiazepine most commonly involved in emergency room visits due to overdose, usually in combination with alcohol or opioids.

If too much Xanax or another benzodiazepine has been taken, emergency medical treatment should be received as soon as possible. It is essential to determine if the Xanax was taken by itself or in combination with other substances to treat the overdose. Any symptoms should be monitored until emergency medical help arrives. It is also important to find out if the overdose occurred accidentally or intentionally. Anyone who overdoses intentionally on benzodiazepines should receive mental health treatment to address suicidal thoughts.

Alcohol Poisoning

Alcohol poisoning happens when the body’s blood alcohol level reaches dangerous levels, leading to possible death. Alcohol is a sedative. As higher amounts of alcohol are consumed, the brain slows down body functions. Alcohol poisoning increases the risk of seizures. The common signs and symptoms of alcohol poisoning are:

Confusion, stupor
Difficulty waking up
Vomiting
Slowed breathing rate - less than 8 breaths per minute
Irregular breathing
Clammy skin
Dulled responses, including no or impaired gag reflex
Slow heart rate
Low body temperature
Pale skin or bluish skin color
Seizures

Who May Be at Risk of an Alcohol Overdose?

Anyone who quickly consumes too much alcohol is at risk of alcohol poisoning. One of the highest risk factors is binge drinking. Binge drinking is a drinking pattern that brings blood alcohol concentration (BAC) to .08 percent or higher.¹⁶

An average male who consumes five drinks in two hours likely qualifies as a binge drinker. A woman may only have to consume four drinks in two hours to qualify as binge drinking.¹⁶

Treatment Following an Overdose

Once there is no longer a risk of death or permanent damage, the overdose can be addressed. If the overdose resulted from addiction, a drug or alcohol treatment program could help. Some of the treatment methods used in this type of program include:

Detoxification

Also called detox, this process helps to remove substances from the body in a medically safe manner.

Medication-Assisted Treatment

Medications may be used to make the detox process more comfortable or to help curb drug cravings as recovery begins.

Behavioral Treatment

Counseling to teach how to change behaviors is usually provided, including cognitive behavior therapy, family counseling, and incentive programs.

Types of Treatment Programs

Treatment programs may be inpatient or outpatient:

Inpatient

During this type of program, you are admitted to a drug rehabilitation facility and stay there for the program’s duration. Inpatient programs are usually necessary for people with longer-term drug problems.

Outpatient

This type of drug treatment program occurs on a set schedule, but you stay in your own home when not at treatment. People who are discharged from inpatient programs usually attend outpatient programs for follow-up care.

Final Thoughts

An overdose is a severe medical condition that can lead to permanent damage or death if treatment is not initiated immediately. By knowing the symptoms to look for, this serious medical condition can be treated quickly, and permanent damage can be avoided. Ensure you know the overdose symptoms, and if anyone you know is living with drug addiction, encourage them to seek help immediately.