Opioid Overdose: Recognize Signs, Act Fast, and Use Naloxone

Opioid Overdose is a life-threatening condition where opioids suppress the brain's breathing control center. This leads to dangerously slow or stopped breathing, causing oxygen deprivation. Without immediate action, brain damage or death can occur within minutes. According to the CDC, 187 Americans die from drug overdoses every day, with opioids involved in over 80% of those deaths. Knowing the opioid overdose signs is the first step in saving a life.

Key Signs to Watch For

When someone is overdosing, they may show several clear symptoms. The classic triad includes pinpoint pupils, unconsciousness, and slow breathing-but not all signs appear in every case. Here's what to look for:

• Unresponsiveness: The person won't wake up, even when shaken or shouted at. This is often the first sign people notice.
• Pinpoint pupils: Extremely small pupils that don't react to light. However, this isn't always present, especially with certain opioids or stimulant mixtures.
• Blue or purple lips/nails: Known as cyanosis, this happens when oxygen levels drop. Skin may also appear pale or ashen.
• Slow or shallow breathing: Fewer than 12 breaths per minute, or irregular gasping sounds. Sometimes called 'agonal breathing'-this is a sign of respiratory failure.
• Cold, clammy skin: Skin feels cool and sweaty, even if the person is in a warm environment.

Other possible signs include choking or gurgling noises, limp body posture, or confusion before losing consciousness. Remember, if you're unsure, act fast-delaying could cost a life.

Immediate Emergency Steps

Time is critical. The first thing you must do is call 911 immediately. Even if you plan to give naloxone, emergency responders need to know the situation. When you call, tell them exactly what you're seeing-like 'unresponsive person with slow breathing'-so they can prepare. Do not wait to see if the person wakes up on their own. Every minute counts.

Next, if Naloxone is available, administer it right away. Naloxone works quickly to reverse opioid effects, but it's not a substitute for medical care. The CDC emphasizes: 'Overdose deaths are preventable with prompt action.' Stay with the person until help arrives. Your presence can keep them safe while waiting for professionals.

How to Use Naloxone Correctly

Most naloxone today comes as an intranasal spray (like Narcan). Here's how to use it:

1. Remove the cap from the spray nozzle.
2. Place the nozzle in one nostril of the person.
3. Press the plunger firmly to deliver the full dose.
4. If needed, give a second dose in the other nostril after 2-3 minutes.

Naloxone typically starts working in 2-5 minutes. If the person doesn't respond, give another dose. Keep in mind that naloxone's effects wear off in 30-90 minutes. Opioids can stay in the system longer, so the person may need multiple doses. Always call 911-even if they wake up-because they could relapse into overdose later.

Importantly, naloxone is safe. It won't harm someone who hasn't taken opioids. If you're unsure, administer it anyway. As Canada's Health Department states: 'Administer naloxone even if you're in doubt.'

What Happens After Administering Naloxone

After giving naloxone, the person may wake up quickly. But this doesn't mean they're out of danger. Here's what to do next:

• Keep them awake and breathing. Talk to them gently to stay engaged.
• Monitor their breathing closely. If it slows again, prepare to give another naloxone dose.
• Stay with them until emergency responders arrive. They need medical evaluation even after revival.

Many people mistakenly think they're safe once revived. But opioids can re-enter the system after naloxone wears off. In fact, the CDC warns that 'naloxone can wear off before the person has completely recovered from their overdose.' That's why medical professionals must assess them. Also, check for injuries from falls or seizures during the overdose.

Preventing Future Overdoses

Surviving an overdose is just the start. Preventing future incidents requires ongoing support. Here are key strategies:

• Fentanyl test strips: These cheap strips can check if drugs contain fentanyl. Many illicit pills and powders are laced with fentanyl, which is 50x stronger than heroin. Using test strips reduces risk significantly.
• Medical treatment: Opioid use disorder (OUD) is a medical condition. Treatment options like medication-assisted therapy (MAT) with buprenorphine or methadone can help manage addiction safely.
• Harm reduction: Programs like needle exchanges and supervised consumption sites reduce overdose risks. They also connect people to treatment and support services.
• Open conversations: Talk to healthcare providers about pain management alternatives. Many overdoses start with prescription opioids. Discussing safer options early can prevent misuse.

Communities with naloxone distribution programs see 14% lower overdose death rates. Public health efforts like these save lives. The CDC's 2023 Overdose Prevention Strategy focuses on expanding access to naloxone, testing, and treatment. Every action matters.

Frequently Asked Questions