How to Recognize Drug Overdose Symptoms
Drug abuse always carries the risk of serious side effects, including overdose. Whether you abuse alcohol, an illegal drug such as cocaine, or medications prescribed by a doctor—such as opioid painkillers—addiction development will always be a concern. And in many cases, if substance abuse behavior persists, there remains a real possibility of a drug overdose.
Any drug overdose can be either accidental or intentional. Accidental overdoses tend to happen when people take more of a prescription medication than originally intended to achieve certain results, or when they use too much of an illegal drug trying to get a better high. Intentional overdoses are usually a result of someone trying to commit suicide. Regardless of the intent, any loss of life due to an overdose is tragic and any overdose can have severe and lasting repercussions.
If substance abuse behavior persists, there remains a real possibility of overdose.
According to the National Institute on Drug Abuse, the total number of deaths due to drug overdose rose more than twofold from 2002 to 2015.1 Furthermore, according to a 2016 report from the Centers for Disease Control and Prevention (CDC), the number of opioid-related deaths has increased by 200% since 2000.2 The numbers underscore, perhaps today more than ever, the importance of recognizing the signs and symptoms of a drug overdose so you can get the help you or a loved one needs—and possibly save a life.
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Signs and Symptoms of Drug Overdose
The physical and psychological signs of a drug overdose can vary depending on the type of drug taken, and whether the drug was taken in combination with other substances.
Common signs and symptoms of a drug overdose can include:3,4
- Dilated pupils.
- Unsteady walking.
- Chest pain.
- Severe difficulty breathing, shallow breathing, or complete cessation of breath.
- Gurgling sounds that indicate the person’s airway is blocked.
- Blue lips or fingers.
- Nausea or vomiting.
- Abnormally high body temperature.
- Violent or aggressive behavior.
- Disorientation or confusion.
- Convulsions or tremors.
A person may not exhibit all or even most of these signs, but even a few of these symptoms can indicate a person is experiencing an overdose.
Overdose Risk Factors
If you abuse any substance, there is always a risk of overdosing. However, certain actions and conditions may further increase that risk, including:4,5,6
- Significant physiologic dependence on the drug.
- Prior overdose(s).
- Abusing multiple substances, including alcohol.
- Taking a large amount of the substance at once.
- Dropping out of substance abuse treatment.
- Gradually increasing the dose of the substance over time.
- A reluctance to seek emergency help when needed.
- Intravenous drug use.
- Being recently released from prison.
- Previous suicide attempts.
- Resuming drug use after a period of abstinence.
- Low level of physical tolerance.
Tolerance refers to the state that occurs when your body has become accustomed to the presence of the drug, so it requires increased amounts or more frequent doses of the drug to achieve the kind of high you previously got with a smaller dose. If you continue to increase your dose or take the drug more frequently, you may have a higher risk of overdosing.
Tolerance may also influence overdose risk in another way. For instance, people with a history of chronic or heavy substance abuse may develop considerable tolerance to the effects of a drug, allowing them to take more than someone who is “drug naïve,” or has less of a history with the substance. Following attempts to quit the drug, or any period of abstinence, tolerance may abate in the drug-free interim. Should that person suddenly return to using the drug, especially in doses that they may have once been accustomed to, overdose may be more likely.
What to Do If You Overdose on Drugs?
If you or a loved one has potentially overdosed on drugs, seek immediate medical attention by calling 911 to receive emergency help right away. You might also implement a few of the following procedures while waiting for medical personnel to arrive. However, be sure to avoid putting your own safety at risk since certain drugs can prompt violent or unpredictable behavior in the person taking them.
- Check the person’s breathing and heart rate.
- If the person is unconscious, try to get a response. Ask the person questions to assess their level of alertness and to calmly keep them engaged, if possible.3
- If the person is not breathing, turn them on their side.3
- If you are medically qualified to do so, provide CPR if necessary.4
- Give first aid as directed by 911 operators.3
- Do not allow the person to take any more of the substance.
- Obtain as much information as possible, including the dose and the last time the person took the drug.
- If prescription medications or otherwise labeled substances have been used, take the container with you to the ER, even if it is empty.
- Make note of any identifying paraphernalia, or bring along any containers of other drugs or substances the person may have taken.
- Do not try to reason with the person or give your opinions about the situation.
- Stay as calm as possible while waiting for medical personnel arrive.
- Assure the person that help is coming.
Preventing Drug Overdose
Of course, not using drugs is the most advisable way to prevent an overdose. But if you, or someone you care about, is already suffering from an addiction or demonstrating problematic substance use behavior, taking certain steps can help decrease the likelihood of overdose, including:7,8
- Increasing your awareness of overdose signs and risks.
- Knowing the drug and dose of the drug you are taking.
- Avoiding multiple substance use (e.g., do not drink alcohol if you are using any drug).
- Starting with a low dose if you haven’t used in a while.
- Using in the presence of another person, if you must use. If you do overdose, the person can seek help.
- Seeking substance abuse treatment if you think you have an addiction.
Treatment for substance abuse and addiction issues can help prevent an overdose, as well as help you start on the path to clean and sober living. Some of the treatment options you might consider include:
- Detox. You can enroll in either an inpatient or outpatient detox program for help and support in managing withdrawal and reducing cravings at this early stage of recovery. After the detox period ends, you’ll need to enter a formal recovery program to ensure your best chances of sobriety.
- Inpatient or Residential Treatment. You can select from many inpatient programs that last anywhere from a few weeks to several months. Inpatient treatment programs provide a highly structured environment with 24/7 care and support. You’ll participate in a wide range of treatments, including group therapy, individual counseling, drug testing, psychoeducational groups, and relapse prevention education classes.
- Luxury Treatment. For those who require the structure and support of an inpatient program but would prefer luxurious perks and amenities (such as gourmet meals, spa treatments, and private rooms) that can make your stay feel more like a resort stay, luxury treatment might be the way to go.
- Executive Treatment. Professionals in highly demanding careers may opt for executive treatment facilities, which provide similar care to luxury treatment centers but allow time for working and, in some cases, even traveling (for work purposes) if necessary.
- Partial Hospitalization. Many people transition from inpatient treatment to partial hospitalization, a type of highly structured and therapeutically intensive outpatient program. You live at home but attend treatment most days of the week for several hours per day. Some facilities offer weekend or evening treatment as well.
- Intensive Outpatient. This form of outpatient treatment mainly offers individual and group counseling services. You live at home but attend treatment between 10-12 hours per week. Services are often available throughout the day or evening, and even on weekends, in some cases.
- Standard Outpatient. You attend regularly scheduled group therapy and individual counseling sessions one or two days or evenings per week. This form of treatment may be beneficial for long-term maintenance of sobriety following completion of more intensive treatment programs, and may continue for years, if desired.
- Gender-Specific Treatment. Gender-specific treatment can be a beneficial recovery option for those who prefer to focus on treatment without the distraction of the opposite sex.
- Veteran Treatment. Addressing the unique psychosocial needs of those who have served in the armed forces, veteran treatment provides a range of services, including addiction treatment, vocational rehabilitation, and treatment for any co-occurring mental or physical health concerns.
- 12-Step Groups. Based on the 12 steps of recovery developed for and used by Alcoholics Anonymous, 12-step groups offer a structured path to recovery based on acknowledging a higher power and working through specific steps with the aid of a sponsor. People may attend 12-step groups as a supplement to other forms of treatment or to continue their recovery once they have successfully completed a treatment program.
The specific types of therapy you may receive can vary based on the substance you use. Generally speaking, though, the type of therapy you might receive includes:
- Cognitive-Behavioral Therapy (CBT). This form of therapy focuses on identifying and changing dysfunctional thoughts and behaviors that may have contributed to or perpetuated your substance abuse problem.
- Medication-Assisted Treatment (MAT). In certain cases, you may receive specific medications to help you wean off the drug. Additional pharmaceutical intervention may be helpful in addressing any co-occurring mental or physical ailments.
- Individual Counseling. You work one-on-one with a counselor to help address psychological and social issues that may underlie your addiction.
- Group Counseling. A counselor leads a group of others in recovery. You gain support and learn from others who have been in your shoes.
Drug Specific Overdose Information
- National Institute on Drug Abuse. (2017). Overdose Death Rates.
- Centers for Disease Control and Prevention. (2016). Morbidity and Mortality Weekly Report (MMWR): Increases in Drug and Opioid Overdose Deaths — United States, 2000–2014.
- National Council on Alcoholism and Drug Dependence. (2015). Drug Overdose: A Medical Emergency.
- U.S. National Library of Medicine: Medline Plus. (2016). Drug use first aid.
- Davoli, M., Perucci, C.A., Forastiere, F., Doyle, P., Rapiti, E., Zaccarelli, M. & Abeni, D.D. (1993). Risk Factors for Overdose Mortality: A Case-Control Study within a Cohort of Intravenous Drug Users. International Journal of Epidemiology, 22 (2), 273–277.
- Harm Reduction International. (2017). Risk Factors and Risk Environments.
- North Carolina Harm Reduction Coalition. (2017). Overdose.
- European Monitoring Centre for Drugs and Drug Addiction. (2016). Preventing overdose deaths in Europe.