Opioid Overdose Symptoms & Signs

Opioid overdose is a serious concern in the U.S. and around the globe. According to the World Health Organization, there were around 600,000 deaths related to drug use in 2019; around 80% of these were opioid-related, and 25% of those deaths were directly caused by opioid overdose.¹ In the U.S., opioids were involved in 80,411 overdose deaths in 2021, which accounts for more than 75% of all drug-related deaths.²

Recognizing opioid overdose may help save someone’s life.³ Keep reading to learn about opioids, opioid overdose, factors that can increase the risk of overdose, signs and symptoms of opioid overdose, opioid overdose treatment, and how to find treatment for opioid addiction.

What are Opioids?

Opioids are drugs that people use illicitly to get high. Some are illegal, like heroin, and others are legal medications that doctors may prescribe to treat pain, such as painkillers like oxycodone and synthetic opioids like fentanyl, but are being misused.^4,5 People misuse opioids for a number of reasons but often because opioid intoxication can cause feelings of euphoria.¹

People misuse prescription opioid painkillers by swallowing prescription painkiller tablets, grinding up tablets and injecting them, or snorting the powder.⁵ People typically use heroin by smoking it, injecting it, or snorting it.⁵

Using opioids can come with a variety of short-term side effects like drowsiness, nausea, or constipation, but misuse adds additional or increased risk, including contracting infectious diseases (if injecting using shared needles), addiction, and an increased risk of overdose, which can be fatal.^1,5

Some of the most well-known opioids include:⁵

• Heroin.
• Codeine.
• Fentanyl (Actiq, Duragesic).
• Hydrocodone (Vicodin).
• Hydromorphone (Dilaudid).
• Methadone (Dolophine, Methadose).
• Morphine (Duramorph).
• Oxycodone (OxyContin, Percocet).
• Oxymorphone (Opana).

Opioid Overdose

Overdose means that a person has taken enough of a drug to cause life-threatening symptoms or death.⁶ Just being prescribed an opioid carries with it a risk of overdose, dependence, and addiction, but the risk is increased with nonmedical use, or misuse.¹ An opioid overdose is so dangerous because their pharmacological effects can cause breathing to slow or stop completely.¹

Opioid Overdose Symptoms

Opioid overdose symptoms can occur because of the effect of opioids on the part of the brain that controls breathing.¹

Signs of opioid overdose include:³

• Small, constricted pinpoint pupils.
• Losing consciousness or loss of awareness and responsiveness or seeming to fall asleep.
• Slow, shallow/weak, or no breathing.
• Choking or gurgling sounds.
• Limp body.
• Cold and/or clammy skin
• Bluish or purplish tint to the skin (often seen in the lips and under the nails).

Opioid Overdose Triad

The first three symptoms (pinpoint pupils, losing consciousness, respiratory depression) are commonly known as the opioid overdose triad, and if you recognize these symptoms, medical assistance is urgently needed.

Respiratory depression, which refers to slowed or stopped breathing, is one of the most dangerous consequences of the overdose triad because it can lead to hypoxia, or a lack of oxygen in the brain.⁶ This can cause coma, brain damage, and even death.⁶

Factors That Increase the Risk of Opioid Overdose

Overdose is preventable, and being aware of the different factors that can make an opioid overdose more likely may help you, or someone else, avoid an overdose.³

Some of these factors include:^1,3

• A history of overdose.
• A history of a substance use disorder (SUD), the clinical term for a diagnosis for addiction.
• Having sleep apnea or another condition that causes sleep-disordered breathing
• Taking high doses of opioids, or greater than 50 MME (milligram morphine equivalent).
• Using opioids by injection.
• Resuming opioid use after a period of abstinence which can result in decreased tolerance; this can occur to people who relapse, who are recently released from prison, or people who are on a tapering regimen and resume their previous doses.
• Using prescription opioids without a doctor’s approval or supervision.
• Using multiple opioids, or using other substances that can cause respiratory depression, such as benzodiazepines or alcohol, with an opioid.
• Suffering from kidney or liver failure.
• Being male.
• Having a low socioeconomic status.

Opioid Overdose Treatment

Opioid overdose is treatable and reversible provided that a person receives prompt administration of naloxone, also known as Narcan, and basic life support.¹ If you suspect that someone has overdosed, you should call 911 right away and then follow these steps:³

• Administer naloxone/Narcan.
• Keep the person awake and breathing.
• Lay them on their side to prevent choking.
• Stay with them until emergency workers arrive.

Naloxone, also branded as Narcan and Kloxxado, is an opioid overdose reversal medication that is available by prescription or over the counter in an easy-to-use, pre-dosed nasal spray.⁶ It reverses opioid overdose by binding to opioid receptors and blocking the effects of opioids, which may help a person resume breathing.⁶ Naloxone has a short duration of action, however, and there is a limited window of time in which naloxone remains effective, which is why it’s critical to both administer it right away and for a person to receive emergency medical attention, to ensure they continue to breathe.⁷

Preventing Opioid Overdose

One way to reduce the risk of opioid overdose is to get help to stop misusing opioids if you are finding it difficult to stop taking them .¹ Addiction treatment programs can make a huge difference by promoting recovery and minimizing the potential for future opioid overdoses.³ Treatment can help struggling opioid users uncover and begin to heal the underlying reasons for their addictions, while also building the skills to manage cravings and resist triggers for continued substance abuse.⁶

Opioid Addiction Treatment Programs

Opioid addiction treatment can involve different components. It often starts with medically supervised detox to help someone safely and comfortably undergo opioid withdrawal.^8,9 Although not typically life-threatening, opioid withdrawal can be extremely uncomfortable and may result in a person returning to opioid use. Medical supervision and medication that can be prescribed before or during withdrawal can minimize or reduce withdrawal symptoms, as well as reduce opioid craving, and reduce the risk of relapse or a return to opioid use.^6,8

After detox, people may transition to an inpatient program and/or some form of outpatient rehab.⁸

Different levels of care are available to suit different needs. This may include:^8,9

• Inpatient rehab, which means you live onsite at a rehab facility, receive round-the-clock care, and participate in different types of treatment and therapy.
• Intensive outpatient programs (IOP), which is a highly supportive form of outpatient care that is often used as a step-down when you complete inpatient treatment.
• Outpatient rehab, which means you live at home but travel to a facility on a set schedule to receive treatment and therapy. These programs can take place on a wide range of intensity levels.

Aftercare, which is also known as continuing care, are programs and services, such as individual counseling or self-help meetings, that take place after the inpatient or outpatient treatment has been completed. Aftercare helps support recovery and abstinence and can contribute to preventing relapse and a return to illicit opioid use.¹⁰

Find Opioid Addiction Rehab Near You

If you or a loved one are concerned about overdose or are struggling with opioid misuse or addiction, you should know that opioid addiction treatment is available. You can find opioid addiction rehabs near you and you can also use the insurance verification tool to learn about using insurance to help cover rehab cost.

If you are looking for treatment for substance abuse, call to connect with a compassionate admissions navigator today. Our professional and caring admissions navigators are here for you 24/7.