Opioid Overdose

What is Opioid Overdose?

Substance use disorders (SUDs) impact the lives of millions of Americans. More than 100,000 people died from drug overdoses from April 2020 to 2021, an increase of 28.5% from the prior year, according to a report by the Centers for Disease Control and Prevention (CDC).

An opioid overdose can occur when a person:

• Overdoses on an illicit opioid drug, such as heroin or morphine
• Overdoses on methadone
• Accidentally takes an extra dose
• Deliberately misuses a prescription opioid or opioid-based pain medication in way that was not as prescribed by their physician
• Mixes opioids with other prescriptions, alcohol, or over-the-counter medications. Overdoses can be fatal when mixing an opioid with anxiety treatment medications or derivatives of Benzodiazepine, such as Xanax or valium.
• Uses medication prescribed for someone else. Children are particularly vulnerable to accidental overdoses if they take medication not intended for them.

How to Prevent Opioid Overdose

Opioid overdose can occur even with prescription opioid pain relievers and medications used in treating SUD such as methadone and buprenorphine. In addition, individuals using naltrexone for MOUD have a reduced tolerance to opioids, and therefore, using the same, or even lower doses of opioids used in the past, can cause life-threating consequences.

Always follow the instructions you receive with your medication. Ask your practitioner or pharmacist if you have questions or are unsure of how to take your medication.

The following tips can help you or a loved one avoid opioid overdose:

• Take medicine as prescribed by your practitioner
• Do not take more medication or take it more often than instructed
• Never mix pain medicines with alcohol, sleeping pills, or illicit substances
• Never take anyone else medication
• Prevent children and pets from accidental ingestion by storing your medication out or reach. For more information, visit CDC’s Up and Away educational campaign.
• Dispose of unused medication safely. Talk to your MOUD practitioner for guidance, or for more information on the safe disposal of unused medications, visit FDA's disposal of unused medicines or DEA's drug disposal webpages.

How to Recognize Opioid Overdose

Opioid overdose is life-threatening and requires immediate emergency attention. Recognizing the signs of opioid overdose is essential to saving lives.

Call 911 immediately if a person exhibits ANY of the following symptoms:

• Their face is extremely pale and/or feels clammy to the touch
• Their body goes limp
• Their fingernails or lips have a purple or blue color
• They start vomiting or making gurgling noises
• They cannot be awakened or are unable to speak
• Their breathing or heartbeat slows or stops

How to Treat Opioid Overdose

Family members, caregivers, or the people who spend time with individuals using opioids need to know how to recognize the signs of an overdose and how to administer life-saving services until emergency medical help arrives. Individuals experiencing an opioid overdose will not be able to treat themselves. Naloxone was approved by the Food and Drug Administration (FDA) as the first over the counter medication to prevent opioid overdose. Check with your healthcare provider, pharmacy, community-based distribution programs, local public health organizations or the local health departments on how to obtain naloxone in your state.

If you suspect someone is experiencing an opioid overdose, take action immediately:

• Call 911
• Begin CPR if the person has stopped breathing or if breathing is very weak (best performed by someone who has training)
• Treat the person with naloxone or nalmefene to reverse opioid overdose (if available)

Publications and Resources

• SAMHSA's Overdose Prevention and Response Toolkit
• Opioid Overdose and Naloxone Manual at Harm Reduction Coalition
• Opioid Overdose Prevention at the New York State Department of Health Prescribe to Prevent: Prescribe Naloxone, Save a Life
• Homelessness Programs and Resources