Drug Overdose

Overdose (sometimes referred to as OD) is a major public health issue. Learn how you can prevent harm and respond to an overdose.

An overdose happens when someone takes enough of a drug to cause a toxic or lethal reaction. You can overdose on almost any drug, whether it is prescription, over-the-counter, or an illicit substance.

From the years 1999-2017, about 700,000 people in the United States died from drug overdoses. Overdoses are a completely preventable cause of death and, as a society, we should take every reasonable step to help lower this number.

We can prevent overdose deaths with reliable and strong education efforts about substances of abuse, their effects on health, and addiction and dependence.

Drug overdose can be fatal. If you suspect someone is experiencing an overdose, call 911 immediately. Do NOT be afraid to seek help. If you do not have access to a phone contact Web Poison Control Services for online assistance.

What Is An Overdose?

Overdosing is when someone takes too much of a substance which causes poisoning or death. People can overdose accidentally or they might take too much in a suicide attempt. Suicide by overdose does not always kill the person attempting it and can result in permanent damage, depending on the drug.

Between the years 2011-2016, the drugs most commonly involved in an overdose were:

• Alprazolam
• Cocaine
• Diazepam
• Fentanyl
• Heroin
• Hydrocodone
• Methadone
• Methamphetamine
• Morphine
• Oxycodone

Notice that six out of ten drugs on this list are opioids. About 70% of deaths from overdose in 2017 were caused by opioids, and 130 people die each day in the United States from an opioid overdose.

According to research, an opioid almost always tops the list of drugs involved in overdoses, and cocaine usually lands second or third in frequency.

How Does Overdosing Happen?

A few different ways, overdosing can be both accidental and intentional.

Some examples of overdose situations include:

1. Children accidentally swallowing pills, not knowing what they are.
2. Intending to get high but taking too much by mistake.
3. Intending to kill oneself by drug overdose.
4. Mixing up or taking too much of a prescription drug by mistake.
5. Taking the wrong medication, and too much.

We usually associate drug overdoses with substances of abuse, but many overdoses happen because of a mistake. Removing the stigma from drug overdose is an important first step in providing the right care for people who need it.

How Can You Prevent Overdoses?

To prevent an accidental overdose from prescription or over-the-counter medication, the following steps might help:

1. Properly label all medication and do not remove it from its original container.
2. Never mix multiple drugs in the same container unless in a properly labeled mediset.
3. Do not leave drugs lying around where children, animals, or adults needing care can reach them.
4. Never remove child-resistant tamper lids from medications unless you can guarantee that no one else has access to them.
5. Do not leave medication in the open or lying around, and always store it in a safe and secure location.
6. If you suspect an overdose and the person is awake and conscious, call poison control at 1-800-222-1222.
7. If you suspect an overdose and the person IS NOT AWAKE or is unconscious, call 911 immediately and follow their directions.

If you, friends or family members use substances of abuse that have an overdose potential, take a harm reduction approach to reduce the risk of overdose. Helpful steps can include:

• Do not mix drugs, especially depressants like opioids, alcohol or benzodiazepines.
• Do not use drugs by yourself, and reach out to a sponsor or supportive individual, if necessary.
• If you just left the hospital, jail or detox your tolerance will be lower than it previously was.
• Talk with other members of your household and make sure they are educated on the signs and symptoms of a drug overdose.

Note that a harm reduction approach is not an endorsement to abuse drugs. Regardless of how you feel about yourself, there are people in your life that do not want to see you hurt.

Related Topic: Harm reduction therapy

Depressant Overdose

Depressants like opioids, alcohol or benzodiazepines can result in an overdose. Signs of an overdose can include:

• Blue lips or fingertips
• Blurred vision
• Clammy or cold skin
• Dizziness
• Dry mouth
• Extreme confusion
• Nausea and vomiting
• Slurred speech
• Trouble breathing

Serious depressant overdoses can lead to permanent damage, coma, and death. Depressants can shut down the parts of your brain that make you breathe, causing oxygen delivery to stop. Without oxygen, the brain quickly runs out of energy and starts to die. Other organs can be permanently damaged, but the brain is the first to lose adequate circulation. Therefore, damage to other parts of the body does not matter if the brain stops working.

Opioid Overdose

Heroin overdose, fentanyl overdose, and other prescription opioids are all involved in the many opioid overdoses that occur.

Symptoms of opioid overdose are the same as symptoms of depressant overdose. However, opioid overdose can be reversed if the person overdosing receives appropriate medical attention.

Opioid overdose may occur with illicit opioids like heroin, or from prescription pain-killers like hydrocodone, oxycodone or codeine.

Naloxone for Opioid Overdose

Naloxone is an opioid antagonist, which means it blocks other opioid drugs in the brain. Opioid drugs attach to opioid receptors on the surface of brain cells, which starts a chemical signal that can increase or decrease feelings of pain in the body.

Naloxone is useful because even if someone has consumed a large amount of heroin, fentanyl or another opioid in the body, naloxone can bind more tightly to opioid receptors than opioids of abuse. In this way, naloxone bumps opioids out of opioid receptors and stops them from working.

Naloxone DOES NOT remove the opioid from the body, however. If someone receives naloxone, they still need to go to the hospital for medical support while their body metabolizes the opioid.

Alcohol Overdose

Alcohol overdose is commonly referred to as alcohol poisoning. The most common way someone dies during an alcohol overdose is they stop breathing or they vomit which blocks the airway, preventing them from being able to breathe.

While someone is experiencing alcohol poisoning, their brain cannot fully wake and cough to clear vomit from their airway.

Other signs of alcohol overdose include:

• Blue or pale skin
• Confusion
• Low body temperature
• Passing out and cannot be awakened
• Seizures
• Slow or irregular breathing
• Vomiting

Stimulant Overdose

Cocaine overdose, methamphetamine overdose, and Adderall overdose fall into the category of stimulant overdose. Since stimulants increase energy, people do not die by suffocation during a stimulant overdose.

Stimulants cause the heart to beat too quickly and can cause clots that lead to stroke and heart attack. The rhythm of the heart can be affected, which may cause the heart to stop completely. Another serious side effect of stimulant overdose is necrosis, which is when skin and organ tissue starts to die because it does not receive enough oxygen.

Common and obvious symptoms of stimulant overdose include:

• Aggression
• Confusion
• Dangerously high temperature
• Fast breathing
• Fast heart rate
• Hallucinations (seeing or hearing things that are not there)
• Hyperactive (too fast) reflexes
• Panic or anxiety
• Restlessness
• Tremors

Related Topic: Stimulant overdose treatment

Marijuana Overdose

While many people claim that you cannot overdose from cannabis, you can in fact overdose on weed. However, what makes marijuana unique is that it does not cause death or permanent harm during an overdose.

Toxicity to cannabis is mostly self-limiting, meaning that if you take too much you will become unconscious before any serious harm occurs.

Symptoms of marijuana overdose are mostly psychological and include:

• Anxiety
• Confusion
• Fast heart rate
• Panic or anxiety
• Paranoia
• Severe nausea and vomiting

Vomiting is the most serious potential side effect and can cause dehydration if not treated. If you cannot stop vomiting during a cannabis overdose, report to the nearest hospital for treatment.

What Should You Do If You’re Overdosing?

If you are experiencing an overdose and you are alone, call 911. Calling poison control is an option, but if you lose consciousness during the phone call a 911 operator can more easily track your location.

If you cannot get to a phone, find someone who can help and give them as much information about the overdose as possible including:

• What drug you took
• How much you ingested
• How you took it
• How long ago you took it
• How often you use the drug
• If you have taken any other drugs, either legal or not

What Should You Do If You See Someone Overdosing?

Read about overdose first aid and become familiar with different techniques. Your knowledge may help save a life.

If you are with someone who is having a mild overdose where they do not lose consciousness and they are awake, calling poison control is an option. However, poison control may recommend that you call an ambulance, so make sure to follow their advice. Poison control in most states is staffed by a nurse or pharmacist trained in poison management.

If the person you are with has lost consciousness, call 911 first. They may advise you to call poison control in the meantime, but make sure an ambulance is on the way first.

Do You Get In Trouble If You Go to the Hospital When Overdosing?

You will not get in trouble for overdosing unless a serious crime has been committed. Medical records are confidential and cannot be turned over to the police without a court order.

If you report a drug overdose or assist in saving someone’s life, you are generally protected by Good Samaritan laws in most states. Consult an attorney or look up the specific laws in your state to learn specifics about laws surrounding overdose.

How to Get Overdose Treatment

Accidental and intentional overdoses are treated in the hospital. Based on the circumstances, the treatment team may then recommend substance abuse or mental health treatment after the medical situation is stable.

Note that even if the treatment team makes a recommendation, you are not compelled to follow the plan and whether to pursue treatment or not is your choice.

If you or someone you know has experienced a drug overdose, it may be a symptom of a substance abuse problem. Substance use disorders cause permanent harm. If you are concerned, call The Recovery Village, and we can help you explore treatment options. You are not alone, The Recovery Village can help.

Editor – Gretchen Koebbe

Gretchen Koebbe is a writing and reading specialist based out of Detroit. Read more

Medically Reviewed By – Dr. Conor Sheehy, PharmD, BCPS, CACP

Dr. Sheehy completed his BS in Molecular Biology at the University of Idaho and went on to complete his Doctor of Pharmacy (PharmD) at the University of Washington in Seattle. Read more