8 Signs and Symptoms of Opioid Overdose and What to do?

If a person shows these signs, consider it an emergency and act quickly.

Prescription opioids such as oxycodone and hydrocodone, along with synthetic variants like fentanyl, are legally available, while illicit opioids like heroin are obtained illegally. Despite their varying side effects, a common peril unites all opioids: the potential for overdose.

Between 2021 and 2022, the Centers for Disease Control and Prevention (CDC) revealed that a staggering 75% of drug-related fatalities, totaling over 80,000 cases, implicated the use of one or more opioids.1

In response to the alarming surge in opioid-linked deaths, Ashley McGee, RN, Vice President of Nursing at Mountainside Treatment Center, emphasized the critical importance of recognizing the indications of opioid addiction and overdose, underlining their capacity to avert tragic outcomes.

Acquiring awareness about overdose signs and promptly seeking assistance holds the potential to rescue lives. Familiarizing yourself with the indicators and symptoms of an overdose, as well as understanding the appropriate actions to take when confronted with an overdosing individual, can make a vital difference.

What Causes an Opioid Overdose?

Understanding the triggers behind overdose risks can empower you to take preventive measures. When opioids surpass your body’s processing capacity, an overdose can occur, as elucidated by McGee.

Multiple factors contribute to this peril: consuming excessive opioids in a short span, ingesting them too rapidly, using opioids with high potency, or combining these elements can culminate in an overdose. Furthermore, even adhering to prescribed opioid doses from a healthcare professional can result in an overdose if these opioids interact adversely with other medications, such as antibiotics.

The velocity of opioid consumption plays a pivotal role in overdose likelihood, according to Michael Damioli, LCSW, Clinical Director at Colorado Medication Assisted Recovery. Swift ingestion of potent opioids, such as fentanyl or heroin, escalates the risk significantly.

Of noteworthy concern, fentanyl stands out as a chief catalyst for opioid overdoses. The Food and Drug Administration’s 2021 report disclosed that the proliferation of fentanyl within the market, often clandestinely combined with other illicitly obtained substances, notably amplified overdose fatalities.

Opioid Overdose Risk Factors

Numerous factors contribute to the heightened vulnerability of individuals to opioid overdose, encompassing the following considerations:3

1. Opioid Use Disorder: Those grappling with an opioid use disorder face an augmented risk.

2. Injection of Opioids: The act of injecting opioids amplifies the likelihood of overdose.

3. Resuming Opioid Use Post Abstinence: After a prolonged period of refraining from opioids, resuming their consumption elevates the danger of overdose.

4. Non-Prescribed Use of Prescription Opioids: Engaging with prescription opioids without a valid prescription increases the risk.

5. High Dosage of Prescribed Opioids: Daily consumption exceeding 100 milligrams of morphine equivalence in prescribed opioids escalates vulnerability.

6. Concurrent Use with Other Substances: Combining opioids with alcohol or other substances like benzodiazepines, barbiturates, anesthetics, and select pain medications that suppress respiratory function heightens the risk.

7. Coexisting Health Conditions: The presence of other health ailments like HIV, liver or lung diseases, and mental health disorders exacerbates the risk.

8. Age: Individuals over 65 years of age face a heightened susceptibility.

According to Damioli, a critical insight emerges from the scenario where individuals who have undergone a period of opioid abstinence, such as those in addiction recovery who experience relapses, face significant peril. Their lowered opioid tolerance leaves them prone to unintentionally consuming higher doses of substances like heroin, triggering potential overdose incidents.

8 Signs and Symptoms of an Opioid Overdose

When opioids inundate the body, affecting vital systems such as the heart, lungs, blood circulation, and brain, a range of indications and manifestations mark an opioid overdose:

1. Discoloration and Skin Changes: Lips or fingernails may take on a bluish or purplish-black hue. Individuals with lighter skin might exhibit blue or purplish-black skin, while those with darker skin may display a gray or ashen appearance.

2. Skin Condition: Skin becomes cold and clammy to the touch.

3. Auditory Indicators: Audible sounds like gurgling, snorting, or choking, colloquially referred to as the “death rattle,” could be present, sometimes accompanied by vomiting.

4. Impaired Alertness and Communication: The person experiences difficulty in awakening or speaking.

5. Cardiovascular Effects: Heart rate becomes notably slow or ceases altogether.

6. Respiratory Effects: Breathing becomes drastically slowed or halts entirely.

7. Muscular Lethargy: The body becomes limp and lacking in muscle tone.

8. Constricted Pupils: The pupils constrict to pinpoint size.

These signs and symptoms carry even greater gravity if the individual’s breathing and blood pressure are severely compromised or absent, signaling potential organ failure and a heightened risk of fatality, cautioned Damioli.

What To Do If Someone Has an Opioid Overdose

Acquiring comprehensive knowledge about the indicators of an overdose and promptly taking appropriate measures can potentially be a life-saving endeavor. If you recognize signs and symptoms of an overdose, here’s the recommended course of action:

1. Call 911

Prompt and effective action is pivotal in such situations. If you identify signs of an overdose, take the following steps without delay:

1. Immediate Contact for Assistance: Dial 911 or emergency services without hesitation. If there’s another person present, delegate this task to them. The urgency of the situation necessitates swift action.

2. Prioritize Swift Intervention: Recognize that even seemingly mild overdoses can exert profound and enduring impacts on an individual’s long-term health. The severity of an overdose can escalate rapidly, potentially leading to fatal outcomes, as elucidated by Damioli.

It’s crucial to not allow apprehensions about potential consequences deter you from potentially saving a life. Legal protections often encompass individuals who possess or have ingested prescription or illicit substances. Damioli highlighted that a majority of states have enacted ‘Good Samaritan’ laws, which safeguard those who report an overdose from legal liabilities, including cases where they possess or use drugs themselves. Your focus should be on the immediate well-being of the individual in distress.

2. Administer Narcan

Narcan (naloxone) functions as an opioid antagonist, temporarily counteracting or halting the effects of opioids. Administered via a nasal spray (common for non-clinicians) or injection, Narcan serves as a pivotal intervention. It can be obtained through prescription, local harm reduction centers, or over-the-counter availability in select states.

However, it’s imperative to emphasize that, despite administering naloxone, seeking medical attention for the individual experiencing an overdose remains paramount, as highlighted by McGee.

Naloxone’s effect typically lasts for a duration of 30 to 90 minutes. Subsequent to this period, signs and symptoms of overdose might reappear. Additionally, Narcan administration can trigger withdrawal symptoms in the affected person.

In certain cases, especially those involving potent opioids like nitazenes, a single dose of Narcan may prove insufficient. The determination to administer additional doses lies with healthcare professionals.

When multiple individuals are present at the scene, optimal response involves one person promptly administering Narcan while another person immediately contacts 911. This collaborative approach ensures swift and comprehensive assistance.

3. Perform Rescue Breathing

When faced with an opioid overdose, the affected person’s breathing may decelerate or cease entirely, necessitating assistance to maintain proper breathing while awaiting emergency services.

In such a scenario, you can employ rescue breathing using the following procedure:

1. Position the Person: Place the individual on their back and gently tilt their head backward to ensure an open airway.

2. Clear the Airway: Ensure that there’s nothing obstructing the person’s mouth or cheek, which might impede their breathing.

3. Initiate Rescue Breathing: Pinch the individual’s nose gently and form a seal by placing your mouth over theirs.

4. Begin Breathing: Begin by delivering two small breaths and proceed to provide additional breaths at five-second intervals.

5. Roll to the Side: Once the person resumes breathing, carefully roll them onto their side. This helps prevent any risk of choking.

6. Maintain Alertness: Sustaining the individual’s wakefulness is crucial throughout this process. Keeping them conscious and responsive is of utmost importance.

By adhering to these steps, you can contribute to ensuring the individual’s immediate well-being while awaiting professional medical assistance.

A Quick Review

Understanding the signs and symptoms of an opioid overdose carries immense importance, given the concerning frequency of overdose-related fatalities. Should you identify these indicators, it’s imperative to promptly summon 911 or emergency services.

While awaiting the arrival of professional assistance, you have the option to provide immediate aid by administering Narcan and engaging in rescue breathing if the person is no longer breathing unaided. The ability to recognize overdose signs and promptly seek help holds the potential to profoundly impact and potentially save a life.