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Learn How to Detect and Respond to an Overdose in Honor of International Overdose Awareness Day

by Todd Fausnaught, M.D. | Aug 29, 2019

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Do you know how to recognize the signs of an overdose? Or what to do if someone is overdosing?

The organizers behind International Overdose Awareness Day want to ensure that you do.

International Overdose Awareness Day is a global event held each year on August 31st to raise awareness of overdose and reduce the stigma of a drug-related death. Since its launch in 2001, the global event has also acknowledged the grief felt by families and friends remembering those who have died or had a permanent injury as a result of drug overdose.

Above all, International Overdose Awareness Day aims to reduce overdose deaths by educating people about the signs and symptoms of overdose.

Here’s what everyone should know:

Opioids

Signs of an opioid overdose

Opioids dull the senses and induce relaxation and euphoria. They depress (slow down) breathing and the heart rate.

In high doses, opioids depress the body’s natural urge to breathe. When someone is having an overdose, they can stop breathing and may die. Even if a person does not die from overdose, they can sustain brain damage.

Signs of overdose can include:

  • No response to stimuli
  • Shallow/stopped breathing
  • Can’t be woken up
  • Unusual snoring/gurgling sounds
  • Blue/grey lips or fingertips
  • Floppy arms and legs

If you cannot get a response from someone, do not assume they are asleep. Unusual or deep snoring is a common sign of overdose. Do not let people at risk “sleep it off.”

Response to an opioid overdose

Sometimes it can take hours for someone to die from an opioid overdose. Action taken as soon as possible could save a life. If you think someone has overdosed, knowing how to respond is crucial:

Check for vital signs:

    • A  Alert: Not responding to voice?
    • B  Breathing: Noisy? Shallow? Slow? Stopped? Strange snoring?
    • C  Colour: For fair-skinned people, blue or pale lips or fingertips? For darker skinned people, grayish or ashen lips and skin color.

If you see any of these signs, you should immediately move to activate the response plan for opioid overdose.

      • Before you act, check for dangers such as needles.
      • Call an ambulance, tell the operator your location, and stay
        on the line.
      • Try to get a response from the person by calling their name and/or giving a sternal rub (rub your knuckles firmly across their sternum).
      • If you can’t get a response, put them in a recovery position that allows their airways to remain open.

If you HAVE Narcan / Naloxone:

  • Assemble the naloxone ready for use and inject the full amount into the outer thigh or upper arm (or use nasal spray).
  • Record the time of administration. Provide this information to paramedics when they arrive.
  • If the person is not breathing, apply rescue breathing (two breaths every five seconds).
  • If there has been no response after 3-5 minutes, give another dose of naloxone. Remember to record the time of administration.

(Note: Naloxone will only temporarily reverse an overdose.)

If you DO NOT HAVE Narcan/Naloxone:

  • If the person is breathing, leave in recovery position and monitor breathing.
  • If person is not breathing, apply rescue breathing and continue until:

– The person starts to breathe on their own and an ambulance arrives

– Someone else can take over for you

What NOT to do in the event of a suspected opioid overdose 

  • Do NOT leave the person alone.
  • Do NOT give the person anything to eat or drink, or try to induce vomiting.

Alcohol

Signs of an alcohol overdose

  • Confusion
  • Loss of coordination
  • Vomiting
  • Seizures
  • Irregular breathing (a gap of more than 10 seconds between breaths)
  • Slow breathing (less than eight breaths per minute)
  • Pale or blue tinged skin
  • Low body temperature (hypothermia)
  • Unconsciousness or passing out

Response to an alcohol overdose

  • Call an ambulance, tell the operator your location, and stay on the line.
  • Keep the person warm.
  • If you can’t get a response or the person is unconscious, put them in a recovery position. Don’t leave them on their back.
  • If they are awake, try to keep them in a sitting position and awake.
  • Be prepared to give CPR if they stop breathing before an ambulance arrives.
  • If muscle spasms or seizures occur, remove anything from the immediate environment that might cause injury.

What NOT to do in the event of a suspected alcohol overdose 

  • Do NOT leave the person to sleep it off: the amount of alcohol in someone’s blood continues to rise even when they stop drinking.
  • Do NOT give them coffee: alcohol and coffee both dehydrate the body. Having both can lead to severe dehydration and permanent brain damage.
  • Do NOT make them sick: alcohol can interfere with a persons gag reflex, causing them to choke on their own vomit.
  • Do NOT walk them around: alcohol slows brain function and affects coordination and balance. Walking them around might cause accidents.
  • Do NOT put them in a cold shower: it could dangerously reduce body temperature and lead to hypothermia.
  • Do NOT let them drink more alcoholthe amount of alcohol in their bloodstream could become even higher – which could put them in further danger.

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Depressants

Signs of an overdose from depressants 

  • Vomiting
  • Unresponsive, but awake
  • Limp body
  • Pale and/or clammy face
  • Blue fingernails or lips
  • Shallow or erratic breathing, or not breathing at all
  • Slow or erratic pulse (heartbeat)
  • Choking or sounds of a gurgling noise
  • Loss of consciousness

Response to an overdose from depressants

  • Call an ambulance, tell the operator your location, and stay on the line.
  • Be prepared to give the person CPR if they stop breathing before an ambulance arrives.
  • Ensure the person has adequate air by keeping crowds back or opening windows. Loosen tight clothing.
  • If the person is unconscious or wants to lie down, put them in a recovery position and continue to monitor them.
  • Provide paramedics with as much information as possible, such as what, and how much of the drug was taken, how long ago and any pre-existing medical conditions. If the drug came in a bottle or packet, give the packaging to the ambulance officers.

What NOT to do in the event of a suspected overdose from depressants 

  • Do NOT ignore snoring or gurgling: this could mean someone is having trouble breathing.
  • Do NOT leave the person alone.
  • Do NOT give the person anything to eat or drink, or try to induce vomiting.
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New psychoactive substances

New psychoactive substances (NPS), also known as ‘synthetic drugs’ or ‘legal highs,’ are chemicals that are made to act in a similar way to drugs like cannabis, ecstasy, cocaine, or methamphetamine.

NPS come in different forms, including:

  • a)  Powders / pills.
  • b)  Synthetic cannabis (synthetic chemicals that have been added to herbal or plant material).

Signs of an overdose from new psychoactive substances

The effects of NPS vary from substance to substance and so may signs of overdose.

Physical signs:

  • Rigid muscles / spasms
  • Shaking / shivering
  • Fever / overheating
  • Nausea or vomiting
  • Difficulty / stopped breathing
  • Can’t be woken up
  • Seizure

Psychological signs:

  • Confusion or distress
  • Paranoia, fear and panic
  • Agitation and aggression

Response to an overdose from new psychoactive substances

If you think someone has overdosed, please consider the following:
  • Before you act, check for dangers such as needles.
  • Call an ambulance, tell the operator your location, and stay on the line.
  • If confused or panicking, try to reassure the person.
  • Maintain calmness in the area.
  • If overheating, try to cool the person down by loosening outer clothing or putting a wet towel on the back of the neck or under their arms.

What NOT to do in the event of a suspected overdose from new psychoactive substances

• Do NOT leave the person alone.
• Do NOT give the person anything to eat or drink, or try to induce vomiting.

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Stimulants

Signs of an overdose from stimulants

Physical signs

  • Hot, flushed or sweaty skin
  • Headaches
  • Chest pain
  • Unsteadiness
  • Rigid muscles, tremors, or spasms
  • Uncontrolled movements or seizures
  • Difficulty breathing

Psychological signs

  • Psychotic symptoms in individuals with no prior mental illness
  • Severe agitation or panic
  • Altered mental state, such as confusion or disorientation

Response to an overdose from stimulants

  • Before you act, check for danger
  • Call an ambulance, tell the operator your location, and stay on the line.
  • Move the person to a quiet, safe room away from bystanders, noise, excessive light, heat, and other stimulation.
  • If confused or panicking, try to reassure them.
  • If overheating, try to cool them down by loosening outer clothing or putting a wet towel on the back of the neck or under their arms.
  • If you can’t get a response or the person is unconscious, put them in the recovery position.
  • If muscle spasms or seizures occur, remove anything from the immediate environment that might cause injury.

What NOT to do in the event of a suspected overdose from new psychoactive substances

  • Do NOT leave the person alone.
  • Do NOT give the person anything to eat or drink, or try to induce vomiting.

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Also read:

"Relapse" Sounds Like A Bad Word. But Recovery Often Comes With A Slip.

Reviving Overdose Victims Isn't Enough To Save Their Lives. The Milwaukee Task Force We Support Gets This.

The Fuzzy Borders Between Social Drinking And Alcohol Dependence

 


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Todd Fausnaught, M.D.

Todd Fausnaught, MD is the Area Medical Director of Pennsylvania for CleanSlate, a leading national medical group that provides office-based outpatient medication treatment for the chronic disease of addiction, primarily alcohol and opioid use disorders.

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