Patient education: Opioid overdose (The Basics)

What are opioids? — Opioids are a group of medicines. They are sometimes called "opiates." Some prescription pain medicines are opioids. These include codeine, oxycodone, hydrocodone, morphine, hydromorphone, meperidine, and fentanyl. They are sold under the brand names OxyContin, Percocet, Vicodin, Norco, Kadian, and many others.

Heroin (sometimes called "dope" or "smack") is also an opioid. But if a person gets heroin illegally, it often contains very strong opioids like fentanyl. These are more likely to cause an overdose.

Opioids help relieve pain. They can also affect breathing, change your mood, and make it hard to think and make decisions.

What is an opioid overdose? — An overdose happens when a person takes more of an opioid than their body is used to or more than their doctor prescribed. Some overdoses are mild. Others can cause serious problems, even death.

The effects of opioids can be made worse if they are taken with alcohol or certain other medicines. Medicines that could make opioid effects worse include "sedatives" like alprazolam (brand name: Xanax), lorazepam (brand name: Ativan), gabapentin (brand names: Gralise, Neurontin), and others.

What are the symptoms of an opioid overdose? — When a person takes too much of an opioid, they can have:

●Extreme sleepiness – It might be hard to wake them up.

●Snoring or gurgling sounds as they breathe

●Slow breathing (less than 1 breath every 5 seconds), or no breathing at all

●Very small pupils (the black circles in the center of the eyes)

●Slurred speech or be unable to talk

●Blue lips or fingernails

How is an opioid overdose treated? — People who overdose on opioids are treated with a medicine called naloxone. It works by blocking and reversing the effects of opioids. Naloxone can prevent death from an overdose.

It is important to get help right away if someone is overdosing. This might help to avoid serious problems and even death.

What should I do if I think that someone has overdosed? — If you think that someone is having a drug overdose:

●Call for an ambulance (in the US and Canada, call 9-1-1). Let them know you think the person might have overdosed. Tell them if you think the person is not breathing. The sooner treatment begins, the better their chances for recovery.

●Give naloxone if available (figure 1 and figure 2).

●Start rescue breathing ("mouth to mouth") if the person is not breathing or is breathing very slowly. You might need to start chest compressions if they have no pulse. The emergency dispatcher will give you step-by-step instructions.

●Lay the person on their side.

●Stay with the person until help comes. You might need to give more naloxone or start rescue breathing.

What else can I do to prevent someone from dying of an opioid overdose? — To help keep people safe:

●Be prepared to deal with an overdose. Know what the signs are.

●If you or someone you know uses opioids or is trying to stop using them, keep naloxone with you. Make sure that you and your family and friends know how and when to use it and where it's kept.

•Naloxone comes in a shot, or as a spray that goes in the nose (sample brand name: Narcan nasal spray). Some brands of the nasal spray are available without a prescription. Some substance use treatment centers or safe injection sites might also be able to provide naloxone.

•If you get naloxone to keep at home, read the instructions ahead of time. Make sure that you know where it's kept. It is very important that the person still gets medical care even if they got naloxone.

How can I avoid another overdose? — When someone continues to use opioids, they are at a high risk for another overdose.

Here are some tips for people who use opioids or have not been able to stop on their own:

●Talk to a doctor about how to gradually stop using opioids. This might not be easy to do, but there are medicines that can help with cravings. These medicines, such as buprenorphine or methadone, have been shown to help people function normally again and can save lives.

●Meet with a recovery coach or doctor who specializes in taking care of people with substance use disorder.

●Do not use opioids alone.

●Be very careful if you haven't used opioids for a while or haven't been using as much. Taking more, even in an amount that you used to take, could cause an overdose if your body is no longer used to it.

●Be very careful if you start a new medicine or start using another new drug. Also, be careful if using opioids when you're not feeling well.

●Do not get opioids from any place other than a pharmacy. Opioids bought on the street can contain very strong drugs that increase the risk of overdose. If you have to buy opioids illegally, check them first with fentanyl test strips.

●Do not drink alcohol if you take opioids. Talk to a doctor or pharmacist before taking any other medicines with opioids.

●Avoid people who use illegal drugs or think that it is OK to use drugs without a medical need.

●Stay away from places or people where you might be tempted to use opioids or drink alcohol.

●Try to find healthy ways to deal with negative feelings and stress. A doctor or counselor can help with this. Relaxation methods like reflection, deep breathing, and muscle relaxation can be helpful. Things like yoga, exercise, and tai chi are also good.

More on this topic

Patient education: Taking opioids safely (The Basics)
Patient education: How to give naloxone (The Basics)
Patient education: Opioid use disorder (The Basics)
Patient education: Prescription drug misuse (The Basics)
Patient education: Managing acute pain at home (The Basics)