How to Recognize and React to a Drug Overdose

A drug overdose requires immediate attention. Seeing a loved one overdose can be very frightening and traumatic. Amid the chaos of the scene, you need to act with a clear head to prevent long-term physical problems and even death. Your quick actions may save your loved one’s life. 

man with headache has opiate overdose

Of course, nobody wants to see their loved one get to this point. If you suspect a loved one is abusing prescription or illicit drugs, your first line of defense is early intervention. Persuading your loved one to seek addiction treatment or get counseling may prevent dangerous overdoses from occurring. Sadly, even those occasionally experimenting with some drugs can be prone to an overdose.  

According to the Centers for Disease Control and Prevention, more than 700,000 people died from a drug overdose from 1999 to 2017. That’s over half a million needless deaths and devastated families. In fact, in the United States, accidental drug overdose is the leading cause of death for individuals under 50.

Knowing the signs of an overdose and how to react may turn a devastating moment into an opportunity to make the first steps towards positive change.

What is a drug overdose?

A drug overdose occurs when someone takes too much of a drug or combination of drugs. If the person’s metabolism cannot detoxify the drug fast enough, it could produce unwanted, dangerous side effects. The toxic effects of the drug overwhelm the body’s normal functioning.

Most people unintentionally overdose on drugs. They may mix up their medications or accidentally take the wrong dose. They have no intention of harming themselves, but, for whatever reason, the amount of the drug was too much for their body to handle. Others may overdose with the intention of harming themselves or getting a desired high. 

Who has the highest risk for a drug overdose?

Some people are more likely to either accidentally or intentionally overdose on drugs. Prevention is important especially in high risk groups like teens. They include:

  • Very young children who swallow drugs by accident
  • Elderly individuals taking many different medications
  • Those taking medications for chronic pain
  • Individuals who go to different doctors for medications
  • Those with a history of addiction or substance use
  • Individuals with underlying mental health conditions
  • People who mix alcohol with prescriptions or illicit drugs

How to recognize a drug overdose

Knowing the signs of a drug overdose can allow you to act fast and appropriately to get a loved one help. Since an overdose usually affects a person’s physical and mental functioning, some signs to look out for include:

  • Abnormal vital signs. This can include excessively high or low blood pressure, respiration, pulse, and temperature. In extreme cases, vital signs may be absent.
  • Unusual appearance of the skin. Depending on the overdose, a person can become very flushed or pale. Skin or lips may also turn grayish or blue. They may sweat excessively or feel cool to the touch. 
  • Altered state. Those who seem peculiarly sleepy or confused may have consumed too much of a drug. Some may even fall into a coma or coma-like state. 
  • Chest pain. Damage to the lungs or heart during an overdose may cause chest pains.
  • Stomach pain and nausea. In some cases, a person experiencing an overdose may have fits of vomiting and/or diarrhea. If this occurs and you notice blood in the vomit or stool, immediate medical attention may be necessary.
  • Violent or aggressive behaviors. The altered state of an overdose may trigger strange or dangerous behavior.
  • Seizures. Some drug overdoses may cause convulsions or seizures. This can be very scary for those witnesses who aren’t sure what’s going on.

Of course, these are general signs. Different drugs create different reactions to the body, which will be discussed later in the article.  The signs and symptoms of a drug overdose often depend on the specific drug and how a person’s body reacts to it. Drugs affect people differently. Some people have higher tolerances for drugs and can take more of a drug without disastrous results. Others may experience a negative reaction with just a small amount of a drug. 

Most common drugs involved in overdoses

A study conducted by the National Center for Health Statistics analyzed the data of overdose deaths from 2011 to 2016. Each year, many of the same drugs consistently ranked highest regarding fatal overdoses. 

For example, in 2016, the most common drugs related to fatal overdoses were:

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

These certainly aren’t the only drugs that can cause an overdose. The list does show, however, how pervasive heroin and opiate medications are in fatal overdoses. Six of the ten drugs listed above are in the opioid family. The CDC estimates 130 Americans die each day from an opioid overdose. 

Of course, for every fatal overdose, there are many other non-fatal overdoses. Some people get access to emergency services with enough time to spare their lives. Others survive an overdose on their own, but continue the same behavior that led to the issue initially. The disease of addiction has ravaged their lives to the point that even after a severe incident, they aren’t able to give up their substance of choice. Without appropriate drug treatment and counseling, their next overdose may end with death.

What to do during an overdose

Getting immediate medical attention is often necessary. Of course, when you experience a loved one overdosing, you’re probably scared. You may think if they just called it a night and slept it off things would be okay in the morning. After all, you don’t want them to get in trouble or have to deal with large medical bills. 

As these thoughts go through your mind, you should consider that in many overdose situations the individual is fighting for his or her life. Without help, they may not win the battle. Below is a list of common overdose drugs and tips that may help you respond. As always, we recommend consulting with a medical professional and/or calling 911 in the case of any emergency, as this article is not meant to be taken as medical advice.


Opioids are a blanket term for naturally occurring opiates and synthetic compounds impacting specific receptors of the brain. These drugs typically help to treat chronic and severe pain. Common opioids include heroin, fentanyl, hydrocodone, morphine, oxycodone, codeine, and methadone. 

One overdosing on opioids may have:

  • Small, contracted pupils
  • Loss of consciousness
  • Awake but unable to talk
  • Slow, shallow, erratic, or stopped breathing
  • Bluish or ashen colored skin
  • Snore-like, choking sounds
  • Slow, erratic, or nonexistent heartbeat
  • Body is very limp

Responding to an opioid overdose

Check the person for breathing and responsiveness. If the person is nodding off, try to stimulate them and get them to focus. If naloxone is available and you are properly trained in how to use it, administer the drug. Naloxone counters the effects of an opioid overdose. 

Get medical help immediately. Even if you administered Naloxone, it is prudent for the individual to get medical care. 


Cocaine is a powerful and very addictive stimulant. As a street drug, it may appear as a fine, white powder. Cocaine can be snorted or injected. It also can be formed into crack, which is smoked. High doses can result in lethal overstimulation of the body and brain. 

One overdosing on cocaine may have:

  • An irregular heart rate
  • Elevated body temperature
  • Extremely high blood pressure
  • Nausea
  • Agitation
  • Tremors
  • Psychotic behaviors 

Responding to a cocaine overdose

If you suspect a loved one has overdosed on cocaine, get medical help right away. Calling 911 or your local emergency number may be the best thing you can do to prevent a lethal heart attack or stroke. If the person starts having a seizure, remove nearby objects to keep him or her safe.


Methamphetamines, or meth, are another highly addictive stimulant producing a period of intense euphoria. The crystal meth is a white, odorless powder with a bitter taste. It is usually smoked, snorted, or injected. 

One overdosing on methamphetamines may have:

  • Chest pains
  • Very high or low blood pressure
  • Irregular heartbeats
  • Trouble breathing
  • Agitation
  • Psychotic behaviors
  • Hallucinations
  • Elevated body temperature

Responding to a methamphetamine overdose

Recovering from a methamphetamine overdose often requires immediate medical attention. The extremely high blood pressure and body temperature can lead to heatstroke, organ failure, or a hemorrhage. Call 911 or your local emergency number immediately.


This synthetic drug (3,4-methylenedioxymethamphetamine) is chemically similar to hallucinogens and stimulants. Commonly called Ecstasy or Molly, this drug is taken as a capsule or tablet, or snorted as a powder. It increases energy, sensations of pleasure, and emotional feelings. MDMA can also distort a person’s sense of time and perception.

One overdosing on MDMA may have:

  • Excessively high or low blood pressure
  • Abnormal heart rhythms
  • Fast or difficult breathing
  • Dangerously high body temperature
  • Rigid muscles or muscle spasms
  • Jaw clenching
  • Panic attacks or agitation
  • Fainting
  • Pale or blue-gray skin
  • Nausea and vomiting
  • Seizures
  • Psychotic behaviors

Responding to an MDMA overdose

One of the main concerns regarding an MDMA overdose is an individual's high body temperature. Those taking the drug during raves or at dance clubs may dance for hours in hot, crowded environments. The excessively high body temperature can set off a chain reaction of internal damage, which could be fatal. 

If you suspect an MDMA overdose, get the person to a colder area and get medical treatment immediately. Prompt treatment can help prevent death or permanent damage to the internal organs. 


Benzodiazepines, or benzos, are prescription sedatives that decrease anxiety, help with sleep, and may prevent seizures. Common benzodiazepines include Valium and Xanax. Taken as prescribed, these drugs are relatively safe. Taking benzos recreationally or more than prescribed can be deadly. This is especially true if mixing the drug with other central nervous system depressants.  

One overdosing on benzodiazepines may have:

  • Low blood pressure
  • Clammy skin
  • Large pupils
  • Shallow or slow breathing
  • A rapid or weak pulse
  • Poor reflexes
  • Lips turning bluish
  • Loss of balance
  • Uncoordinated movements

Responding to a benzodiazepine overdose

If the person is unconscious, not breathing, or having difficulty breathing, get emergency help right away. Infrequent benzo users may be administered flumazenil to help reverse the overdose. Those dependent on the drug, however, may experience significant withdrawal symptoms and seizures with flumazenil. 

Most benzodiazepine overdoses need medical monitoring until the drug toxicity wears off. A major overdose may require ventilators or other respiratory support.  


Drinking too much alcohol can lead to death. Many factors influence a person’s tolerance to alcohol. When a loved one starts showing signs of an alcohol overdose--or alcohol poisoning--letting them “sleep it off” may not be the best answer.

One overdosing on alcohol may have:

  • Confused, altered state
  • Trouble staying conscious
  • Slow or irregular breathing
  • Vomiting
  • Low body temperature
  • Clammy, pale skin
  • Seizures 

Responding to an alcohol overdose (poisoning) 

If a loved one is showing signs of alcohol overdose and losing consciousness, call your local emergency number. If vomiting occurs, try to keep the individual upright or lying on his or her side to prevent choking. 


Cannabis, or marijuana, is a mind-altering drug that is usually smoked or consumed orally. It is not possible to fatally overdose on cannabis, but using too much can result in uncomfortable symptoms. With the rise in popularity of edibles, dabbing, and concentrated oils, there is much more of the psychoactive component of marijuana (THC) in marijuana products today than there was in the past.

One overdosing on cannabis may have:

  • Distorted or paranoid thoughts
  • Anxiety
  • Pale skin
  • Lower body temperature
  • Nausea
  • Vomiting
  • Shortness of breath
  • Tremors
  • Panic attacks

Responding to a cannabis overdose

Try to get the person to a private place where he or she feels comfortable. Treating a marijuana overdose takes time and support for the individual. If the person has trouble breathing or shows symptoms of an overdose for more than an hour or two, get medical help. Trained professionals can help monitor the individual’s physical and mental conditions. 

Coping with a loved one’s overdose

A loved one’s overdose can be painful for everyone involved. If the individual survives the overdose, it is usually a very loud wake-up call that something needs to be done about his or her substance use. In many cases, drug treatment is necessary for the individual to regain control of his or her life. This includes withdrawal symptom management, comprehensive therapy and counseling, and essentially relearning how to enjoy life without the crutch of drugs or alcohol.

It's likely that you will also struggle with intense emotions related to your loved one’s overdose. You may struggle with fear, anger, grief, resentment, hope, and feeling like you could have done more during and well after your loved one’s overdose. 

It’s okay to ask for help. To talk to someone that knows what you’re going through. If your loved one survived the overdose and is in treatment, there is usually family therapy available during these programs. In addition, support groups for friends and family members of an addicted individual can connect you with others who experienced the same situation. Sharing your story, learning from others, and getting emotional support can help you through the negative emotions related to your loved one’s overdose.  

Struggling with your difficult emotions on your own may make them worse. Take some time for self-care and counseling so you can feel better about yourself and your relationship with your loved one.  For immediate help, call Pinnacle Peak Recovery at 844-921-0635.

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