Drug overdoses have been on the rise over the last several decades, and while the trend is up overall, opioid overdoses have risen disproportionately to other drugs of abuse. During the current COVID-19 epidemic, hospitals and emergency rooms are under a heavy burden already, so having some additional resources may provide help to those who would otherwise die of an overdose. This guide is meant to provide information, education, and access to further resources and is not intended as medical advice.
Before going any further, it should be emphasized that if someone is unresponsive, or may be suffering a drug overdose, the first move should always be to call emergency medical services. Medical professionals and their training take precedence over anything discussed in this guide, and obtaining their help should be the first choice in any emergency medical situation.
Emergency service phone numbers in some different countries include:
- America (and American territories), Canada, and Mexico: 911
- European Union: 112
- United Kingdom: 999 or 112
- Switzerland: 144 or 112
- Russia: 03 or 103 (Ambulance) or 112 for general emergency services
- Japan: 119 (Ambulance)
- Australia: 000 or 112
- South America: Numbers vary by country. Click the link for a list.
- South Africa: 10177
- Africa: Numbers vary by country. Click the link for a list.
- India: 102 (Ambulance) or 112 for general emergency services.
- China: 120 (Ambulance) / Hong Kong: 999 (Ambulance)
Click here for additional emergency services phone numbers by country.
Overdose Prevention Resources
While the first step should always be to call emergency services, if it is certain that someone is overdosing on a particular drug, certain steps may be taken to increase their chances of survival. Below we have listed educational resources that can, for example, provide links to naloxone administration training programs and locations to obtain naloxone for preventing an opioid overdose death. While opioids have a clear-cut medication to use, other drugs may not have such an easily accessible treatment option.
This medication can save lives during opioid overdoses, but only if someone knows how and when to use it. Here are some educational resources to find training courses for naloxone use.
Narcan.com: An information and education resource about the uses, risks, and some ways to get Narcan for preventing opioid overdose deaths.
Food and Drug Administration: A guide that provides information about naloxone and links to further resources.
Get Naloxone Now: A site that provides training on naloxone, its safe administration, and ways to inform others in your community about the benefits of naloxone with regard to opioid overdoses. Also provides information about state laws that may influence someone obtaining naloxone.
Prescription Drug Abuse Policy System: A comprehensive database of naloxone laws by state. An interactive map that can help someone easily determine the legal status and requirements for obtaining naloxone without a personal prescription. They also provide an interactive map detailing good samaritan laws by state, and the specifics of these laws in a browseable, state-by-state breakdown.
StopOverdose.org: A resource site for locating naloxone in Washington state that also provides general opioid overdose information. Includes sections such as what is an overdose, how to identify an opioid overdose, and what to do in the event of an overdose.
Recent laws passed in many states have increased the access and availability of naloxone. Here are some resources to obtain naloxone or information on how to obtain naloxone.
Next Distro: An online overdose education and prevention program designed to inform and provide naloxone resources for the prevention of opioid overdose deaths.
Naloxone Exchange: A delivery naloxone service that will mail naloxone to your address for use in reversing opioid overdoses, and hopefully saving lives.
CVS: Information about what is needed to get naloxone from a CVS pharmacy and includes a step-by-step guide as far as what to do in the event of an overdose.
Walgreens: A guide on where to get naloxone at the nearest Walgreens, information on how to use naloxone, and general educational resources for finding out more about naloxone.
Prevent & Protect: A resource guide that provides a search tool to find naloxone near you, information about using naloxone to prevent an overdose death, and tools for finding treatment if you or a loved one is using opioid drugs.
GoodRx: A prescription medication discount service, GoodRx provides a resource to find naloxone near you and provides discount coupons to fill the prescription. Their site also features a blog including information on where to get naloxone without a prescription.
Opioid Use Disorder Recovery Resources
The most commonly abused opioids include heroin and prescription pain pills. The absolute best way someone can protect themselves from an opioid overdose is to get sober and stop using opioids. Easier said than done, this is true, so we have tried to make it a little easier by providing a list of treatment aids that will help someone find their way into a drug and alcohol rehab center.
Medically Assisted: A resource and tool to find medication-assisted treatment programs near you including information on types of programs and the medications used.
Decisions In Recovery: Information about medication-assisted treatment (MAT) programs and resources on how to find a provider near you.
SAMHSA: An opioid treatment program directory listing dozens of programs in all 50 states.
U.S. Department of Health and Human Services: A site created in response to the opioid epidemic, they provide links to treatment, information about naloxone, and resources for finding federal grants to aid your community’s response to the opioid epidemic.
Other Depressant Overdose Resources
Commonly abused depressants include alcohol, benzos, and GHB. Depressant overdoses can be extremely dangerous, and even deadly. The risk of breathing failure, brain damage, or suffering an accident due to impaired mental states is very serious. If someone is experiencing a depressant overdose, call emergency medical help immediately, try to help them into the recovery position, and monitor their breathing until help arrives.
Some additional resources for information on depressants overdoses include:
National Institute on Drug Abuse: A guide on prescription depressant drugs including benzos, so-called “Z-drugs” like Ambien, and the older barbiturate class of drugs. Also provides information on how to spot and overdose, and what to do in the event of an overdose.
International Overdose Awareness Day: This site provides comprehensive fact sheets about both alcohol overdoses and other depressant overdoses including what to look for, what to do, and what not to do if someone is experiencing an overdose.
Alcohol and Drug Foundation: General information on overdoses from alcohol and various drugs.
Pennsylvania Department of Drug and Alcohol Programs: An overdose overview guide on what steps to take if someone is overdosing, the signs and symptoms of an overdose, and how to avoid overdoses in the first place.
Stimulant Overdose Resources
The most addictive stimulants include crystal meth, cocaine, and amphetamines. Overdoses from stimulants generally produce similar sets of symptoms and are treated in a similar manner. For more information about general or specific types of stimulant overdoses, check out the following resources below.
International Overdose Awareness Day: Information on crystal meth overdoses including what to look for, what to do, and what not to do in the event of an overdose.
Toward the Heart: A stimulant overdose awareness guide that provides tips and resources for what to do if someone near you is experiencing a stimulant overdose.
National Institute on Drug Abuse: A fact sheet about methamphetamine including information on meth overdoses. Also provided are fact sheets on prescription amphetamine overdoses. Prescription amphetamines include Adderall, Ritalin, and Vyvanse.
Leeds, Grenville, and Lanark District Health Unit: A hospital in Ontario Canada, they provide information and resources about crystal meth and overdoses.
Minnesota Department of Health: A resource guide about methamphetamine addiction that provides harm reduction and overdose awareness resources.
Manitoba Department of Health: Information about the signs and symptoms of a crystal meth overdose and further resources about meth in general.
Overdose Awareness Resources
Even though overdoses and overdose deaths have been increasing in recent years, there is still a lack of awareness among the general population regarding drug overdoses. These resources aim to increase awareness and provide educational and informative materials so that more people can understand the threat posed by overdoses today.
International Overdose Awareness Day: An educational and community-focused organization that provides resources and materials to promote overdose awareness. Their site includes a schedule of events in 2020 and with August 31st being International Overdose Awareness Day, they provide resources on how to contribute and spread the message. They also provide overdose fact sheets for information about overdoses from alcohol, opioids, other depressants, and stimulants to inform and educate.
Faces & Voices of Recovery: A resource hub that provides information and toolkits for education about opioids and opioid overdoses. Includes toolkits for creating community organization and interacting with state governments regarding opioid overdoses and prevention activism.
National Institute on Drug Abuse: This government site provides a wealth of information about naloxone and how it works and resources for finding naloxone in your state.
SAMHSA: This site provides an opioid overdose prevention toolkit for medical professionals, communities, and local governments that provides strategies to reduce opioid overdoses.
What Do I Do If Someone Is Overdosing?
In the event of a drug or alcohol overdose, the best choice is to dial 911, or the appropriate emergency services number, and then monitor the person until emergency medical help arrives. If they are having a seizure, wait until convulsions have ceased and then attempt to place them in the recovery position until further help can arrive. If they have suffered head or neck trauma, do not move them and wait for trained medical professionals.
While opioids have a widely available and fairly safe treatment for overdoses in the form of naloxone, most other drugs do not. The approach taken by medical professionals in most cases is to reduce the risks by treating the symptoms of the overdose, and this often requires strong medications that may be potentially dangerous unless administered by a trained medical professional.
How to Recognize Signs of an Overdose
Different drug overdoses will manifest different symptoms. While there may be variability between individual drugs, the main categories of drug overdoses often fit into two distinct categories: depressant and stimulant drug overdoses. While the specifics may vary, in general, depressants will slow vital functions while stimulants will accelerate vital functions, and these are the mechanisms by which overdoses may be fatal.
Overdoses from different depressant drugs include:
With the recent opioid epidemic plaguing America and other countries, there has been an increase in access and availability of the medication Narcan. This medication contains the active ingredient naloxone, an opioid antagonist, that can reverse the effects of opioid drugs. While the exact mechanism is not fully understood, it appears to act as a competitive antagonist, forcing the opioid drugs out of brain receptors and replacing them. This reverses the effects of the drugs including the dangerous depressive effects on breathing, the leading cause of death in opioid overdoses.
Heroin addiction brings with it the highest risk of overdose, but prescription pain pill addiction can lead to fatal overdoses as well. Even kratom, commonly taken by people trying to quit opioids to ease withdrawals, can result in fatal overdoses.
Having Narcan at hand may help save someone’s life, or at least prevent death until emergency medical help can arrive. While Narcan may not be enough to save someone, it may buy them enough time until effective treatment can be provided. There is a wealth of resources to become informed and educated about Narcan, and there are easy ways to obtain Narcan. Below, we will provide resources for information and education, as well as easy and cheap ways to get Narcan so that in the event of an opioid overdose, lives may be saved. 5, 6, 7
Alcohol (aka ethanol) can cause dangerous and potentially fatal problems in the event of an overdose. Heart issues, breathing troubles, and metabolic disturbances are common during an overdose, and treatment of these symptoms is usually supportive in nature. There are no known medications that can treat an alcohol overdose, so medical support and monitoring is really the only tactic to use. The body is kept as safe as possible while it metabolizes the alcohol and thereby reduces the depression and risks.
Some symptoms of an alcohol overdose include:
- Unconsciousness (with an inability to wake up)
- Slow or Labored Breathing
- Irregular Heartbeat
- Confusion or Delirium
- Increased Aggression
- Brain Damage
- Liver Damage
Some medications may be used in cases of increased aggression, but these are used sparingly and under close supervision, as they may interact with alcohol to produce undesirable consequences. Stomach pumping with charcoal may be utilized if the alcohol ingestion was recent. Blood sugar, blood pressure, electrolyte levels, and heart rate usually requires close observation and supportive care, as these may lead to dangerous complications if left untreated. 1
Prescription benzodiazepine (benzo) medications such as Xanax, Klonopin, and Valium are common drugs of abuse and, subsequently, overdoses occur. This is especially the case when combined with other drugs like alcohol or opioids as the depressant effects of these drugs may amplify the effect of benzos, or vice-versa. If someone is using benzos, it is crucial to warn them not to use other depressants, as this greatly increases the chance of overdose, and complicates the treatment process.
Some common signs of a benzo overdose include:
- Confusion and Delirium
- Depressed or Irregular Breathing
- Slow Heart Rate
- Ataxia (impaired coordination)
Benzos actually do have an “antidote” medication, although it presents its own risks. Flumazenil, a GABA receptor competitive antagonist is able to remove benzo drugs from their receptors in the brain and replace them, thereby stopping their effects. This medication can sometimes be dangerous to use in this manner, especially with long-time benzo users. It can reduce the seizure threshold and in a chronic benzo user, and this can lead to seizures. This is usually reserved for emergency situations, as the risks often outweigh the benefits. Otherwise, supportive care is the preferred method of benzo overdose care. 2
Depressant drugs, also known as downers, act to slow and “depress” physical and psychological functions. A depressant overdose can cause severe and potentially fatal depression of vital functions that can lead to permanent injury or death through multiple routes including:
- Respiratory Failure
- Cardiac Arrest
- Brain Damage (usually from lack of oxygen)
Depressant overdoses are fairly uniform in the sense that they usually exhibit exaggerated signs of minor intoxications. This can include unconsciousness, impaired mental faculties, and a sometimes dangerous depression of vital functions. These types of overdoses are usually treated with supportive care or, in the case of opioids, a reversal drug such as naloxone. Depressant overdoses can be hard to identify immediately, as it can often appear as if someone is just asleep. It may take a trained eye and careful scrutiny to realize that they are breathing extremely slowly, or not at all.
Medications and medical attention can either reverse or treat the symptoms of these overdoses, depending on the particular depressant drug. There are very few depressant drugs, other than opioids, that have a “reversal” medication and most of these depressant overdoses must be waited out while the patient is supported.
Crystal Meth Overdoses
Crystal meth is one of the most potent stimulant drugs known today. An overdose on meth can exhibit hyperactive symptoms in both physical and psychological aspects. If someone has suffered an overdose on crystal meth, medical help should be summoned immediately.
Some of the symptoms of a crystal meth overdose include:
- Convulsive Seizures or Intense Tremor
- Coma or Unconsciousness (inability to wake up)
- High Fever
- Heavy Sweating (regardless of ambient temperature)
- Chest Pain and/or Difficulty Breathing
- Irregular and/or Rapid Heart Rate
- Cardiac Arrest or Stroke
There are medications that can be used to treat the symptoms of a meth overdose, but these are controlled substances and must be administered by trained medical professionals. Some common types of medications used include antipsychotics, sedatives, antihistamines, and certain kinds of blood pressure medications. 3
Cocaine is a powerful stimulant drug and overdoses are, unfortunately, fairly common. While cocaine overdoses can range from simply uncomfortable to potentially life-threatening, even the relatively minor overdoses should be treated medically. Even though the symptoms may not seem severe, there is an increased risk of dangerous complications in any cocaine overdose.
Some common symptoms of a cocaine overdose include:
- Areflexia (lack of reflex responses)
- Brain Damage
- Irregular Heartbeat
- Cardiac Arrest
- Cyanosis (grey or blue skin color)
- Labored Breathing
Medications may be used to reduce the risk and severity of these symptoms, and cooling the body in cases of hyperthermia is a commonly used tactic. The common medications used include antipsychotics, sedatives, antihistamines, and certain blood pressure medications. 4
Stimulant overdoses can be difficult to identify, as they can exhibit unintuitive and sometimes confusing symptoms. While psychosis or seizures may be expected when dealing with a stimulant overdose, they may also present coma or unconsciousness. The best course of action is to call an ambulance as soon as possible and stay with the person to monitor their condition. There is currently no effective medication that can be used to reverse a stimulant overdose. The only effective medical approach is to offer supportive care while the patient recovers.