Signs and Symptoms of an Opioid Overdose

During an overdose, breathing can be dangerously slowed or stopped, causing brain damage or death. It is important to recognize the signs⁵ and act fast. Signs include:

• Small, constricted “pinpoint” pupils
• Falling asleep or loss of consciousness
• Slow, shallow breathing
• Choking or gurgling sounds
• Limp body
• Pale, blue, or cold skin

What To Do If You Think Someone Is Overdosing

1. Call 911 immediately.
2. Administer naloxone, if available.
3. Try to keep the person awake and breathing.
4. Lay the person on their side to prevent choking.
5. Stay with them until emergency workers arrive.

• It may be hard to tell if a person is high or experiencing an overdose. If you are not sure, it is best to treat it like an overdose—you could save a life.
• Naloxone, available as an injection or intranasal spray, should be given in cases of known or suspected opioid overdose.
• Many times, more than one dose of naloxone is necessary.
• Naloxone can and should be administered to pregnant women in cases of overdose to save the mother's life.
• Participants being treated for OUD and their family or significant others should be given naloxone or prescriptions for naloxone (including at least two doses of medication).
• Treatment court staff, probation and parole officers, judges, prosecutors, and others with direct participant contact should be trained and authorized to administer naloxone if laws, court rules, regulations, and similar stipulations permit.
• Correctional health staff should be trained and authorized to administer naloxone as recommended in the 2020 ASAM guideline for the treatment of OUD.