Recognizing & Responding to Overdose

An opioid overdose happens when opioids suppress the brain stem to the point where breathing slows or stops entirely. These signs mean to act immediately.

• ▸Breathing: extremely slow, fewer than 8 breaths per minute, shallow, irregular, or stopped completely.
• ▸Skin color: blue or grayish tint on lips, fingertips, or face (cyanosis).
• ▸Responsiveness: cannot be woken up by shouting, shaking, or a sternal rub with knuckles on the chest bone.
• ▸Sounds: gurgling, choking, or deep snoring sounds called the death rattle.
• ▸Pupils: extremely small, pinpoint pupils even in dim light.
• ▸Muscles: completely limp, floppy body; jaw may be clenched.

Follow these steps in order. Do not wait to see if it gets better on its own.

• ▸Call 911. Say: 'I think someone is having an opioid overdose.' Give the location, stay on the line, and use Good Samaritan protections by calling for help.
• ▸Give Narcan. Tilt their head back slightly, insert the nasal spray nozzle into one nostril, and press the plunger firmly to release the dose.
• ▸Start rescue breathing if trained. Tilt the head back, lift the chin, pinch the nose shut, and give 1 slow breath every 5 seconds while watching for the chest to rise.
• ▸Wait 2-3 minutes. If there is no improvement and they are still not breathing or still unresponsive, give a second dose of Narcan in the other nostril.
• ▸Use the recovery position. Once breathing resumes, turn them on their side with their top knee bent forward to prevent choking.

Naloxone, brand name Narcan, is a medication that rapidly reverses an opioid overdose by blocking opioid receptors in the brain and restoring normal breathing within 2-3 minutes.

It is available as a nasal spray, requires zero medical training, and can be purchased at most pharmacies without a prescription. It has absolutely no effect on someone who has not taken opioids, so there is no risk in giving it if you are unsure whether opioids are involved. If you are wrong, nothing happens. If you are right, you just saved a life.

Narcan is powerful, but it does not replace emergency medical care.

• ▸Narcan wears off in 30-90 minutes. The person can go back into overdose. Always call 911 even if Narcan works.
• ▸Narcan only reverses opioids. It will not help with alcohol, benzodiazepine, or stimulant overdoses alone.
• ▸Do not put them in a cold shower or give them coffee. These do not work and waste critical time.
• ▸Do not leave them alone. Stay with them until EMS arrives, even after Narcan works.
• ▸Get free Narcan from UAU, local pharmacies, or Texas harm reduction organizations.