Overdose Symptoms and Emergency First Aid: What to Do
An overdose happens when someone takes more of a drug or medicine than their body can safely handle. It can happen with illegal drugs, prescription medicines, alcohol, or a mixture of substances.
The signs can vary depending on what was taken. Someone may become very sleepy, confused, have trouble breathing, have a seizure or lose consciousness. If you think someone is having an overdose, call 999 straight away and stay with them until help arrives.
Knowing what to do in those first few minutes can help keep the person safe while you wait for medical help. This guide explains the common signs of an overdose and the first aid steps you can take.
What Is an Overdose?
An overdose happens when a person takes more of a drug, medicine or other substance than their body can safely handle. The amount that causes an overdose can vary depending on the substance and the person.
An overdose can happen after taking too much of a substance at once or taking a dose that is too high for the person’s tolerance. It can also happen when a substance is taken in a way that was not intended or prescribed.
In simple terms, an overdose means that the amount of a substance in the body has reached a level that can cause serious harm.
What Causes an Overdose?
An overdose can happen for different reasons, and it is not always caused by deliberately taking a large amount of a substance. A person’s tolerance, the type of substance, and how it is taken can all affect the risk.
Here are some common situations that can lead to an overdose:
1) Taking Too Much of a Drug
Taking more of a drug than the body can handle can lead to an overdose. This can happen deliberately or by mistake, especially when the strength of a drug is not known.
Prescription medicines can also cause an overdose if more than the prescribed amount is taken. Keeping medicines away from other people and taking them only as prescribed can reduce this risk.
2) Mixing Drugs
Taking two or more drugs together can change how they affect the body. Some combinations can make a person much more sleepy or slow their breathing.
The effects can also be difficult to predict when the strength or contents of an illegal drug are unknown.
3) Mixing Drugs With Alcohol
Alcohol can increase the effects of some drugs and medicines. Combining alcohol with opioids, benzodiazepines, or other substances that slow the nervous system can be particularly dangerous because breathing can become dangerously slow.
4) Taking More Than Prescribed
Taking extra doses of prescription medication can cause an overdose, even if the medicine was prescribed for you.
This can happen when someone takes an extra dose because they think the first one has not worked, forgets how much they have already taken, or takes someone else’s medication.
5) Using Drugs After a Period of Abstinence
Someone’s tolerance to a drug can fall after they stop using it for a while. If they later take the amount they used to take before stopping, that dose may have a much stronger effect.
This is one reason an overdose can happen after a period in recovery or after someone has stopped using a drug for some time.
What Are the Symptoms of an Overdose?
An overdose can affect a person’s breathing, consciousness, movement, and other basic body functions. The symptoms also depend on the substance involved.
Knowing these warning signs can help you recognise when someone needs emergency medical help:
Difficulty Breathing
Difficulty breathing can happen when a drug slows down or interferes with the part of the brain that controls breathing. Opioids are particularly known for this effect. Breathing may become slow, shallow or irregular, which reduces the amount of oxygen reaching the body.
Loss of Consciousness
An overdose can cause someone to become unconscious when the substance has a strong effect on the brain. The person may become extremely drowsy, stop responding to people around them or be impossible to wake.
Very Slow or Abnormal Breathing
Very slow, shallow or irregular breathing can happen when a substance suppresses the nervous system. Opioids, alcohol and some sedative medicines can have this effect, especially when they are taken together.
Blue or Grey Lips and Fingertips
Blue or grey colouring around the lips, face or fingertips can happen when the blood is carrying too little oxygen. This can occur when an overdose has seriously affected a person’s breathing.
Seizures
Some drugs can interfere with the brain’s normal electrical activity and trigger a seizure during an overdose. Stimulants such as cocaine and some medicines can increase the risk, particularly when a large amount has been taken.
Severe Confusion or Agitation
An overdose can affect the brain and cause major changes in behaviour or awareness. A person may become extremely confused, restless, agitated or unable to understand what is happening around them.
Vomiting
Vomiting can occur when a substance irritates the digestive system or affects the areas of the brain that control nausea and vomiting. It can also occur alongside changes in consciousness during an overdose.
Very Small or Pinpoint Pupils
Very small pupils are strongly associated with opioid use and can occur during an opioid overdose. Opioids affect the nervous system and can cause the pupils to become unusually small.
Fast or Irregular Heartbeat
Some substances, particularly stimulants, can increase activity in the cardiovascular system. This can cause the heart to beat unusually fast or develop an irregular rhythm during an overdose.
Cold, Clammy or Pale Skin
Cold, pale or clammy skin can occur when an overdose affects circulation, breathing or the body’s normal response to the substance. It may appear alongside other physical changes as the body struggles to maintain normal functions.
What to Do During an Overdose and What to Avoid
If you think someone may be having an overdose, the first few minutes can be important. Knowing how to check their condition and what actions to avoid can help prevent further harm while medical help is on the way.
The table below explains the main things to do and avoid:
| What to Do | What to Avoid |
|---|---|
| Call 999 as soon as you suspect an overdose and tell the operator what has happened. Give them any information you have about the substance involved and the person’s current condition. | Do not wait for the person to feel better before getting help. An overdose can become more serious as the substance continues to affect the body. |
| Stay with the person and check whether they respond when you speak to them or gently touch their shoulder. If they stop responding or become much harder to wake, their level of consciousness may be changing. | Do not leave the person alone, even if they appear to be awake and stable. Their condition can change quickly after taking drugs, medicines or alcohol. |
| Check their breathing by looking for normal movement of the chest and listening for regular breaths. Gasping, very slow breathing, long pauses or unusual breathing sounds can mean they are not breathing normally. | Do not assume that someone difficult to wake is simply sleeping. A person who does not respond to your voice or gentle touch may be unconscious. |
| If the person is unconscious but breathing normally, place them in the recovery position. This helps keep the airway open and can reduce the risk of choking if they vomit. | Do not leave an unconscious person lying flat on their back. If they vomit in this position, they may choke or breathe the vomit into their lungs. |
| If the person is unresponsive and not breathing normally, start CPR and follow the instructions given by the 999 call handler. | Do not wait for their breathing to return to normal on its own. Gasping or irregular breathing should not be treated as normal breathing. |
| If an opioid overdose is suspected and naloxone is available, use it according to the instructions provided with the kit. Naloxone can temporarily reverse the effects of opioids, but emergency medical treatment is still needed. | Do not give another drug or substance in an attempt to cancel out the overdose. Mixing substances can make their effects more unpredictable and may increase the risk of harm. |
| Tell the medical team what the person has taken, if you know. Information about the substance, amount, time it was taken and any other substances used can help them decide how to treat the person. | Do not hide information about drug or alcohol use because you are worried about getting the person into trouble. Medical staff need accurate information to provide appropriate care. |
| Keep medication packets, bottles or drug packaging if it is safe to do so. This may help medical staff identify the substance and its strength. | Do not try to make the person vomit. Vomiting can cause choking, particularly if the person is drowsy or unconscious. |
| If the person has a seizure, move nearby objects away so they do not injure themselves. Stay with them and follow the instructions given by the emergency operator. | Do not hold the person down or put anything in their mouth during a seizure. These actions can cause injury. |
| Keep following the instructions given by the 999 call handler until medical help arrives. Tell them if the person’s breathing, consciousness or other symptoms change. | Do not put the person in a cold shower. Cold water will not reverse an overdose and can create additional risks if the person is confused or unconscious. |
Can an Overdose Cause Permanent Damage?
Yes, an overdose can cause permanent damage, particularly if the brain or other organs are deprived of oxygen for too long.
The risk depends on the substance, the amount taken, how quickly treatment is given and what happens during the overdose. Severe overdoses can cause brain injury, organ damage or death.
Getting emergency help quickly gives the person the best chance of receiving the treatment they need.
How AnorMed Can Help After an Overdose
An overdose can be a warning that someone’s drug or alcohol use has become unsafe. Surviving an overdose does not mean the risk has gone away, especially if the person continues using the same substance or has developed a dependence.
AnorMed is an independent addiction treatment referral service, not a medical clinic or rehab provider. Our advisors can help you understand treatment options and connect you with suitable rehabilitation providers across the UK and Europe.
Treatment may include medically supported detox, residential rehab, outpatient treatment, psychological support and aftercare. The right option depends on the substance involved, the person’s physical and mental health, their level of dependence and the support they need.
If someone has just overdosed, call 999 first. AnorMed can help with addiction treatment after the immediate medical emergency has been dealt with.
FAQs
Can someone overdose while still awake?
Yes. A person can be awake but show serious overdose symptoms such as severe confusion, extreme agitation, breathing problems or seizures. Do not wait for them to lose consciousness before calling 999.
Can alcohol poisoning be considered an overdose?
Yes. Drinking a dangerous amount of alcohol can overwhelm the body and cause alcohol poisoning. Severe alcohol poisoning can affect consciousness, breathing, body temperature, and other vital functions, making it a medical emergency.
Can naloxone save someone from an overdose?
Naloxone can temporarily reverse an opioid overdose and may restore normal breathing. It does not treat every type of overdose and does not replace an ambulance, so 999 should still be called.
What happens if someone overdoses but seems to recover?
A person can appear better after an overdose and still need medical assessment. This is particularly relevant with opioid overdoses because naloxone can temporarily reverse opioid effects, but the opioid may continue working after naloxone wears off. The person can develop breathing problems again and needs continued medical observation.
What information should you give doctors after an overdose?
Useful information includes the name of the substance, the amount taken, when it was taken and any other medicines, drugs or alcohol used around the same time. If the exact amount is unknown, it is still useful to tell medical staff what you do know. Medicine packets, containers and other packaging can also help identify the substance.
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