How to Recognize an Overdose
An opioid overdose occurs when a person has excessive unopposed stimulation of the opiate pathway. This can lead to decreased respiratory effort and possibly death. The frequency of opioid overdose is rapidly increasing. Drug overdose is the leading cause of accidental death in the United States, with opioids being the most common drug.
In 2019, nearly 50,000 people in the United States died from opioid overdoses. The CDC currently estimates more than 1000 emergency department visits daily related to the misuse of opioids and about 91 opioid overdose deaths every day.
Prescriptions for opioid-containing medications quadrupled between 1999 and 2010. This paralleled a four-fold increase in opioid overdose deaths due to opioids. The majority of opioid deaths are attributable to the use of heroin and synthetic opiates other than methadone.
On the street, the majority of illicit drugs available are often contaminated with other substances. Sometimes to increase profits, sellers often add other agents to the formula without telling the end-user. In many cases, these additives are pharmacologically active and often cause an overdose death.
Sometimes it can be difficult to tell if a person is just very high, or experiencing an opioid overdose. The following will present some information on how to tell the difference. If you’re having a hard time telling the difference, it is best to treat the situation like an overdose – it could save someone’s life.
If someone is really high and using downers like heroin, or opioid painkillers:
- Pupils will contract and appear small
- Muscles are slack and droopy
- They might “nod out”
- Scratch a lot due to itchy skin
- Speech may be slurred
- They might be out of it, but they will respond to outside stimuli like loud noise or a light shake from a concerned friend.
If you are worried that someone is getting too high, it is important that you don’t leave them alone. If the person is still conscious, walk them around, keep them awake, and monitor their breathing.
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Signs And Symptoms of Opioid Overdose
Opioids are frequently prescribed for moderate to severe pain in the US. Cases of opioid overdose and opioid toxicity are continually reported in all major cities in the United States. More notable is that the prescriptions for opioids have dramatically increased over the past two decades.
Most states have established prescription drug monitoring programs to counter the liberal prescription of opiates by healthcare workers. In fact, in Kentucky, healthcare professionals must first consult with the state’s online drug database to determine which opioid painkiller drug can be prescribed to patients.
The following are signs of an opioid overdose:
- Loss of consciousness
- Unresponsive to outside stimulus
- Awake, but unable to talk
- Breathing is very slow and shallow, erratic, or has stopped
- For lighter-skinned people, the skin tone turns bluish purple, for darker-skinned people, it turns grayish or ashen.
- Choking sounds, or a snore-like gurgling noise (sometimes called the “death rattle”)
- The body is very limp
- The face is very pale or clammy
- Fingernails and lips turn blue or purplish black
- Pulse (heartbeat) is slow, erratic, or not there at all
How to Respond to an Opioid Overdose
If taken differently than prescribed, opioids can cause death by slowing, and eventually stopping, a person’s breathing. However, a quick response to an opioid overdose, including administering naloxone and calling for medical assistance, can prevent brain injury and death.
Opioid overdose symptoms may not fully improve or may quickly return after initial treatment with naloxone. Other medical complications also are possible. Note that an incapacitated individual’s symptoms may be unrelated to opioids.
- Assess the scene of the incident
Do not enter any area that appears unsafe for any reason. If you see drug powders or residues, do not risk exposure. Wait for professional emergency responders. Avoid contact with drug containers, needles, and other paraphernalia.
2. Call trained staff to the scene and put on gloves for personal protection
3. Recognize and evaluate signs and symptoms
Try to wake up the person by speaking loudly or rubbing the breastbone with knuckles. A person experiencing opioid overdose often shows the following signs:
- Unconsciousness, or inability to wake up
- Limp body
- Falling asleep, extreme drowsiness
- Slow, shallow, irregular, or no breathing
- Pale, blue, cold, and/or clammy skin
- Choking, snoring or gurgling sounds
- Slow or no heartbeat
- Very small or “pinpoint” pupils
Recognizing an opioid overdose may be difficult. If it is unclear, treat the situation like an overdose and proceed with treatment.
4. Administer naloxone
- Administer naloxone following all manufacturer’s instructions for safe use.
- Administer a second dose of naloxone if the person is still unresponsive after 2-3 minutes and professional emergency responders have not arrived.
- Note that it may take 5 minutes or more for signs of opioid overdose to reverse.
Naloxone effects are temporary. Immediate medical attention is necessary. Calling 911 is always the first course of action [BC 2017]. A person with an opioid overdose who is revived by naloxone can become unconscious or stop breathing again.
5. Start other first-aid interventions if trained to do so
Position the person on his/her side and keep the airway open. Do not delay other interventions, such as rescue breathing or CPR, while waiting for naloxone to work. Monitor the person’s condition while waiting for emergency assistance. If breathing stops at any time, begin rescue breathing or CPR, if trained to do so.
Naloxone temporarily reverses the effects of the opioid, including sedation. Monitor the person suspected of opioid overdose for any changes in condition. Serious side effects from naloxone, including allergic reactions, are very uncommon. Only in rare cases would naloxone cause acute opioid withdrawal symptoms such as body aches, increased heart rate, irritability, agitation, vomiting, diarrhea, or convulsions.
7. Follow-up activities after an overdose
- Establish follow-up services to care for the worker who experienced an opioid overdose. Plan for referral to treatment programs, medical professionals, employee assistance professionals, and associated resources.
- Consider any follow-up needs for responders and bystanders, including employee assistance or mental health services.
- Provide appropriate support and referrals to coworkers and family members of the worker who experienced an overdose.
- Check the status of drug stock, equipment, and supplies and replenish as needed.
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Prevention and Risk Factors
There are several factors that can increase a person’s risk of overdosing. They include:
- Changes in tolerance from not using or using less. This happens after being in jail, detox, or following a period of abstinence.
- Changes in quality or purity of heroin and fentanyl.
- Mixing opioids with alcohol or benzodiazepines (benzos). Benzos include Klonopin, Xanax, Ativan, Valium, Librium, and others.
- Mixing opioids with stimulants, such as: crack/cocaine, meth, speed, and others.
- Having poor nutrition, a weak immune system, heart problems, or other health issues (i.e.HIV, Hepatitis C, unhealthy lungs from smoking or liver damage from drinking).
- Surviving a past overdose.
Prevent a fatal opioid overdose
There are many harm reduction strategies for preventing overdoses from occurring and preventing overdoses from becoming fatal. The goal of these strategies is to keep individuals who use opioids alive:
- Always carry naloxone (multiple doses if possible).
- Whenever possible, use it with someone else around.
- Try to alternate using with those around you, so that one of you is still able to use naloxone if the other one overdoses.
- If you have to use alone, call someone you trust before using and ask them to either stay on the phone with you while you use or call you in 10 minutes to see if you’re OK. If you don’t answer, have them call 911 with your location.
- If you can’t call anyone, use it in a semi-public location where someone will be able to find you if you overdose. Leave naloxone out and nearby, so that whoever finds you can use it on you.
- Start low, and go slow.
- Every time you buy a new bag, do a small tester shot. Only do more after waiting a few minutes, and seeing how your body reacts.
- Avoid mixing opioids with other substances, such as alcohol and benzos.
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Use Opioids Safely
You should always be careful when taking any medicine, but you need to take extra care when taking opioids:
- Take your medicine exactly as prescribed – do not take extra doses
- Check the instructions every time you take a dose
- Do not break, chew, crush, or dissolve opioid pills
- Opioids can cause drowsiness. Do not drive or use any machinery that may injure you, especially when you first start the medicine.
- Contact your provider if you have side effects
- If you can, use the same pharmacy for all your medicines. The pharmacy’s computer system will alert the pharmacist if you are taking two or more medicines that could cause a dangerous interaction.
Opioid Overdose Treatment
If you suspect someone is experiencing an opioid overdose immediately consider the following actions to save their life:
- Call 911
- If the person has stopped breathing or if breathing is very weak, begin CPR (best performed by someone who has training)
- If available, treat the person with naloxone to reverse opioid overdose
Family members, caregivers, or people who spend time with individuals using opioids need to know how to recognize the signs of an overdose and how to administer life-saving services until emergency medical help arrives. Individuals experiencing an opioid overdose will not be able to treat themselves. Naloxone  is a medication approved by the Food and Drug Administration (FDA) to prevent opioid overdose. Check with your healthcare provider on how to obtain naloxone in your state.
Opioids Addiction Treatment
Opioid addiction is a chronic disease and should be treated the same as other chronic diseases. Like those, it should constantly be monitored and managed. Opioid addiction treatment is different for each individual. The main purpose of opioid addiction treatment is to help the person stop using the drug. Opioid addiction treatment also can help the person avoid using it again in the future.
The body does go through specific symptom stages known as the opioid withdrawal timeline. The opioid withdrawal timeline varies from a few days to a few weeks, depending on the type of opioid that was used, how long it was used, and any other substances that may have been used in conjunction with opioids as well. Medically managed withdrawal opioid detox ensures the individual remains safe and stays as comfortable as possible.
The first step in treatment is detoxification. It will help you navigate the complicated withdrawal process, but it doesn’t address patterns of thought and behavior that contribute to opioid abuse. Various treatment approaches and settings can help provide the ongoing support necessary to maintain long-term sobriety after you complete detox.
Cravings are very common during detox and can be challenging to overcome. This often leads to relapse. Constant medical care provided during inpatient treatment helps prevent relapse. Clinicians can provide necessary medication and medical expertise to lessen cravings and the effects of withdrawals.
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- Person-Centered Therapy – is a strategy that allows and encourages clients to understand and resolve their concerns in a safe, supportive environment.
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Medication-Assisted Treatments (MAT) for substance use disorders and mental health disorders are commonly used in conjunction with one another. This includes the use of medications and other medical procedures. During your rehab, the staff from your treatment facility will help you identify what caused your addiction and teach you skills that will help you change your behavior patterns and challenge the negative thoughts that led to your addiction. Sometimes, the pressures and problems in your life lead you to rely on substances to help you forget about them momentarily.
If you or your loved one is suffering from Opioid withdrawal symptoms and addictions, and at some point experienced opioid overdose symptoms, indeed, help is just a phone call away. Professional opioid addiction treatment is necessary for fast and effective recovery. Contact us today at We Level Up treatment facility. We provide utmost care with doctors and medical staff available 24/7 for life-changing and lasting recovery. We offer an enhanced opportunity to return to a fulfilling and productive life.
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 NCBI – https://pubmed.ncbi.nlm.nih.gov/29262202/
 NIDA – https://nida.nih.gov/drug-topics/opioids/opioid-overdose-crisis
 WHO – https://www.who.int/news-room/fact-sheets/detail/opioid-overdose
 SAMHSA – https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/opioid-overdose