By Jointra Editorial Team, Certified EMT
More than 80,000 Americans die from opioid overdose every year. The majority of these deaths are preventable with a single medication: naloxone (Narcan). Yet most people don't know how to recognize an overdose or how to use it.
The classic triad of opioid overdose is:
1. Pinpoint pupils — extremely small, even in dim light 2. Unconsciousness or unresponsiveness — won't wake up, won't respond to voice or sternal rub 3. Respiratory depression — breathing very slowly (fewer than 8 breaths per minute), shallowly, or not at all
Other signs: blue or gray lips or fingertips (cyanosis), gurgling or snoring sounds, limp body, pale or clammy skin.
Do not wait for all three signs. If someone is unresponsive and breathing abnormally after suspected opioid use, act immediately.
1. Try to wake them — call their name, rub your knuckles firmly on their sternum 2. Call 911 3. Give naloxone — administer intranasally or via auto-injector per product instructions 4. Rescue breathing — if they are not breathing, give one breath every 5 seconds 5. Place in recovery position if breathing returns and you must leave briefly 6. Give a second dose if no response in 2–3 minutes
Naloxone blocks opioid receptors and reverses overdose within 2–5 minutes. It is safe — it has no effect if opioids are not present. It wears off in 30–90 minutes, which is why calling 911 is still critical: the overdose can return.
Naloxone is available without a prescription at most pharmacies in all 50 states. Many EMS agencies now carry it, and harm reduction programs distribute it free of charge.
When the person wakes up, they may be confused, agitated, or in withdrawal. Do not leave them alone. They may want to use again to counteract withdrawal — this is dangerous as the naloxone will wear off. Stay with them until EMS arrives.
Most states have Good Samaritan laws that protect people who call 911 during an overdose from prosecution. Know your state's law — fear of arrest should never be a reason not to call for help.