Signs of an Overdose and What to Do: A Guide That Could Save a Life

Quick answer: If someone will not wake up, is breathing slowly or not at all, or has blue-gray lips or fingertips — call 911 immediately, give naloxone (Narcan) if it is available, and stay with them. Naloxone is safe to give even if you are not sure opioids are involved; it will not harm someone who has not taken opioids (CDC: Lifesaving Naloxone). Nevada's Good Samaritan law protects people who call for help in good faith during an overdose. Keep reading — the details matter and they take three minutes to learn.

Opioid overdose (heroin, fentanyl, pain pills)

This is the most common fatal overdose, and fentanyl has made it far more sudden. Signs:

• Unresponsive — you cannot wake them by shouting or rubbing your knuckles hard on their sternum
• Breathing that is slow, shallow, gurgling ("death rattle"), or stopped
• Blue or gray lips, fingertips, or skin (on darker skin, check lips and nail beds)
• Pinpoint pupils
• Limp body, pale or clammy face

What to do, in order:

1. Call 911. Say "someone is unresponsive and not breathing." You do not have to say drugs are involved for help to come.
2. Give naloxone if available — spray into one nostril. If there is no response in 2-3 minutes, give a second dose. Fentanyl often takes more than one.
3. Rescue breathing if they are not breathing — tilt head back, one breath every 5 seconds.
4. Recovery position — on their side, top knee forward — so they cannot choke if they vomit.
5. Stay. Naloxone wears off before many opioids do; they can slip back into overdose after waking up.

In Nevada, naloxone is available at pharmacies without a personal prescription. If someone in your home uses opioids — even prescribed ones — having it on hand is the same logic as owning a fire extinguisher.

Alcohol poisoning

Not "sleeping it off" — alcohol poisoning kills. Call 911 for: cannot be woken, breathing slowly or irregularly, cold or clammy or bluish skin, vomiting while unconscious, or seizures. Do not leave them to sleep, do not put them in a cold shower, do not give coffee. Turn them on their side and get help.

Stimulant overdose (cocaine, methamphetamine)

Looks different — the body overheats and the heart races out of control: chest pain, extremely rapid heartbeat, dangerously hot skin, severe agitation or paranoia, seizure, or sudden collapse. Call 911; cool them if overheated; do not restrain someone who is seizing.

Nevada's Good Samaritan law — call without fear

Nevada law provides protection from certain drug-related charges for people who seek emergency help in good faith during an overdose, and for the person overdosing. The legal system would rather have a living witness than another death. Call.

After the emergency

Surviving an overdose is the loudest warning a body can give. The days right after are also a moment when many people are finally willing to accept help. If that moment arrives in your family, we answer 24/7 and can often admit the same day: (725) 550-5655. Medical detox exists so nobody has to gamble on the next one.