Opioid Overdose: How to Recognize the Signs, Respond in an Emergency, and Use Naloxone
31 October 2025
Every day in the U.S., 187 people die from drug overdoses. Most of them involve opioids - prescription painkillers, heroin, or, more often now, synthetic drugs like fentanyl. And here’s the hard truth: opioid overdose doesn’t always look like what you see in movies. It’s not always someone slumped on the floor with a needle in their arm. Sometimes, it’s a person who just won’t wake up after taking what they thought was a regular pill. If you don’t know the signs or how to respond, that person could die in under five minutes.
What Happens During an Opioid Overdose?
Opioids - whether oxycodone, hydrocodone, fentanyl, or heroin - work by binding to special receptors in your brain. These receptors control pain, but they also control breathing. When too much opioid floods the system, it shuts down the brain’s signal to breathe. Oxygen stops reaching your organs. Your lips turn blue. Your body goes limp. Your heart slows. Brain cells begin dying within minutes. This isn’t just a risk for people with addiction. It happens to people taking prescribed pain meds, people who don’t know their pills contain fentanyl, or even someone who relapses after months or years clean. Their tolerance is gone. A dose they used to handle becomes lethal.How to Spot an Opioid Overdose
You don’t need to be a doctor to recognize an overdose. Look for these three classic signs - known as the opioid overdose triad:- Unresponsive to shaking or shouting - Try shaking their shoulder and yelling their name. If they don’t respond at all, that’s a red flag.
- Slow, shallow, or stopped breathing - Watch their chest. Are they taking fewer than 12 breaths a minute? Or are they making choking, gurgling, or snoring sounds? That’s not sleep - that’s drowning on air.
- Pinpoint pupils - Shine a light in their eyes. If the pupils are tiny like pinpricks, even in dim light, it’s a strong indicator of opioid use.
What to Do Immediately: The 3-Step Emergency Response
There’s no time to panic. Follow these three steps exactly as recommended by the CDC and health departments nationwide:- Call 911 right away - Even if you’re about to give naloxone, call first. Tell the dispatcher you suspect an opioid overdose. They can give you instructions while help is on the way.
- Give naloxone if you have it - Naloxone (brand name Narcan) is a life-saving drug that blocks opioids from brain receptors. It works in 2 to 5 minutes when sprayed into the nose or injected into the muscle. It’s safe. If the person didn’t take opioids, it won’t hurt them. If they did, it can bring them back.
- Stay with them until help arrives - Naloxone wears off in 30 to 90 minutes. Opioids can stay in the body much longer. The person could stop breathing again. Keep checking their breathing. If they stop, start rescue breathing: tilt their head back, pinch their nose, and give one breath every 5 seconds.
How to Use Naloxone: A Simple Guide
Naloxone comes in two main forms: nasal spray and auto-injector. The nasal spray (like Narcan) is the easiest for non-medical people to use. Steps for nasal naloxone:- Call 911 first.
- Remove the device from its package. Don’t test it or prime it - it’s ready to use.
- Place the person on their back. Tilt their head back slightly.
- Insert the nozzle into one nostril. Press the plunger firmly until you hear a click.
- Remove the device. If they don’t respond in 3 minutes, give a second dose in the other nostril.
- Continue rescue breathing if they’re not breathing on their own.
Why Naloxone Isn’t a Cure - And What Comes Next
Naloxone doesn’t treat addiction. It doesn’t fix the root problem. It’s a rescue tool - like a fire extinguisher. It buys time, but the person still needs medical care. After they wake up, they may feel sick. Naloxone can trigger sudden withdrawal: nausea, vomiting, sweating, anxiety, or even aggression. That’s normal. It’s not the naloxone hurting them - it’s their body reacting to the sudden absence of opioids. They need to go to the hospital. Even if they seem fine. Opioid overdoses can cause lung damage, heart rhythm problems, or brain injury from lack of oxygen. A doctor needs to check them. And after that? They need support. Counseling. Medication-assisted treatment (like buprenorphine or methadone). A plan to prevent another overdose. Many people who survive an overdose never get that help - and that’s why so many die again.
Fentanyl Is Changing the Game
Today, most overdose deaths involve fentanyl - a synthetic opioid 50 to 100 times stronger than morphine. It’s often mixed into other drugs without the user’s knowledge. A fake oxycodone pill? Could be fentanyl. A powder sold as cocaine? Could be laced with fentanyl. A counterfeit Xanax? Same thing. That’s why fentanyl test strips matter. They’re cheap ($1-$2 each) and easy to use. Just mix a tiny bit of the drug with water, dip the strip, and wait a minute. If it shows fentanyl, don’t use it. If you do use it, have naloxone ready. Two doses, not one.Who Should Have Naloxone?
Everyone. Seriously. If you know someone who:- Takes opioids (even prescribed ones)
- Has a history of addiction
- Uses street drugs
- Is in recovery
- Has mental health struggles
Final Thought: You Can Save a Life
Opioid overdose deaths aren’t inevitable. They’re preventable. And the tools are simple: know the signs. Call 911. Give naloxone. Stay with them. You don’t need to be a hero. You just need to act.Can naloxone hurt someone who didn’t take opioids?
No. Naloxone only works if opioids are in the person’s system. If they took something else - like alcohol, cocaine, or benzodiazepines - naloxone won’t affect them. It won’t cause harm, side effects, or withdrawal. If you’re unsure, give it anyway. The risk of not giving it is death.
How long does naloxone last, and can it wear off too soon?
Naloxone usually lasts 30 to 90 minutes. But many opioids - especially fentanyl - stay in the body much longer. That means the person can stop breathing again after naloxone wears off. Always call 911 and stay with them. You may need to give a second dose. Never assume one dose is enough.
Where can I get naloxone for free?
Many pharmacies in California and across the U.S. dispense naloxone without a prescription. Local health departments, needle exchange programs, and community organizations often give it out for free. In Sacramento, you can pick it up at the Sacramento County Health Department or through organizations like Project DAWN. Check your state’s health website - most have maps or directories.
What if I’m afraid to call 911 because of legal trouble?
All 50 states and D.C. have Good Samaritan laws that protect people who call 911 during an overdose. You won’t get arrested for possessing small amounts of drugs if you’re seeking help. The law is designed to save lives, not punish. Emergency responders are there to help - not to arrest. Don’t let fear stop you.
Can I use naloxone on a child or elderly person?
Yes. Naloxone is safe for people of all ages, including children and seniors. The dosage doesn’t change based on age. If someone - no matter their age - shows signs of opioid overdose, give naloxone and call 911. The risk of not acting is far greater than any potential side effect.
Are fentanyl test strips reliable?
They’re not perfect, but they’re better than nothing. Fentanyl test strips can detect the presence of fentanyl in drugs with about 90% accuracy when used correctly. They won’t tell you how much is there, or if other drugs are mixed in. But if they show fentanyl, avoid using the substance. They’re a harm reduction tool - not a guarantee of safety.
What if I don’t know how to do rescue breathing?
If the person isn’t breathing, just do chest compressions. Push hard and fast in the center of the chest - about 100 to 120 beats per minute (like the beat of "Stayin’ Alive" by the Bee Gees). It’s not ideal, but it keeps blood flowing to the brain until help arrives. Rescue breathing is better, but compressions are better than nothing.
Wendy Tharp
November 2, 2025 AT 06:35People just don’t get it. You let someone use drugs, you’re enabling them. If they OD, it’s their fault for being weak. Why should I waste my time learning how to use naloxone when I could be helping someone who actually wants to get better? This whole ‘everyone should have it’ thing is just encouraging bad behavior.
And don’t even get me started on fentanyl test strips. Like that’s gonna stop junkies? Newsflash: they’ll still use it. They’re not rational. They’re addicts. Stop coddling them.
My cousin died from an overdose. I didn’t cry for her. I was mad. She had three chances to get clean. She chose drugs over family. That’s not a tragedy-it’s a choice.
So yeah, I’m not keeping naloxone in my house. I’m not babysitting people who refuse to grow up.
And no, I don’t feel bad about it.
Subham Das
November 2, 2025 AT 22:48Ah, the modern Western dilemma: we have the technology to reverse death, yet we lack the moral courage to confront the existential void that drives people to self-annihilation through chemical means.
Naloxone is a Band-Aid on a hemorrhaging artery of societal decay. We medicate the symptom while ignoring the disease-the alienation, the collapse of community, the commodification of human suffering into a marketable tragedy.
When a man in rural Ohio takes a pill he thinks is oxycodone and dies, is it the pharmaceutical industry? The DEA? The opioid epidemic? Or is it the quiet, creeping nihilism of a culture that measures worth in likes and likes in dopamine?
And yet-we give him naloxone. We revive him. We let him live to face the same void tomorrow.
Is this compassion? Or is it a grotesque farce of mercy? We resurrect the dead so they may die again, not from the drug, but from the meaninglessness that made them seek it in the first place.
Perhaps the real overdose is not of opioids-but of hope.
And if we are to save lives, we must first save souls. But who among us is qualified to do that?
Do we have the language? The wisdom? Or just a nasal spray and a prayer?
I do not have the answers. Only questions. And they echo louder than the sirens.
Cori Azbill
November 3, 2025 AT 07:37Okay but who’s paying for all this free naloxone? 🤔
Like, I get it, save lives, yada yada. But my taxes are already going to fund free condoms, gender-affirming care, and 12-step programs that don’t work. Now we’re giving out overdose kits like candy at a parade?
And fentanyl test strips? Bro. If you’re buying drugs off a guy named ‘Tito’ on the corner, you already know you’re gambling with your life. Stop acting surprised when you lose.
Also-why is it always ‘everyone should have it’? Should I also carry a defibrillator? A tourniquet? A fire extinguisher? Where does it end?
And don’t even get me started on the Good Samaritan laws. So now if I get caught with weed while saving someone, I’m golden? That’s not justice. That’s a loophole for criminals.
Someone needs to tell these activists: compassion isn’t a subsidy for bad decisions.
Also-emoji: 🤷♀️
Paul Orozco
November 4, 2025 AT 18:57I find it deeply concerning that this post frames opioid overdose as a purely medical issue, when in reality, it is a moral failure of American society. The normalization of painkiller prescriptions, the commodification of mental health, and the erosion of personal responsibility have created a culture where death is treated as an accident rather than a consequence.
Furthermore, the suggestion that anyone-regardless of their relationship to the individual-should carry naloxone is not just impractical, it is irresponsible. It removes accountability from the user and places it on the bystander. Who will carry the naloxone for the person who ODs while driving? While at work? While in a public restroom?
And let us not pretend that fentanyl test strips are a solution. They are a psychological crutch for people who refuse to acknowledge that the only safe drug is no drug.
This post reads like a public service announcement written by a nonprofit with a grant and no real understanding of human nature.
It’s not about tools. It’s about choices. And we’ve stopped holding people to theirs.
Ardith Franklin
November 6, 2025 AT 05:10Let’s be real-this whole naloxone thing is a distraction. The real agenda? Normalize drug use. Make it safe. Make it easy. Make it so people don’t have to feel guilty about killing themselves slowly.
Who funds these programs? Who pushes for free test strips? Who makes sure every pharmacy has Narcan behind the counter?
Big Pharma. The same companies that flooded the country with opioids in the first place. Now they’re selling the antidote. Classic. They make money off the addiction, then off the cure.
And don’t tell me it’s ‘harm reduction.’ That’s just code for ‘we don’t care if you die, as long as we don’t have to clean up the mess.’
They don’t want you to get better. They want you to survive long enough to keep buying.
Check the funding sources. Look at the board members. This isn’t charity. It’s capitalism with a conscience patch.
And yes-I’m paranoid. But my paranoia has a paper trail.
Jenny Kohinski
November 8, 2025 AT 04:08Thank you for this. I’ve been trying to tell my brother for years that he should keep Narcan at home-he’s in recovery and lives alone. He kept saying ‘I’m fine, I don’t need it.’
Now I’m printing this out and handing it to him with a free nasal spray I got from the community center.
Also, I just got my first kit today. I’m keeping one at work, one in my car, and one at my mom’s house. You never know when you’ll be the one who finds someone.
It’s not about being a hero. It’s about being human.
💛
Aneesh M Joseph
November 8, 2025 AT 06:50So you’re telling me I should carry this spray around in case some junkie passes out? Bro. I’m not a nurse. I’m not even a first aider. Why do I have to do this?
And what if I give it to someone and they wake up and beat me up? I’m not signing up for that.
Also, if they’re using fentanyl, one spray won’t do it. So why even bother?
Just let ‘em die. Less junkies on the street.
That’s my two cents.
Deon Mangan
November 8, 2025 AT 19:01Ohhhhh so now we’re all emergency medics? 🤡
Let me guess-next they’ll hand out CPR kits with the Starbucks loyalty card. ‘Here’s your venti oat milk latte… and your auto-injector.’
Look. I’m all for saving lives. But this feels like society outsourcing its moral burden to the untrained public. ‘Hey, you’re just walking down the street? Great! You’re now responsible for reviving a stranger who chose to do drugs.’
And don’t even get me started on the ‘everyone should have it’ rhetoric. I don’t need to carry a defibrillator to walk my dog. Why do I need to carry a drug reversal kit to buy groceries?
Also, I’m pretty sure ‘Narcan’ is pronounced ‘Nar-CAN,’ not ‘Nar-CANE.’ But hey, who am I to correct the internet?
Still… I got one. Just in case. 🤷♂️
Vinicha Yustisie Rani
November 9, 2025 AT 05:42In my village in India, we do not have naloxone. But when someone falls ill from unknown medicine, we do not wait for a machine. We hold them. We speak their name. We fan them. We pray. We do not leave them alone.
This is what your post reminds me of: not the science, but the humanity.
It is not the spray that saves. It is the hand that holds. The voice that calls. The refusal to walk away.
Perhaps the real medicine is not in the vial, but in the courage to care.
Even if you do not understand addiction, you can still sit with the suffering.
That is enough.
And that is everything.
Carlo Sprouse
November 9, 2025 AT 19:48Let’s cut through the feel-good noise. Naloxone is not a solution-it’s a Band-Aid on a bullet wound. And the fact that we’ve made it so accessible is a direct indictment of our failed drug policy.
We have spent decades criminalizing users instead of treating addiction as a public health crisis. Now we hand out nasal sprays like they’re free samples at Costco, while underfunding rehab centers, mental health services, and job training programs.
This isn’t compassion. It’s convenience.
And don’t tell me about ‘harm reduction.’ Harm reduction is what you do when you’ve given up on prevention.
Real progress would be closing the pill mills. Regulating the dark web. Holding pharmaceutical execs accountable. Not giving Narcan to every high school student who wants to feel like a hero.
Save the spray for the ER. And then fix the system.
Otherwise, you’re just rearranging deck chairs on the Titanic.
Cameron Daffin
November 11, 2025 AT 13:06I lost my brother to an overdose two years ago. He was 29. He had a degree. A dog. A sense of humor. He was the guy who remembered your birthday.
He didn’t wake up one day and say, ‘I want to be an addict.’ He got prescribed painkillers after a car accident. Then he got fentanyl-laced pills because he couldn’t afford the real ones. Then he got scared to ask for help because he thought he’d be judged.
He died alone.
And I didn’t know how to save him.
That’s why I carry Narcan now. Not because I think it’s a magic fix. But because I refuse to let someone else die because no one knew what to do.
It’s not about politics. It’s not about morality. It’s about being the person who doesn’t walk away.
And if you think that’s naive…
Then you’ve never held someone’s hand while they stopped breathing.
💛
Sharron Heath
November 12, 2025 AT 15:40While the practical guidance provided in this post is commendable, I must emphasize the necessity of institutional support systems to complement individual action. The proliferation of naloxone distribution, while life-saving, cannot substitute for comprehensive addiction treatment infrastructure, socioeconomic investment, or policy reform.
Moreover, the normalization of emergency intervention as a personal responsibility risks deprioritizing systemic accountability. We must not mistake accessibility for adequacy.
Further research is required to evaluate the long-term efficacy of community-based naloxone programs in reducing mortality rates versus facilitating continued substance use.
Nevertheless, the immediate utility of this knowledge cannot be understated. Thank you for the clarity.
Steve Dressler
November 14, 2025 AT 13:40I’ve been a paramedic for 18 years. I’ve pulled people back from the edge so many times I’ve lost count.
Here’s the thing no one tells you: the hardest part isn’t the spray. It’s not the breathing. It’s not even the screaming when they wake up and try to punch you.
It’s the silence after they’re stable.
The way they stare at the ceiling like they’re already gone.
The way they whisper, ‘I didn’t mean to.’
And then they go home.
And next time, it’s not just one dose of Narcan they need.
It’s a reason to live.
So yeah-I carry it. I teach it. I fight for it.
But I also fight for the people who come after.
Because saving a life isn’t the end.
It’s the first step.
And we’re all just trying to hold the door open.
One breath at a time.
Carl Lyday
November 14, 2025 AT 21:41My mom used to say, ‘You don’t have to understand someone’s pain to stop them from falling.’
I never thought I’d need to know how to use Narcan. I thought it was for ‘those people.’
Then my nephew-17, honor roll, played guitar-got a fake Xanax from a classmate. He didn’t even know it was laced. He was fine. Then he wasn’t.
We didn’t have Narcan.
He survived. But his brain didn’t.
Now I have two kits. One at home. One in my truck.
I don’t care if it’s your cousin, your neighbor, or the guy sleeping on the bench outside the gas station.
If you see someone not breathing, you act.
Because you don’t get a second chance to save someone.
And you don’t get to decide who’s worth saving.
Just save them.
Then call 911.
And stay with them.
That’s it.