What is an Opioid Overdose

Opioid overdose happens when you take too much of an opioid substance.

Opioids are substances that relieve pain by binding to pain receptors in your brain and spinal cord. Opioids include illegal drugs, such as heroin, as well as prescription pain medicines. This can happen with any type of opioid, including:

• Heroin.
• Morphine.
• Codeine.
• Methadone.
• Oxycodone.
• Hydrocodone.
• Fentanyl.
• Hydromorphone.
• Buprenorphine.

The effects of an overdose can be mild, dangerous, or even deadly. Opioid overdose is a medical emergency.

What are the causes?

This condition may be caused by:

• Taking too much of an opioid by accident.
• Taking too much of an opioid on purpose.
• An error made by a health care provider who prescribes a medicine.
• An error made by the pharmacist who fills the prescription order.
• Using more than one substance that contains opioids at the same time.
• Mixing an opioid with a substance that affects your heart, breathing, or blood pressure. These include alcohol, tranquilizers, sleeping pills, illegal drugs, and some over-the-counter medicines.

What increases the risk?

This condition is more likely in:

• Children. They may be attracted to colorful pills. Because of a child’s small size, even a small amount of a drug can be dangerous.
• Elderly people. They may be taking many different drugs. Elderly people may have difficulty reading labels or remembering when they last took their medicine.
• People who take an opioid on a long-term basis.
• People who use:
  • Illegal drugs.
  • Other substances, including alcohol, while using an opioid.
• People who have:
  • A history of drug or alcohol abuse.
  • Certain mental health conditions.
• People who take opioids that are not prescribed for them.

What are the signs or symptoms?

Symptoms of this condition depend on the type of opioid and the amount that was taken. Common symptoms include:

• Sleepiness or difficulty waking from sleep.
• Confusion.
• Slurred speech.
• Slowed breathing and a slow pulse.
• Nausea and vomiting.
• Abnormally small pupils.

Signs and symptoms that require emergency treatment include:

• Cold, clammy, and pale skin.
• Blue lips and fingernails.
• Vomiting.
• Gurgling sounds in the throat.
• A pulse that is very slow or difficult to detect.
• Breathing that is very slow, noisy, or difficult to detect.
• Limp body.
• Inability to respond to speech or be awakened from sleep (stupor).

How is this diagnosed?

This condition is diagnosed based on your symptoms. It is important to tell your health care provider:

• All of the opioids that you took.
• When you took the opioids.
• Whether you were drinking alcohol or using other substances.

Your health care provider will do a physical exam. This exam may include:

• Checking and monitoring your heart rate and rhythm, your breathing rate and depth, your temperature, and your blood pressure (vital signs).
• Checking for abnormally small pupils.
• Measuring oxygen levels in your blood.

You may also have blood tests or urine tests.

How is this treated?

Supporting your vital signs and your breathing is the first step in treating an opioid overdose. Treatment may also include:

• Giving fluids and minerals (electrolytes) through an IV tube.
• Inserting a breathing tube (endotracheal tube) in your airway to help you breathe.
• Giving oxygen.
• Passing a tube through your nose and into your stomach (NG tube, or nasogastric tube) to wash out your stomach.
• Giving medicines that:
  • Increase your blood pressure.
  • Absorb any opioid that is in your digestive system.
  • Reverse the effects of the opioid (naloxone).
• Ongoing counseling and mental health support if you intentionally overdosed or used an illegal drug.

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider. Always ask your health care provider about possible side effects and interactions of any new medicine that you start taking.
• Keep a list of all of the medicines that you take, including over-the-counter medicines. Bring this list with you to all of your medical visits.
• Drink enough fluid to keep your urine clear or pale yellow.
• Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

• Get help if you are struggling with:
  • Alcohol or drug use.
  • Depression or another mental health problem.
• Keep the phone number of your local poison control center near your phone or on your cell phone.
• Store all medicines in safety containers that are out of the reach of children.
• Read the drug inserts that come with your medicines.
• Do not drink alcohol when taking opioids.
• Do not use illegal drugs.
• Do not take opioid medicines that are not prescribed for you.

Contact a health care provider if:

• Your symptoms return.
• You develop new symptoms or side effects when you are taking medicines.

Get help right away if:

• You think that you or someone else may have taken too much of an opioid. The hotline of the National Poison Control Center is (800) 222-1222.
• You or someone else is having symptoms of an opioid overdose.
• You have serious thoughts about hurting yourself or others.
• You have:
  • Chest pain.
  • Difficulty breathing.
  • A loss of consciousness.

Opioid overdose is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.