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Opioid Overdose

ACT NOWSomeone can't be woken and is barely breathing or not breathing. You don't need to be sure it's opioids.

  1. Spot the signs

    • Won't wake up — even to a shout or a hard knuckle-rub on the breastbone.
    • Breathing slow, shallow, stopped, gurgling or snoring.
    • Lips and fingertips blue or gray. Skin pale and clammy. Body limp.
    • Pupils may be pinpoints.

  2. Call 911 — if there's service

    • Before anything else. Say: "unresponsive and not breathing normally."
    • No service? Go straight to naloxone and breathing, and send someone for help.
    • No signal at all? Dial 911 anyway — iPhone 14 and newer offer to text 911 by satellite. Get outside, clear view of the sky.
    • Naloxone buys time. It doesn't replace a hospital.
    • Many states have Good Samaritan laws protecting people who call. Call regardless.

  3. Give naloxone — if you have it

    • None? Skip to the next step — breathing support is what keeps them alive.
    • Nasal spray (often sold as Narcan) — no assembly, no training.
    • On their back. Support the neck; tilt the head back.
    • Nozzle into one nostril until your fingers touch the nose. Press the plunger all the way.
    • No response in 2–3 minutes? Second dose, other nostril.
    • Fentanyl often takes several doses. Keep going if you have more.
    Why

    Naloxone works in minutes and does no harm if you're wrong about the cause.

  4. Help them breathe

    Help them breathe
    • Not breathing, no sign of life? Start CPR now — naloxone must never delay it.
    • Breathing but unconscious? Tilt the head back, watch the chest rise.
    • Breathing on their own? Roll them onto their side so they can't choke if they vomit.
    Why

    An overdose stops breathing before it stops the heart — the problem is oxygen, so rescue breaths matter more here than in a typical cardiac arrest.

  5. Stay with them

    • Naloxone wears off in 30–90 minutes. The opioid can outlast it — they can stop breathing again.
    • Don't leave them alone.
    • Expect confusion, fear or withdrawal when they wake. Stay calm; tell them what happened.

Sources: SAMHSA Overdose Prevention and Response Toolkit · CDC Stop Overdose · American Heart Association (2025 Guidelines for CPR and ECC)

General information to help in an emergency — not a substitute for training or professional care.

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