Opiate Overdose

Signs and symptoms of overdose

Symptoms can depend on how much of the drug and which ones were used. They include:

• Trouble breathing or slow irregular breathing; breathing may even stop, which can cause death

• Drowsiness, trouble arousing, or coma

• Small, pinpoint pupils

• Cyanosis. This is when lips and nails appear blue because you don't have enough oxygen in the blood.

• Slow heart rate

• Low body temperature (hypothermia)

• Muscle spasm

• Seizures

• Death

If your overdose was severe, you may have been given an antidote, such as naloxone. The antidote effect lasts for about 1 to 2 hours. If the opiate has not left your system by the time the antidote medicine wears off, your symptoms may return. These symptoms include drowsiness and slow breathing. 

If you were addicted and physically dependent on opiates, then naloxone may cause withdrawal symptoms to appear right away. These may consist of:

• Body aches

• Diarrhea

• Abdominal cramps

• Upset stomach (nausea)

• Vomiting

• Runny nose

• Sneezing

• Sweating

• Yawning

• Restlessness

• Irritability

• Trembling

These symptoms will go away as the naloxone wears off.

Precaution

Be aware of a drug called xylazine. Xylazine's street name is "Tranq." This drug is approved for use in animals only. Xylazine is not safe in humans. Recently xylazine has been found as an additive in illicit drugs, especially heroin and fentanyl. Exposure to xylazine has been linked to serious and life-threatening side effects. Xylazine overdose can cause slow heart rate and breathing, low blood pressure, and coma. Repeated exposure to xylazine can cause severe skin ulcers. Xylazine overdose does not respond to naloxone. Care for xylazine overdose or exposure is supportive to help the body recover.

Home care

The following guidelines will help you care for yourself at home:

• Rest for the next 12 hours. 

• Don't drive or operate any vehicle or dangerous equipment until all opioid effects have worn off and you no longer feel sleepy or drowsy.

• If you were previously prescribed opioid medicines for pain, don't take any more of this medicine for the next 6 to 8 hours, unless your healthcare provider says it's safe to do so.

• If opioids or other drugs were swallowed, you may have been given liquid charcoal to neutralize those drugs. The charcoal may cause nausea and vomiting over the next few hours. It will also cause a black color to your stools for the next 1 to 2 days. Usually, you will be given a laxative with the charcoal to speed the removal of any toxins from the digestive tract. This may cause diarrhea for up to 24 hours. If no laxative was given, you may become constipated. If this happens, you may take an over-the-counter laxative or suppository.

Follow-up care

Follow up with your healthcare provider, or as advised if all symptoms don't go away within 24 hours, or if constipation is not eased after 2 doses of laxatives. If your overdose was related to a drug addiction, get drug counseling. Consider a drug treatment program to help break your habit.

Call 911

Call 911 if any of the following occur:

• Seizure

• Trouble breathing or slow irregular breathing

• Chest pain

• Sudden weakness on 1 side of your body or sudden trouble speaking

• Very drowsy or having trouble waking up

• Fainting or loss of consciousness

• Rapid heart rate

• Very slow heart rate

When to get medical advice

Call your healthcare provider right away if any of the following occur:

• Cough with colored sputum

• Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

• Redness, swelling or tenderness at the heroin injection site (if using IV drugs)

• Feeling that you might harm yourself or another

Talk with your healthcare provider if you feel that you want to get help and would like to enter a counseling or rehabilitation program.