An overdose is when someone takes more of a substance than they can safely process. This can involve prescription medications, illicit drugs, alcohol, or a dangerous combination of substances. Overdoses can be accidental or intentional, and they are always a medical emergency. Recognizing the signs early and responding quickly can save a life. Understanding what an overdose looks like empowers you to act if you or someone around you is ever in danger.

What is an Overdose?

An overdose happens when toxic levels of a substance overwhelm the body’s systems, impairing vital functions such as breathing, heart rate, and consciousness. Different substances affect the body in different ways, but all overdoses pose serious health risks and require immediate medical intervention. Factors such as tolerance, body weight, physical health, and mixing drugs or alcohol all influence overdose risk.

Common Signs of an Overdose

Symptoms of an overdose depend on the substance(s) involved. However, many share similar warning signs. A person experiencing an overdose may exhibit any combination of these symptoms. Any of these symptoms warrants urgent medical attention.

Difficulty Breathing or Not Breathing

Slow, shallow, irregular, or stopped breathing is one of the most dangerous signs. Opioids, alcohol, and sedatives can depress the respiratory system, making it hard for the body to get enough oxygen.

Extreme Drowsiness or Unresponsiveness

If the person cannot stay awake, cannot answer questions, or is completely unresponsive, this may indicate a life-threatening overdose.

Blue or Gray Skin, Lips, or Fingernails

A lack of oxygen may cause the skin to change color, usually turning bluish, grayish, or pale; this is a critical emergency sign.

Slow, Weak, or Irregular Pulse

Some substances suppress heart function, leading to dangerously low or inconsistent heart rates.

Seizures or Convulsions

Stimulants, including cocaine or methamphetamine, or a combination of substances, can trigger seizures.

Confusion, Agitation, or Hallucinations

Some overdoses cause severe mental status changes, including agitation, paranoia, or hallucinations.

Vomiting, Choking, or Gurgling Sounds

These signs can indicate that the person is losing consciousness or cannot control their airway.

Very High or Very Low Body Temperature

Stimulants may cause overheating and sweating, while depressants can lower body temperature.

Pinpoint or Enlarged Pupils

Pinpoint pupils commonly indicate an opioid overdose. Dilated pupils may signal a stimulant or hallucinogen overdose.

Signs of Overdose by Substance Type

Opioids (Heroin, Fentanyl, Prescription Painkillers)

  • Pinpoint pupils
  • Slowed or stopped breathing
  • Pale, clammy skin
  • Limp body
  • Unresponsiveness

Stimulants (Cocaine, Methamphetamine, Ecstasy)

  • Agitation or anxiety
  • High body temperature
  • Chest pain or rapid heartbeat
  • Seizures
  • Severe confusion

Alcohol

  • Vomiting
  • Slow, irregular breathing
  • Low body temperature
  • Inability to wake up
  • Blue-tinged skin

Benzodiazepines and Other Sedatives

  • Extreme drowsiness
  • Slowed breathing
  • Loss of coordination
  • Confusion

Mixed Substances (Polysubstance Use)

Mixing substances, especially alcohol with opioids or sedatives, dramatically increases overdose risk. Symptoms may be unpredictable and severe.

What to Do If You Suspect an Overdose

Act quickly if you suspect an overdose. Delaying can cost a life. Call emergency services immediately; even if you’re unsure, it’s better to be safe. Check for signs of breathing and responsiveness. Try gently shaking the person or speaking to them.

Administer naloxone (Narcan) if you suspect an opioid overdose. Narcan is safe and can rapidly reverse opioid effects. Place the person in the recovery position (on their side) to prevent choking. Stay with the person until help arrives. They may go in and out of consciousness or stop breathing again.

Preventing Overdoses

While not all overdoses can be prevented, reducing risk is possible. Take medications only as prescribed and avoid mixing substances. Know how to access and use naloxone. Seek professional help if you are ready to put risky behavior behind you and start recovery.

Recognizing the indicators of an overdose is crucial and can be lifesaving. Understanding what to look for and responding quickly can make all the difference. If you ever suspect an overdose, treat it as an emergency. Quick action saves lives.