Preventing and Responding to Overdoses

 

What is an Overdose?

An overdose is when too much of a drug (or drugs) in a person’s body and it affects their body’s ability to maintain basic functions needed for life (such as breathing, heart rate and body temperature regulation). In an opioid overdose, what usually happens is that a person’s breathing slows or stops. Not everyone who overdoses will die but there can be long-term effects such as brain damage from lack of oxygen.

 

Who can Overdose?

Anyone who uses substances (whether they are a new or long-term user) can overdose. A person may be more at risk of an overdose depending on:

• Substance(s) taken
• How much of a substance or substances were taken
• How strong and the quality of the substance(s) used
• If the substance(s) were cut with other drugs
• How the substance(s) were taken (i.e. orally, snorted, injected, etc.)
• Tolerance to the substance(s) used
• Health status (if there are any existing medical conditions)
• Setting where use occurs (e.g. using alone versus in a group)
• New supply or buying from a new dealer.

 

Overdose Prevention

Risk	Overdose Prevention Tip
Mixing	Wait before taking another dose When trying a new or different opioid, use less and give more time to feel the effects.
Quantity Taken	Wait before taking another dose When trying a new or different opioid, use less and give more time to feel the effects.
Strength/Quality/Cut	Test drugs using a small amount first, especially if using a new supply or dealer.   If injecting, take the tourniquet off before depressing the plunger, stop halfway to see the effects, and inject less if it feels too strong.
How substance is taken	Be careful if changing routes (e.g. going from swallowing pills to injecting) – you may not be able to handle the same amount.   If using alone, consider snorting or ingesting instead of injecting.
Tolerance	Use less if you know your tolerance might be lower (e.g. new user, just started using again, trying a new route or substance)   Do testers   Change the route of administration (e.g. injecting to snorting or swallowing drugs) until tolerance is developed.
Health Status	Eat nutritious foods, drink enough water, get enough sleep   Seek health care as regularly as possible.   Go slow (changing the route of administration, use less)   Use less when you have been sick, lost weight, or feeling down – doing more to “feel better” is a risk factor for overdose.
Setting	Carry naloxone and get training for overdose prevention, recognition and response.   Don’t use alone. Make a plan and have a buddy who can call for help if needed (see more about the Good Samaritan Overdose Prevention Act)   Call 911 right away if someone overdoses, even if naloxone is given.

 

Recognizing an Opioid Overdose

Remember that drugs may be combined, so you might see other symptoms. Signs of an opioid overdose include:

• Slow, erratic or no breathing
• Blue lips, nails or skin
• Limp body
• Pinpoint pupils
• Cold, clammy skin
• Doesn’t respond to shouting or shaking
• Deep snoring or gurgling sounds
• Vomiting
• Loss of consciousness

*The difference between “the nods” and an overdose is unresponsiveness (not responding to shouting, shaking, etc.)

 

Responding to an Opioid Overdose

1. Stimulate (shake shoulders, shout)
2. Call 911
3. Give Naloxone
4. Chest compressions and rescue breathing
5. Check (give another dose of naloxone after 3-5 minutes if no change)

DO NOT Put the person in a cold bath Make the person vomit Inject the person with anything other than naloxone (e.g. saltwater, cocaine, milk) Let the person sleep it off.

The Haldimand-Norfolk Health Unit provides training and naloxone kits. See Naloxone Kits for more information.

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