Drug Overdose Symptoms: How to Recognize, Respond, and Get Help

A drug overdose is a medical emergency. If someone is unconscious, cannot be awakened, is having trouble breathing, is experiencing a seizure, or has severe chest pain after using a substance, call 911 immediately.

Do not wait for every symptom to appear. You may not know what the person took, how much they used, or whether a substance contained fentanyl. Acting quickly can save their life.

According to final data from the Centers for Disease Control and Prevention, 79,384 drug overdose deaths occurred in the United States during 2024. Although that represented a substantial decline from 2023, the number shows why recognizing drug overdose symptoms and knowing how to respond remain so important.

An overdose does not have to be the end of someone’s story. Once the immediate emergency has been addressed, professional drug and alcohol addiction treatment can help an individual understand what contributed to the overdose and begin building a safer path forward.

Key Takeaways

• Call 911 immediately if you suspect an overdose.
• Opioid overdose commonly causes unconsciousness and slow, shallow, or stopped breathing.
• Stimulant overdose may cause overheating, chest pain, a rapid or irregular heartbeat, extreme agitation, hallucinations, or seizures.
• Give naloxone if an opioid overdose is possible and naloxone is available.
• Place an unconscious person on their side only if they are breathing.
• If the person is not breathing normally, follow the 911 dispatcher’s instructions and begin CPR if you are trained.
• Stay with the person until emergency responders arrive.
• After the emergency, professional treatment can help address continued substance use and reduce future risk.

What Is a Drug Overdose?

An overdose happens when a substance, or a combination of substances, overwhelms the body’s ability to function safely.

Overdose can affect breathing, consciousness, heart rhythm, blood pressure, body temperature, or several systems at once. It may involve:

• Prescription medications
• Opioids such as fentanyl, heroin, or oxycodone
• Stimulants such as cocaine or methamphetamine
• Benzodiazepines
• Alcohol
• Over-the-counter medications
• Counterfeit pills
• Multiple substances taken together

An overdose can be accidental or intentional. It can happen after taking an unexpected dose, mixing substances, returning to drug use after a period of abstinence, or taking a counterfeit pill containing an unknown ingredient.

Some overdoses develop within minutes. Others become more serious over several hours. A person who initially appears awake or responsive can still be experiencing a life-threatening emergency.

Common Drug Overdose Symptoms

The signs of an overdose depend on the substance involved. However, several warning signs require immediate medical attention:

• Unconsciousness or inability to awaken
• Slow, shallow, irregular, or stopped breathing
• Choking, gurgling, or unusual snoring sounds from someone who cannot be awakened
• Blue, purple, gray, or ashen lips, gums, or nail beds
• A very fast, very slow, or irregular heartbeat
• Chest pain or tightness
• Seizures
• Severe confusion or sudden collapse
• Extreme agitation, paranoia, or hallucinations
• High body temperature or heavy sweating
• Repeated vomiting
• Pale, cold, or clammy skin

Skin discoloration caused by low oxygen may appear differently depending on skin tone. Changes may be easier to see around the lips, gums, inside of the mouth, or nail beds.

If you are unsure whether someone is overdosing, treat the situation as an overdose and call 911.

Signs of an Opioid Overdose

Opioids affect the area of the brain that controls breathing. During an opioid overdose, breathing can become dangerously slow or stop completely.

Opioids include:

• Fentanyl
• Heroin
• Oxycodone
• Hydrocodone
• Morphine
• Codeine
• Other prescription pain medications

Common opioid overdose symptoms include:

• Inability to wake the person
• Slow, shallow, or absent breathing
• Choking, gurgling, or snoring sounds
• A limp body
• Small, constricted pupils
• Cold or clammy skin
• Blue, gray, or discolored lips and nails

Someone making gurgling or snoring sounds while unresponsive should not be assumed to be sleeping. These sounds can indicate that the person is struggling to breathe.

Illicitly manufactured fentanyl is especially dangerous because it is highly potent and may be present in counterfeit pills or mixed with other drugs without the person’s knowledge.

Signs of a Stimulant Overdose

Stimulants place intense strain on the cardiovascular system and interfere with the body’s ability to regulate temperature.

Stimulants include cocaine, methamphetamine, amphetamines, and some prescription medications when misused.

Serious stimulant overdose symptoms can include:

• Rapid or irregular heartbeat
• High blood pressure
• Chest pain or tightness
• Overheating
• Excessive sweating
• Tremors
• Severe anxiety or panic
• Confusion
• Hallucinations
• Psychosis
• Agitation or aggression
• Nausea or vomiting
• Seizures
• Signs of a stroke or heart attack

A person experiencing stimulant toxicity may still be awake and talking. Do not assume the situation is safe because the person is conscious. Chest pain, overheating, seizures, severe confusion, or an irregular heartbeat require emergency medical care.

There is no medication available to bystanders that reverses a stimulant overdose in the way naloxone can reverse an opioid overdose. Call 911 so medical professionals can manage the person’s temperature, heart rhythm, blood pressure, seizures, and other complications.

Because cocaine and methamphetamine may be contaminated with fentanyl, administer naloxone if it is available and opioid exposure is possible.

Signs of Alcohol, Benzodiazepine, or Sedative Overdose

Alcohol, benzodiazepines, and other sedatives slow central nervous system activity. The danger increases when these substances are combined with each other or with opioids.

Possible signs include:

• Extreme drowsiness
• Confusion
• Inability to awaken
• Slow or irregular breathing
• Poor coordination
• Vomiting
• Pale, bluish, or clammy skin
• Loss of protective airway reflexes
• Seizures in some situations

Do not leave an unconscious person to “sleep it off.” A person who is unresponsive can choke, stop breathing, or experience other serious complications.

Naloxone does not reverse alcohol or benzodiazepine overdose. However, it should still be given when opioid involvement is possible because many overdoses involve more than one substance.

What to Do If You Suspect an Overdose

If someone may be overdosing, use the following steps.

1. Call 911

Tell the dispatcher that the person may be experiencing an overdose. Describe whether the person is conscious and breathing.

Give your exact location and follow the dispatcher’s instructions. If another person is present, ask them to call while you remain with the individual.

Arizona law provides certain protections related to possession and drug paraphernalia when someone seeks medical assistance in good faith for a drug-related overdose. These protections are limited, but fear of legal consequences should not prevent anyone from calling for help.

2. Check Responsiveness and Breathing

Call the person’s name and tap their shoulder. Look for normal chest movement and listen for breathing.

Gasping, choking, gurgling, or occasional breaths are not normal breathing.

3. Give Naloxone If Opioid Exposure Is Possible

Naloxone is a medication that temporarily reverses the effects of opioids. It can restore breathing during an opioid overdose.

If naloxone nasal spray is available:

1. Remove the device from its package.
2. Place the tip into one nostril.
3. Press the plunger firmly to release the dose.
4. Follow the product instructions and the 911 dispatcher’s guidance.
5. If the person does not respond after 2 to 3 minutes, give another dose if available.

Naloxone will not reverse an overdose caused only by cocaine, methamphetamine, benzodiazepines, or alcohol. It is unlikely to harm someone if opioids are not present, so give it when an opioid overdose is possible.

Naloxone is temporary. A person can stop breathing again after initially waking up, especially when a potent or long-lasting opioid is involved. Emergency medical evaluation is still necessary.

4. Support Breathing

If the person is not breathing normally, follow the dispatcher’s instructions. Begin CPR if you are trained and use an automated external defibrillator if one is available.

Do not delay naloxone or emergency care while trying to determine exactly which substance was used.

5. Use the Recovery Position When Appropriate

If the person is unconscious but breathing, place them on their side with their head supported. This position can help keep the airway open and reduce the risk of choking if they vomit.

Do not place someone in the recovery position instead of beginning CPR when they are not breathing normally.

6. Stay Until Help Arrives

Continue monitoring the person’s breathing and responsiveness. Tell emergency responders what you know about the substances taken, when they were used, and whether naloxone was given.

Do not leave the person alone, even if they wake up and say they feel fine.

What Not to Do During an Overdose

During an overdose emergency:

• Do not leave the person alone.
• Do not let an unconscious person “sleep it off.”
• Do not put the person in a shower or bath.
• Do not give them food, coffee, alcohol, or other drugs.
• Do not try to make them vomit.
• Do not slap, kick, or otherwise try to cause pain.
• Do not assume one naloxone dose has ended the emergency.
• Do not delay calling 911 while searching for more information.

If the person is severely agitated after stimulant use, reduce noise and stimulation while waiting for help. Keep a safe distance if needed and remove nearby hazards without restraining the person unless emergency professionals instruct you to do so.

How to Reduce Overdose Risk

The safest way to prevent an overdose is not to use non-prescribed substances. People who continue to use drugs can still take practical steps to reduce risk.

Carry Naloxone

Naloxone is available over the counter. Arizona also makes it available through pharmacies and community programs. The Arizona Health Care Cost Containment System provides information about obtaining naloxone and responding to opioid overdose.

Friends and family members should know where naloxone is stored and how to use it.

Avoid Mixing Substances

Combining opioids with alcohol, benzodiazepines, sleep medications, or other sedatives greatly increases the risk of respiratory depression.

Mixing stimulants with opioids is also dangerous. One substance does not cancel out the other.

Be Aware of Lost Tolerance

Tolerance can decrease after detox, treatment, hospitalization, incarceration, or any period without use. Returning to a previously used amount can cause a fatal overdose.

For opioid use disorder, detoxification by itself is not considered sufficient treatment. Medication-assisted treatment, counseling, and continued recovery support can reduce overdose risk and help individuals maintain progress.

Take Medication Only as Directed

Do not take more than the prescribed amount or combine medication with alcohol or other drugs without consulting a healthcare professional.

Store medication securely and dispose of unused medication through an authorized take-back program.

Seek Support After an Overdose

A nonfatal overdose is a serious medical event and an important opportunity to connect with care. Treatment can address substance use, mental health symptoms, trauma, cravings, triggers, and other factors that may contribute to continued risk.

When addiction and mental health concerns occur together, dual diagnosis treatment can address both conditions as part of one coordinated plan.

How Lifeline Rehabilitation Center Can Help After an Overdose

Lifeline Rehabilitation Center is not an emergency medical provider. If an overdose is happening now, call 911.

After emergency stabilization, Lifeline provides structured addiction treatment in Scottsdale for people affected by alcohol or drug use. Lifeline also supports individuals experiencing co-occurring mental health concerns such as anxiety, depression, trauma, or mood disorders.

Treatment begins by understanding the individual’s substance use, mental health needs, current stability, responsibilities, and recovery goals. Depending on that assessment, Lifeline’s programs may include:

• Partial Hospitalization Program
• Intensive Outpatient Program
• Outpatient treatment
• Individual and group counseling
• Cognitive behavioral therapy
• Dialectical behavior therapy
• Trauma-focused care
• Family counseling
• Medication management
• Relapse prevention
• Expressive and creative therapies
• Aftercare planning and alumni support

When medically supervised withdrawal is needed, Lifeline coordinates with trusted Arizona detox providers. Once the individual is medically stable, Lifeline’s Scottsdale programs provide continued structure, clinical care, and practical recovery support.

Lifeline’s expressive and evidence-based treatment modalities give individuals multiple ways to understand triggers, regulate emotions, rebuild confidence, and develop healthier coping skills. Clinical therapies such as CBT and DBT are combined with creative approaches that may include art, music, writing, mindfulness, movement, and breathwork.

This approach recognizes that overdose risk is not always connected to one issue. Substance use may overlap with trauma, isolation, unstable mental health symptoms, relationship difficulties, or a loss of purpose. Effective treatment looks at the whole person rather than focusing only on the emergency that brought them to care.

An overdose does not mean that someone is beyond help. It means the current situation is dangerous and a different level of support may be needed.

If you or someone you love is concerned about continued drug use or a recent overdose, connect with Lifeline Rehabilitation Center. Our admissions team can answer questions about treatment options, explain possible next steps, and help verify insurance benefits.

Frequently Asked Questions About Drug Overdose Symptoms

Can someone be overdosing if they are still awake?

Yes. A person experiencing stimulant toxicity may remain awake while having chest pain, overheating, extreme agitation, hallucinations, or a dangerous heart rhythm. Someone in the early stages of another overdose may also initially remain responsive. Call 911 if serious symptoms are present.

How can I tell whether someone is very intoxicated or overdosing?

It can be difficult to tell. If the person cannot be awakened, is not breathing normally, makes gurgling sounds, has discolored lips or nails, experiences a seizure, or reports chest pain, treat the situation as an overdose.

When in doubt, call 911.

Can naloxone reverse every type of overdose?

No. Naloxone reverses opioid effects. It does not reverse alcohol, benzodiazepine, cocaine, or methamphetamine overdose.

Because fentanyl may be mixed with other substances, naloxone should be given when opioid exposure is possible. The person still needs emergency medical care.

What if the person wakes up after receiving naloxone?

Stay with them and wait for emergency responders. Naloxone’s effects are temporary, and overdose symptoms can return. The person may also have complications requiring medical evaluation.

How many doses of naloxone should I give?

Follow the product instructions and the 911 dispatcher’s guidance. If the person does not respond after 2 to 3 minutes, a second dose may be needed. Continue emergency breathing support as directed.

Does Arizona protect people who call 911 about an overdose?

Arizona’s Good Samaritan law provides certain protections from charges related to possession, use, or drug paraphernalia when evidence is discovered because someone sought medical assistance in good faith for an overdose. It does not provide immunity for every possible offense.

Call 911 even if you are worried about legal consequences. Saving a life is the priority.

What should happen after a nonfatal overdose?

The person should receive emergency medical evaluation even if they appear to recover. Follow-up care should address continued substance use, overdose-prevention planning, access to naloxone, and appropriate addiction treatment. Lifeline can help individuals and families explore structured treatment after the immediate medical emergency has been resolved.