Emergency

Overdose signs

• Unresponsive / can't be woken, even to a firm sternal rub
• Slow, shallow, or stopped breathing
• Pinpoint pupils
• Blue/grey lips, fingertips, or skin (cyanosis)
• Limp body; pale, clammy skin
• Choking or gurgling sounds ("death rattle")
• Slow, erratic, or absent pulse

First response

• Try to wake them — shout their name, firm sternal rub
• Call emergency services immediately
• Administer naloxone if available
• Give rescue breaths (or CPR if there is no pulse)
• Place them in the recovery position
• Stay with them; re-dose naloxone every 2–3 minutes if there is no response

Reversal agent

Naloxone (Narcan) — opioid antagonist. May require repeated doses; its effect can wear off before the opioid does.

For the medical team

Tell the dispatcher: opioid overdose suspected, whether naloxone was given and the response, and breathing/pulse status. Name the substances involved if known. Good Samaritan laws protect callers in many jurisdictions.

Resolution

With prompt naloxone and rescue breathing, reversal is usually rapid. Because naloxone can wear off before the opioid — especially with long-acting opioids (methadone) or high-potency ones (fentanyl) — a period of monitoring is needed even after the person revives.

Every recorded risk