What Are the Signs of a Drug Overdose?

Drug overdoses are very common and dangerous events. Each year, more than 100,000 people in the U.S. die from a drug overdose. For those that survive an overdose, some go on to have harmful, long-term effects. Recognizing signs of an overdose early, can get treatment in place to prevent some of these complications.

Let’s take a closer look at overdoses and their signs and symptoms to help keep yourself and your loved ones safe.

What is an overdose?

An overdose occurs any time you take too much of a drug. With an excess of the drug in your system, it begins to overwhelm the normal functioning in your body and brain. 

The toxic amount of the drug can be life-threatening and result in death. Or it could make you very ill, mentally and physically. Sometimes the effects can be brief or they can last a lifetime.

Some overdoses are obvious, with dramatic symptoms that require immediate medical attention. Other overdoses are more subtle and mild with an unclear set of symptoms. Whatever the case, being aware and educated about overdoses is essential to limit potential harm.

Overdose symptoms

Some general and common symptoms of a drug overdose are:

• Nausea, vomiting, and diarrhea

• Pain

• Drowsiness, confusion, and poor coordination

• Agitation and paranoia

• Loss of consciousness

• Breathing problems

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But keep in mind, the signs of overdose will differ greatly. Some factors that determine the signs and symptoms of overdose are:

• The drug or drugs used

• How much was used

• How the drug was consumed (smoked, snorted, or injected)

• The age and health of the individual

• Previous experiences with drugs and overdoses

Overdoses can range from mild to severe, with coma or death being a real possibility. The breathing issues linked to opioid overdoses can cause loss of oxygen to the brain. This can lead to permanent brain damage and long-term health effects. 

You can reduce your risk of overdose by avoiding dangerous substances and following prescription instructions for medications. 

What are the signs and symptoms of an opiate overdose?

Opioid or opiate overdoses are very common. And they can happen very quickly and with little warning. The signs of an opioid overdose include:

• Skin that’s pale or very clammy to the touch

• Lips and fingernails turning blue

• Limp body

• Vomiting or gurgling noises from the mouth

• Slowed breathing

• Slowed heart rate

• Being unconscious or unable to speak

• Small pupils

Opioids and opiates have the same effects in the body. The terms differ only in where the drug comes from. Opiates — like morphine and codeine — occur in nature and are derived from the poppy plant. Opioid could refer to a drug that happens naturally or is made in a lab. 

What does a depressant overdose look like?

Central nervous system (CNS) depressants, such as benzodiazepines, create drowsy and calming effects. When a depressant overdose occurs, it produces:

• Vision problems

• Extreme weakness and passing out

• Slowed or stopped breathing

• Confusion and lower alertness

• Coma

What are the signs of alcohol poisoning?

Alcohol overdose symptoms include:

• Slow and irregular breathing

• Slow heart rate

• Dulled reflexes

• Confusion and trouble staying awake

• Low body temperature and blue or pale skin

• Seizures

What does a stimulant overdose look like?

Opioids, depressants, and alcohol have some overlapping side effects. But stimulants create different effects. The most common symptoms of stimulant overdose are:

• Restlessness and overactive reflexes

• Quicker breathing

• Fever

• Fast and irregular heartbeat

• Extreme blood pressure changes

• Irritability, paranoia, and aggression

• Convulsions and coma

What happens in the body when you overdose?

When you use alcohol and other drugs, the substance begins disrupting your brain’s chemical messengers. The drug could slow down messengers, like in the case of alcohol, opioids, and depressants. Or it could speed up the messaging, like with cocaine, methamphetamine, and prescription stimulants.

Some disruption causes happiness, excitement, or relaxation. But too much imbalance causes a dangerous response. The drugs that slow down the body can stop your breathing and heartbeat. Drugs that speed the body up can damage your heart and trigger dangerous mental health symptoms.

What types of substances can cause an overdose?

Numerous substances can produce an overdose. Accidental overdoses can stem from:

• Alcohol

• Prescriptions medications, like attention-deficit hyperactivity (ADHD), anxiety, and painkiller medications

• Over-the-counter (OTC) medications like acetaminophen

• Illegal substances, like heroin, methamphetamine, and cocaine

• Certain herbal remedies and supplements

The CDC studied the drugs linked to overdose. Of the top 10 drugs:

• Six were opioids, including fentanyl, heroin, and oxycodone.

• Two were stimulants — cocaine and methamphetamine.

• Two were depressants — alprazolam (Xanax) and diazepam (Valium).

Alcohol wasn’t included on this list, but it’s a major contributor consistently. More than 2,200 people die from alcohol poisoning each year. Most are adults between 35 and 64 years old.

Can you prevent a drug overdose?

In most situations, you can prevent a drug overdose. Try these overdose prevention tips:

• Take your medications exactly as they’re prescribed. Pay attention to the dose, the frequency, and the route of ingestion.

• Don’t mix different types of drugs. Doing so can intensify or cover up their effects.

• Never take a substance that you can’t verify. Dangerous substances, like fentanyl, can be mixed into drugs, which can increase the risk of overdose. 

• Get help. If you believe that your substance use or someone else’s is becoming problematic, reach out to a healthcare professional, therapist, or loved one.You can also reach out to a helpline like the National Helpline from the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-HELP (4357).

How are overdoses treated?

People experiencing overdoses need immediate medical attention. The treatment for an overdose depends on the substance used. 

Drug overdose treatment can involve:

• Blood and urine tests

• X-rays and scans

• Fluids through an IV

• Help breathing with oxygen or a breathing machine

• Activated charcoal

• Other medications to limit symptoms

For opioid overdoses, naloxone (Narcan) is the best treatment. This opioid blocker reverses the effects of opioids. 

For CNS depressants, like benzodiazepines and sleeping medications, flumazenil (Romazicon) may be used as overdose treatment. 

With alcohol and stimulant overdoses, healthcare professionals will observe and treat symptoms as they emerge. They’ll work to maintain healthy breathing and heart rates to ensure safety.

What should you do if someone is showing signs of an overdose?

To keep yourself or others safe if someone appears to have an overdose, always stay calm and:

• Contact emergency services immediately. Call 911 and get help.

• Stay with the person, and keep them sitting or lying down.

• Work to prevent choking if they happen to vomit. Roll the person on one side while supporting their head and neck.

• Be honest with professionals about substance use to aid treatment.

Never interfere during an overdose, and wait for the professionals to arrive. Avoid moving the person, using substances to cancel the effects (see exception below), or offering them food. These attempts may not be helpful and can make symptoms worse.

When should naloxone (or Narcan) be administered?

The exception to offering help and assistance is with naloxone. Whether used as a nasal spray (Narcan) or the prefilled syringe, it saves lives and anyone can administer it.

You may be able to get naloxone from a pharmacy, community health center, or training program. Naloxone is often free and available without a prescription at pharmacies. If you suspect that someone is having an opioid overdose, you should give a dose of naloxone while you call 911.

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Written by:

Eric Patterson, LPC

Eric Patterson, LPC, has been a professional counselor in school and outpatient settings — working with clients of all ages to achieve happiness, good mental health, and better lives — for over 15 years. Since 2010, he has provided clinical supervision to other therapists hoping to refine their skills and become licensed professionals.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Frank Schwalbe, MD

Frank Schwalbe, MD, is an assistant professor of anesthesiology at the Yale School of Medicine. He has practiced anesthesiology for 30 years.

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