What Happens During and After an Overdose?

When someone experiences an overdose, their body becomes overwhelmed by the toxic effects of the substance they’ve consumed. Typically, the body processes and eliminates drugs, but when the amount of a drug exceeds what the body can handle, it leads to dangerous and potentially life-threatening symptoms. Understanding these symptoms and the immediate aftermath can save lives and prevent long-term issues.

The Stages of a Drug Overdose

1. Drug ingestion: When someone takes a drug—whether it’s an opioid, stimulant, or depressant—it enters the body and starts to work. Depending on the type of drug, the effects might be felt quickly or take a little longer to kick in.
2. Body’s reaction: As the drug spreads through the body, it affects different organs. For example, opioids can slow down your breathing a lot, while stimulants might make your heart beat too fast or cause seizures.
3. Warning signs: Before an overdose entirely happens, there are often warning signs. You might notice the person becoming confused, losing coordination, or extremely sleepy. These signs can quickly turn into more severe problems like passing out, having seizures, or trouble breathing.
4. Serious overdose symptoms: During an overdose, the body starts to shut down. Breathing might stop or slow down a lot, the heart may beat unevenly, and the brain may not get enough oxygen. Without quick treatment, this can cause permanent damage or even death.
5. Emergency response: If someone overdoses on opioids, giving them naloxone (Narcan) can reverse the overdose and stabilize them. If naloxone isn’t available or for other drugs, CPR and emergency medical care are critical. But remember, this is just the first step—they’ll still need more care afterward.

If you or someone you know is overdosing, call 911 immediately. Don’t wait—quick action can save a life. Stay with the person until help arrives, and if you have naloxone, use it as instructed.

Immediate and Long-Term Effects of an Overdose

An overdose can have both immediate and long-lasting effects on the body and mind. The immediate effects are life-threatening and require urgent medical attention. These include:

• Respiratory failure: Particularly with opioids, the risk of respiratory failure is high. Without enough oxygen, vital organs begin to fail.
• Cardiac arrest: Overdoses can lead to abnormal heart rhythms, potentially resulting in cardiac arrest, where the heart stops pumping blood effectively.
• Seizures: Low oxygen levels or the toxic effects of certain drugs can cause seizures, which may lead to brain damage if prolonged.

Even if you or someone you know survives an overdose, there may be long-term effects, such as:

• Brain damage: Lack of oxygen during an overdose can cause irreversible brain damage, leading to cognitive impairments, memory loss, or motor skill issues.
• Organ damage: The liver, kidneys, and heart can sustain damage from the toxic effects of drugs, particularly if the overdose is severe.
• Mental health issues: The trauma of an overdose and the physical impact on the brain can lead to long-term mental health issues, including anxiety, depression, and PTSD.

Common Causes of Overdose

Understanding the factors that lead to an overdose can be crucial in helping to prevent it. Overdoses can happen for various reasons, and being aware of these can help you or a loved one avoid dangerous situations.

• Accidental overconsumption:  Overdosing can happen when someone unintentionally takes more of a substance than intended. This might happen because they don’t realize how potent or dangerous the drug is, or they misjudge the amount they can safely consume. This is particularly common with substances like prescription medications or illicit drugs that vary in strength.
• Intentional overdose: In some cases, overdoses are the result of a suicide attempt, where a person deliberately consumes a lethal amount of a substance. This can involve prescription drugs, over-the-counter medications, or illicit substances. Intentional overdoses require immediate medical and psychological intervention.
• Polydrug use: Mixing drugs, such as combining opioids with alcohol or benzodiazepines, significantly raises the risk of overdose. The effects of these substances can interact in dangerous ways, overwhelming the body’s ability to process them. Polydrug use is particularly risky because it can depress vital functions like breathing and heart rate to life-threatening levels.
• Relapse after detox: After a period of detox or abstinence, the body’s tolerance to a drug decreases. If a person returns to using the same dose they previously used before detox, they may unknowingly consume a lethal amount. This is common with fentanyl and other opioids and makes relapse incredibly dangerous, as the body can no longer handle the same levels of the substance.
• Ingestion of a purified or altered drug: Sometimes, a person might ingest a drug that is much stronger than what they’re used to. This can happen with drugs that are unexpectedly pure or have been mixed with other potent substances like fentanyl, which is typically the most common scenario in recent times. These unknown additives can dramatically increase the risk of overdose, as the individual may be unaware of the drug’s true potency.

What to Do If Someone Is Overdosing

If you suspect that someone is experiencing an overdose, it’s natural to feel frightened or uncertain about how to respond. Acting quickly and effectively can save a life. Follow these steps to provide the best possible assistance:

1. Recognize the Signs of an Overdose

Being able to identify the signs of an overdose is the first critical step in providing help. While symptoms can vary depending on the substance involved, common signs of an opioid overdose include:

• Unresponsiveness: The person may not wake up or respond to shouting, shaking, or painful stimuli like a firm pinch.
• Slow or shallow breathing: Breaths may be very slow, irregular, or completely stopped. You might notice long pauses between breaths or hear choking sounds.
• Pale or blue skin: Due to a lack of oxygen, skin, especially around the lips and fingernails, may turn pale, bluish, or cold.
• Pinpoint pupils: The pupils become extremely small and do not respond to changes in light.
• Snoring or gurgling sounds: These noises can indicate that the person’s airway is partially blocked and they’re struggling to breathe.

For other substances, signs may include severe agitation, chest pain, seizures, vomiting, or loss of consciousness.

Important: If you are unsure whether someone is overdosing, it’s safest to treat the situation as an overdose and seek immediate help.

2. Call 911 Immediately

Time is of the essence in an overdose situation. Dial 911 as soon as you recognize the signs.

• Provide clear information, including:
  • Your exact location, including any landmarks or room numbers.
  • The person’s condition (e.g., unconscious, not breathing, seizures).
  • What substance(s) were taken, and in what quantity, if known?
  • Any known medical history or allergies of the person.
• Follow Instructions: The operator may provide guidance on what to do until emergency services arrive. Listen carefully and follow their directions closely.

Don’t hesitate to call for help, even if illegal substances are involved. Most states have Good Samaritan laws that protect individuals seeking medical assistance for an overdose from legal consequences related to drug possession.

3. Administer Naloxone if Available

Naloxone (Narcan) is a life-saving medication that can reverse an opioid overdose.

• Use as directed: If you have naloxone, follow the product’s instructions. Naloxone most commonly comes as a nasal spray.
• Act quickly: If the person doesn’t respond within 2-3 minutes, you may need to administer additional doses.
• Availability: Naloxone is available without a prescription in many pharmacies. You should consider keeping it on hand if you or someone you know is at risk of an opioid overdose.

Note: Naloxone is safe to use and has no effect if opioids are not present in the person’s system. Always call 911 even if the person revives, as further medical care is necessary.

Related: Narcan vs. Vivitrol

4. Perform Rescue Breathing or CPR

If the person isn’t breathing or has a weak pulse, you may need to perform rescue breathing or CPR to help keep them alive until emergency services arrive. If you’re unsure how to perform these actions, the 911 operator can guide you through the process.

Many online resources, such as the American Heart Association’s CPR & First Aid Training, are also avaiable. CPR is a valuable skill that could save a life.

5. Stay with the Person

Stay with the person until help arrives. Make sure they are as comfortable as possible and monitor their condition closely. The 911 operator can guide you on what to do while you wait for emergency services.

It’s important not to leave them alone, as their condition could worsen quickly.

What Happens After an Overdose and Emergency Services Are Called?

Once you’ve called 911 and help is on the way, you might wonder what happens next. Understanding the next steps can help ease anxiety for some people during this stressful time. Here’s what you can typically expect:

1. Emergency Medical Services (EMS) Arrival: When EMS arrives, they will assess the situation and provide necessary medical care. This might include administering additional doses of naloxone, providing oxygen, or performing other life-saving measures.

Transportation to the hospital: In most cases, EMS will recommend that the person be transported for further evaluation and treatment. Even if the person appears to be recovering after naloxone, medical professionals should monitor it to ensure there are no complications. The person may have the option to decline transportation or further treatment if they are alert and stable, though this is not recommended.

Hospital care: At the hospital, doctors will continue to monitor the person’s condition. They may provide additional treatment to ensure the overdose is fully reversed and that there are no complications. This could include treating any injuries sustained during the overdose or addressing withdrawal symptoms.

Aftercare and support: Surviving an overdose is a serious event that often indicates the need for more support to prevent it from happening again. After the immediate crisis, medical staff may recommend follow-up care, such as enrolling in a treatment program, counseling, or other forms of support.

If you or someone you know is struggling with addiction, you’re not alone. Porch Light Health offers resources and various expert treatment options for individuals across Colorado and New Mexico, both online and in-person. Call today at 866-394-6123 to learn more. 

How to Help Someone After an Overdose

Helping someone after they’ve overdosed is about more than just the immediate crisis. Here’s how you can support their recovery and reduce the risk of future overdoses:

• Encourage treatment: After an overdose, it’s important to encourage the individual to seek treatment for their substance use. This could involve detox, inpatient or outpatient treatment, or medications for addiction treatment (MAT). Addiction treatment programs can provide the tools needed to manage substance use and reduce the risk of future overdoses.
• Stay involved: Being supportive and involved in the recovery process can make a big difference. If possible, attend appointments with your loved one, help them set goals, and be there to talk when they need it. Knowing that someone cares can be a powerful motivator for change.
• Ensure access to naloxone: Ensure the person has access to naloxone in the future. It’s generally available at many pharmacies and health departments. You can also keep a supply on hand if you’re concerned about the risk of another overdose.
• Support long-term recovery: Recovery is a long-term process that often involves setbacks. Encourage them to engage with support groups like Alcoholics Anonymous, Narcotics Anonymous, or similar organizations. These groups can provide community and accountability, which is crucial for maintaining sobriety.
• Look for signs of relapse: Relapse is a common part of recovery, but it doesn’t mean failure. Be on the lookout for signs your loved one might be using again, and gently encourage them to seek help if you notice any warning signs. Remember that this is ultimately their decision, and it’s not your fault if they decide they aren’t ready. 
• Take care of yourself: Supporting someone through recovery can be emotionally and physically exhausting. Don’t forget to take care of your health and well-being, too. Seek support for yourself through counseling, support groups for loved ones of people with substance use disorders, or simply by ensuring you have time to recharge. Remember, you can’t pour from an empty cup—taking care of yourself allows you to be a better support for your loved one.

The Importance of Follow-Up Care After an Overdose

After an overdose, the next steps are crucial in preventing future incidents. Transitioning from emergency care to ongoing treatment is essential. Unfortunately, many individuals do not receive the necessary follow-up care after being discharged from the hospital after an overdose. 

Why Follow-Up Care Matters: Studies show that even after a nonfatal opioid overdose, a significant number of patients continue to receive opioid prescriptions, often from the same provider who initially prescribed them. Without proper follow-up care, the risk of another overdose remains high. Here’s how you can make sure you or your loved one gets the right support:

How to Advocate for Yourself or a Loved One After an Overdose

1. Ask for mental health support: 

Surviving an overdose can be a traumatic experience, and mental health support is vital for recovery. When in the hospital, you can ask the staff to connect you or your loved one with a mental health professional. This “warm handoff” can help build trust and ensure that the person gets a treatment plan that addresses both substance use and any related mental health issues.

2. Request information about MAT:

MAT can be a game-changer for those recovering from an opioid overdose. It helps manage withdrawal symptoms and reduces cravings, making it easier to stay on the path to recovery. Ask the hospital staff if MAT is appropriate and can be started before discharge. This can significantly improve long-term outcomes and reduce the chances of needing to return to the hospital. 

You can also request connections to outpatient programs like Porch Light Health that specialize in MAT and can provide ongoing support once you leave the hospital. These programs can be vital in helping you or your loved one maintain sobriety and build a healthier future. Learn more about MAT at Porch Light Health.

3. Ensure access to naloxone: 

Naloxone is a life-saving medication that can reverse an opioid overdose. Make sure you or your loved one leaves the hospital with a prescription for naloxone or information about where to obtain it and that you know how to use it. Many pharmacies can fill the prescription or provide it over the counter. Having naloxone on hand can prevent a future overdose from becoming fatal.

4. Connect with recovery and social supports: Recovery is a long-term process, and having the right support network is critical. Ask the hospital or a social worker to help you find local support groups, outpatient substance abuse treatment programs, and resources. As mentioned earlier, 12-step or SMART Recovery support groups can greatly benefit some individuals as they navigate the path to recovery. 

5. Seek stable housing: Access to safe, drug-free housing is a significant factor in preventing future overdoses. If your loved one struggles with housing insecurity, ask about options for sober living environments or other supportive housing programs. Having a safe and stable place to live can reduce stress and provide a strong foundation for recovery.

Key Questions to Ask Before Leaving the Hospital

• Can you connect me with a mental health professional?
• Is MAT appropriate for me/my loved one, and can it be started here?
• How can I get a prescription for naloxone, and where can I learn to use it?
• What recovery support groups or social services can you recommend?
• Are there resources available for housing or sober living environments?
• Are there other local resources or organizations you can connect us with?

Overdose Prevention and Long-Term Support

Preventing future overdoses is a vital part of recovery and often the most pressing concern for loved ones after a nonfatal overdose. Here are some strategies to help reduce the risk of future events:

• Education: Learn as much as possible about the substances involved, the risks of overdose, and the available treatments. Knowledge is a powerful tool in preventing future crises. Understanding the dangers and knowing the signs of overdose can help you act quickly and effectively if needed.
• Building a support network: A strong support system and meaningful connections can help an individual stay on track. This includes family, friends, and healthcare providers who can offer encouragement and guidance.
• Resources: Connecting with local resources, including recovery programs and services that specialize in overdose prevention and addiction treatment, can provide the professional support needed to maintain sobriety. 
• Treatment and counseling: Ongoing treatment and counseling are essential for managing addiction and preventing relapses. This might include regular visits to a therapist, inpatient or residential treatment, or participation in an outpatient treatment program.

Related: Porch Light Health & KKTV 11 News: Discussing Overdose Awareness

How Porch Light Health Can Help

At Porch Light Health, we are committed to supporting individuals and communities in the fight against overdose and addiction. Our outpatient addiction treatment and mental health services, including medications for addiction treatment (MAT), provide the support needed to help you or your loved one recover. 

With more than 60 points of care across Colorado and New Mexico, including walk-in and mobile clinics, we make it easier to access the care you need when you need it. If you’re ready to take the next step toward recovery, contact us today at 866-394-6123 to learn more about how we can support you. You don’t have to walk this path alone.

References

1. Larochelle, M. R., Liebschutz, J. M., Zhang, F., Ross-Degnan, D., & Wharam, J. F. (2016). Opioid Prescribing After Nonfatal Overdose and Associated with Repeated Overdose: A Cohort Study. Annals of Internal Medicine, 164(1), 1-9. https://doi.org/10.7326/M15-0038