Recently, reports of drug overdoses by celebrities and others have been seen on a regular basis in the news. Indeed, according to the Centers for Disease Control and Prevention, drug overdose has reached epidemic levels in the United States. Particularly when it comes to prescription painkillers and anti-anxiety/antidepressant drugs, addiction, overdose, and death rates have increased as much as five times in the last 15 years.

Because of the varying types of drugs, and the lack of knowledge around the symptoms of drug overdose, most people aren’t sure how to recognize or handle a drug overdose. Gaining a better understanding of how to spot an overdose can save valuable minutes and hours in getting the help needed to prevent serious physical injury or death after overdose.

In addition, learning about the stigma surrounding the people who become addicted and the legal consequences of being involved in or reporting a drug overdose can help overcome hesitations about getting help. Knowing about the laws around the country that have to do with drug overdose can clarify the actions that can be taken to help a person who is suspected to have overdosed. With prompt action, the person in need can get lifesaving help and addiction treatment.

Disclaimer: If experiencing or witnessing a suspected drug overdose, the first and most important thing to do is call 911 and report a life-threatening emergency.

prescription meds

The Effects of Drug Overdose

overdose effects

Sometimes, it can be difficult to know whether someone is actually experiencing the symptoms of a drug overdose. Of course, one of the easiest ways to be sure is if the person was seen taking more of a drug than prescribed, or taking a dangerous recreational drug like heroine or methamphetamine. Knowing what to look for can help people catch the signs of overdose and get help before it is too late.

In many ways, the effects of a drug overdose depend on the type of drug that has been consumed. However, according to a description of drug overdose on the Healthline online medical reference library, there are some symptoms that are seen across most drug types. These include:

  • Nausea and vomiting
  • Sleepiness or loss of consciousness
  • Agitation
  • Twitching and convulsions
  • Aggressive or violent behavior
  • Dilated pupils
  • Difficulty breathing or walking
  • Hallucinations, hearing voices, and sensing something that isn’t there

Not all of these symptoms may be present. However, if a person is suspected to be using a drug inappropriately, and some or all of these symptoms are occurring, it is possible the individual may have overdosed.

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What Causes Drug Overdose Symptoms?

Different types of drugs act on the body in different ways, and sometimes that means that they will present wildly different symptoms. This depends on how the drug acts on the body. The basic drug types and their specific actions can give a clearer picture of the type of symptoms to look for.

Depressants

These include painkillers, such as morphine, heroine, and other prescription and illicit opiate drugs. They also include benzodiazepines and similar antidepressant/anti-anxiety drugs like Xanax and Valium, and painkilling drugs like barbiturates. These drugs act on the body by suppressing aspects of the central nervous system to calm responses and relax the brain and body, slowing reflex response, breathing, and heart rate.

According to the International Overdose Awareness Day website, the overdose symptoms specific to depressants include:

  • Extremely slow or no breathing
  • Disorientation
  • Bluish lips or fingertips
  • Unconsciousness
  • Inability to rouse while unconscious
  • Coma

These symptoms result because the nervous system is slowed so completely that it results in low circulation due to extremely low heart rate and blood pressure, lack of oxygen because of limited breathing, and lack of nervous system response. These symptoms can lead to death.

Stimulants

These drugs create the opposite reaction compared to depressants. They stimulate the nervous system to heighten responses and increase alertness and energy. According to the description of these drug types provided by the National Institute on Drug Abuse (NIDA), they do this by increasing heart rate, respiration, and blood pressure. These drug types include steroids like amphetamines, as well as cocaine.

Symptoms of overdose with these drugs, as exemplified by those that accompany methamphetamine overdose, include:

  • Headache
  • Chest pain
  • Agitation or anxiety
  • Fever without sweating
  • Difficulty catching breath
  • Disorientation
  • Seizures
  • Heart attack or stroke
  • Psychosis

Overdose results in these symptoms because of an accelerated heart rate and nervous response, overtaxing these systems. Unconsciousness and coma can occur. Many of these symptoms can lead to death.

Alcohol

Alcohol is a well-known type of depressant, but sometimes exhibits a stimulant effect depending on the amount consumed. An article from Psychology Today indicates that alcohol behaves like a stimulant during the process of drinking, or while the blood alcohol level (BAC) is ascending. However, after drinking is stopped, as BAC begins to descend, it behaves more like a depressant.

Some additional specific symptoms of alcohol overdose or alcohol poisoning include:

  • Disorientation and lack of coordination
  • Conscious non-responsiveness
  • Unconsciousness
  • Hypothermia and blue tinged skin
  • Seizures

Anabolic Steroids

Anabolic steroids are particular types of stimulant that involve chemicals similar to the male hormone testosterone. They are often used to increase strength and muscle growth rather than energy and alertness.

In addition to the other symptoms of stimulant overdose, consuming too much of these drugs can result in:

  • Muscle stiffness
  • Trembling
  • Aggression and irritability
  • Mania
  • Impaired judgment

Hallucinogens

This type of drug causes hallucinations or a dissociative effect – that is, making the person feel separated from reality. NIDA states that these drugs work on the brain in the areas of perception, mood, and cognition to induce dreamlike states. Hallucinogens include drugs like peyote, LSD, mescaline, and magic mushrooms.

Overdose of hallucinogenic drugs rarely results in death. However, depending on the drug and the degree of overdose, it can cause symptoms that include:

  • Anxiety or panic (“bad trip”)
  • Slow or no breathing
  • Convulsions
  • Seizures
  • Non-responsive unconsciousness or coma

Sometimes overdose of hallucinogens can result in dangerous behavior based on the hallucinations being experienced. These behaviors can also be dangerous or deadly. People who are injured during this type of experience may not even be aware of their injury.

magic mushroom

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Drug Overdose Statistics

  • Death from prescription drug overdose has reached epidemic proportions, as over 50 percent of overdoses are caused by prescription drugs. The majority of all drug overdose deaths are from prescription painkillers hydrocodone (Vicodin), oxycodone (OxyContin), oxymorphone (Opana), and methadone.
  • Comparatively, heroin overdose deaths increased fivefold between 2001 and 2013. Just under 1,780 people died from heroin overdose in 2001, compared to nearly 8,260 in 2013. The number of men who die from heroin overdose is generally at least three times higher than the number of women.
drug overdose stats

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How Stigma Factors into Drug Overdose

call 911

When someone is experiencing an overdose, the most important thing to do is call 911 and get immediate medical intervention. However, some people might not be willing to call for help due to certain biases that people hold about drug overdose and fear of what can happen to them if they call for help.

These stigmas include feelings that people have about those who abuse drugs. A study from the Journal of Health and Social Behavior indicates that stigma against those who are mentally ill and who abuse drugs can affect the wellbeing and treatment of these individuals. Labeling individuals as “addicts” can also stigmatize them, making them feel that they are unworthy of or unable to obtain treatment and recovery. This can lead to them continuing to use drugs to the point that overdose becomes nearly inevitable, when it doesn’t have to be.

A different kind of stigma stems from the legal implications of drug abuse and overdose, especially when the abuse has led to illegal actions such as possessing drug paraphernalia, or being under the influence of or possessing illicit drugs. According to the National Conference of State Legislatures, many people avoid getting help for overdose victims or for self-overdose because of fear of police involvement.

Because of this fear, many states have enacted legal protections for those who report a suspected overdose. These “Good Samaritan” laws are designed to encourage people to report an overdose so the person can get emergency help in a timely manner.

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State Good Samaritan Laws Concerning Overdose

The legal complications that can prevent people from seeking help for drug overdose may be overcome by knowing more about the Good Samaritan laws established in a number of states. These laws protect people who are experiencing a drug overdose, or those who may witness or be otherwise involved in a drug overdose. The laws providing legal protection for those who report a drug overdose vary by state.

In addition, there is a medication called naloxone hydrochloride (known as naloxone or Narcan) that can reverse the effect of opiates. This medicine is often used as a rescue method for people who have overdosed on opiate drugs. Naloxone is a prescription medication, which means it is technically not to be distributed by a layperson; as a result, there are laws in many states that regulate naloxone distribution by doctors and administration of the substance by someone who is not a doctor.

A summary by state of the laws regarding reporting overdose and prescribing or administering naloxone is found below.

State
Good Samaritan Law
Naloxone Access Law

Alabama

Yes, protects individuals from prosecution

Yes, reasonable care is required in use by laypeople

Alaska

Yes, protects individuals from prosecution for drug possession only; reporting can be a mitigating factor in sentencing

No

Arizona

No

No

Arkansas

No

No

California

Yes, protects individuals from arrest, charge, and prosecution for drugs and paraphernalia only, not alcohol

Yes, reasonable care is required for both doctors and laypeople

Colorado

Yes, protects individuals from prosecution

Yes, criminal liability for possessing naloxone not removed

Connecticut

Yes, protects individuals from arrest, charge, and prosecution for drugs and paraphernalia only, not alcohol

Yes, reasonable care is required for both doctors and laypeople

Delaware

Yes, protects individuals from arrest, charge, prosecution, and parole violation

Yes, laypeople must participate in a naloxone administration program for prescription by standing order

Florida

Yes, protects individuals from charge and prosecution for drug possession; reporting can be a mitigating factor in sentencing

Yes, reasonable care is required for both doctors and laypeople

Georgia

Yes, protects individuals from arrest, charge, and prosecution for drugs and paraphernalia only, not alcohol

Yes, reasonable care is required in use by laypeople

Hawaii

No

No

Idaho

No

Yes, reasonable care is required for both doctors and laypeople

Illinois

Yes, protects individuals from charge and prosecution for drug possession; reporting can be a mitigating factor in sentencing

Yes, both doctors and laypeople must participate in a naloxone administration program

Indiana

Yes, reporting can be a mitigating factor in sentencing

Yes, both doctors and laypeople must participate in a naloxone administration program

Iowa

No

No

Kansas

No

No

Kentucky

Yes, protects individuals from arrest, charge, and prosecution for drugs and paraphernalia only, not alcohol

Yes, doctors cannot prescribe to a layperson; layperson can administer

Louisiana

Yes, protects individuals from charge and prosecution for drug possession

No

Maine

No

Yes, doctors cannot prescribe to a layperson; layperson cannot administer

Maryland

Yes, protects individuals from prosecution; reporting can be a mitigating factor in sentencing

Yes, doctors cannot prescribe to a layperson; layperson cannot administer; criminal liability for possession removed

Massachusetts

Yes, protects individuals from charge and prosecution for drug possession; reporting can be a mitigating factor in sentencing

Yes, laypeople must participate in a naloxone administration program for prescription by standing order

Michigan

No

Yes, doctors cannot prescribe to a layperson; layperson can administer

Minnesota

Yes, protects individuals from charge and prosecution for drug possession; protects from parole violation; reporting can be a mitigating factor in sentencing

Yes

Mississippi

Yes, protects individuals from arrest, charge, and prosecution for drugs and paraphernalia only, not alcohol; protects from parole violation

Yes, reasonable care is required in use by laypeople

Missouri

No

No

Montana

No

No

Nebraska

No

Yes, doctor must act with reasonable care; laypeople cannot administer

State
Good Samaritan Law
Naloxone Access Law

Nevada

No

No

New Hampshire

No

Yes, reasonable care is required for both doctors and laypeople

New Jersey

Yes, protects individuals from arrest, charge, and prosecution for drugs and paraphernalia only, not alcohol; protects from parole violation

Yes, participation in a naloxone administration program required for third-party prescription and layperson administration

New Mexico

Yes, protects individuals from charge and prosecution for drug possession; reporting can be a mitigating factor in sentencing

Yes, reasonable care is required for both doctors and laypeople

New York

Yes, protects individuals from charge, prosecution; reporting can be a mitigating factor in sentencing

Yes

North Carolina

Yes, protects individuals from prosecution

Yes, reasonable care is required for both doctors and laypeople

North Dakota

No

No

Ohio

No

No

Ohio

No

Yes, prescription by standing order not allowed

Oklahoma

No

Yes, doctors cannot prescribe to a layperson; layperson cannot administer

Oregon

No

Yes, laypeople must participate in a naloxone administration program

Pennsylvania

Yes, protects individuals from charge and prosecution for drug possession and paraphernalia only; protects from parole violation

Yes, reasonable care is required in use by laypeople

Rhode Island

No

Yes, reasonable care is required for both doctors and laypeople

South Carolina

No

Yes, reasonable care and participation in naloxone administration program required for doctors and laypeople

South Dakota

No

No

Tennessee

Yes, protects individuals from arrest, charge, and prosecution for drugs and paraphernalia only, not alcohol; protects from parole violation; reporting can be a mitigating factor in sentencing

Yes, doctors cannot prescribe to a layperson; layperson can administer; reasonable care required by doctors and laypeople

Texas

No

No

Utah

Yes, reporting can be a mitigating factor in sentencing

Yes, doctor must act with reasonable care; laypeople can administer

Vermont

Yes, protects individuals from arrest, charge, and prosecution for drugs and alcohol only, not paraphernalia; protects from parole violation; reporting can be a mitigating factor in sentencing

Yes, participation in a naloxone administration program required as condition of immunity from criminal liability

Virginia

No

Yes, doctors cannot prescribe to a layperson; layperson can administer

Washington

Yes, protects individuals from charge and prosecution for drug possession; reporting can be a mitigating factor in sentencing

Yes, doctors cannot prescribe to a layperson; layperson cannot administer

Washington

Yes, protects individuals from charge and prosecution for drug possession; reporting can be a mitigating factor in sentencing

Yes, doctors cannot prescribe to a layperson; layperson cannot administer

West Virginia

Yes, protects individuals from prosecution for drug possession and alcohol only; protects from parole violation; reporting can be a mitigating factor in sentencing

Yes, naloxone administration programs are required

Wisconsin

Yes, protects from prosecution for drug possession and paraphernalia only

Yes

Wyoming

No

No

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Frequently Asked Questions

What do I do if somebody overdoses?

The first thing to do is call 911. A drug overdose is an emergency that requires immediate medical intervention.

While waiting for emergency response personnel, there are a few steps that can be taken if necessary:

  • Check breathing and airway; if the person has stopped breathing, initiate CPR.
  • Treat for shock; symptoms include weakness, bluish lips and fingertips, clammy and pale skin, and decreasing awareness.
  • Monitor pulse, heart rate, and breathing to report to emergency personnel.
  • Keep any pill bottles or other evidence of drugs that were used to give to emergency personnel; note time drugs were taken, if possible.

Note whether or not there is gurgling or snoring for someone who has passed out, as this could mean that there’s something interfering with breathing. Be sure to keep the situation as safe as possible, and avoid arguing with the person who has taken the drugs. It’s important to get help, because some reactions to drugs and overdose can cause a person to become aggressive or violent.

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What are the laws surrounding overdose?

As described above, Good Samaritan laws and naloxone access laws have been established to encourage people to report overdose. The laws vary by state, but they are designed help prevent severe overdose injury or death by providing people with protection from criminal and civil liability in exchange for reporting suspected overdose.

The programs that have been able to operate because of these laws have been able to reverse overdose in nearly one-fifth of opiate overdose cases where naloxone was distributed. Continued research into the effectiveness of these programs is in progress.

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What are the risk factors of overdose?

People who are at high risk for overdose include:

  • Those who take high daily doses of prescription painkillers
  • People with a psychological illness or a previous history of drug abuse or addiction
  • Those who have multiple copies of the same prescription through different pharmacies
  • Low-income individuals who live in rural areas
  • Those who have tried to stop taking drugs but have relapsed
  • People who leave drug treatment programs before they are finished with the program

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What are the signs?

Signs of overdose vary depending on the drug that has been taken. However, there are some standard signs to watch for if an overdose is suspected:

  • Nausea
  • Vomiting
  • Sleepiness
  • Loss of consciousness
  • Anxiety
  • Twitching and convulsions
  • Destructive or violent behavior
  • Dilated pupils
  • Trouble breathing or walking
  • Hallucinations, hearing voices, or sensing something that isn’t there

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Overdose from specific types of drugs are described above. Some drugs suppress the nervous system and can result in delayed reactions and slowed body processes such as heart rate and breathing. Others can do the opposite, heightening the nervous system response and increasing heart rate, breathing, blood pressure, and other physical reactions to stimulus.

If overdose is suspected, any of these signs could point to a need for medical attention – call 911 to get help.

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Are there permanent effects of overdose?

If a person survives an overdose, it is possible to have permanent effects. Some of these permanent effects could include:

  • Brain damage if the person stopped breathing
  • Other organ damage or failure
  • Other physical injuries
  • Persistent perception issues

These and other changes can result from the lack of oxygen getting to the brain. Other permanent injuries may occur if the person has an accident of some kind while affected by the overdose, such as falling down stairs or losing control of a car.

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What should I do after the overdose of a loved one?

In the case of drug abuse that leads to overdose, it is advisable to get help through a drug treatment center or rehab program. These programs can help the person detox from the drug, work through issues that may contribute to drug abuse or addiction for that person, and give the person medical and therapeutic treatment that can start the individual on the road to recovery.

It is important for family members and other loved ones to support a person through recovery from overdose and addiction. Participating in treatment as requested and required not only offers the person a visible support structure to motivate recovery, but also offers an opportunity for the person and loved ones to rebuild relationship patterns that may not have been helpful. Learning how to support a family member struggling with addiction is one of the more effective ways that the family can contribute to a long-term recovery.

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What substances carry the highest risk of overdose?

Opioid drugs, including prescription painkillers and illicit drugs like heroin, result in the highest numbers of drug overdose deaths and emergencies by far. These highly addictive substances cause a physical tolerance. This means that higher doses of the drugs are needed to get the same physical and mental results that were achieved initially at a lower dose. This is magnified if a person tries to quit these drugs and then relapses, which can make a dose that was tolerated before withdrawal become highly toxic to the system because of reduced tolerance.

Benzos also have high incidences of overdose deaths. A high number of overdose emergencies also arise when benzos and/or alcohol are mixed with opiates, which can amplify the depressant effects of both drugs and result in respiratory failure and death.

Cocaine and heroin also lead to thousands of overdose deaths each year.

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How and when is overdose fatal?

Overdose is fatal when the effects of the substance ingested are too much for the body to handle. This usually occurs because the drug interrupts the body’s natural chemical balance to a degree that suppresses the central nervous system, depressing and even stopping breathing. In the case of stimulants, death can happen if the drug affects the heart to the point of heart attack or stroke.

Some overdoses that might not otherwise be fatal can result in death if there is more than one drug involved. For example, mixing alcohol or benzos with an opiate drug can suppress the nervous system and breathing to a higher degree than taking any of those items alone. Unintentional overdose can occur simply because a person is unaware of these interactions.

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How many drug users overdose?

Every year in the US, there are approximately 44,000 deaths caused by overdose. It is estimated that more than 22 million people have addictions that require treatment, which means that 0.2 percent of people who are addicted to drugs or alcohol die of overdose. This does not include those who survive.

While this is seems to be a low percentage, the rate of death due to overdose has steadily been increasing over the last 15 years. The rise in addictions to opiate drugs has led to this increase in rates of overdose. In addition, the chance for overdose is greater in those who have entered treatment but did not complete it or otherwise relapsed, due to the decrease in tolerance that occurs during detox.

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How can I prevent overdose?

The first way to prevent overdose when it comes to prescription drugs, like opiate painkillers and benzos, is to follow prescription instructions from the doctor exactly. This alone can make it less likely that addiction will develop in the first place.

For people who are already abusing or addicted to drugs, the best way prevent overdose is to get into and complete a rehab program to achieve recovery from addiction. The medical and therapeutic treatments that are involved in a research-based rehab program can help a person who is struggling with drug addiction to safely detox, learn how to manage the triggers that incite cravings and the desire to relapse, and achieve lasting recovery from addiction that can help avoid the danger of overdose.

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Is Narcan legal in my state? How do I get it?

The table above gives a summary of the laws surrounding Narcan – also known as naloxone – in various states. Where it is legal, it is important to see a doctor who is able to prescribe the medication. This is best done through an addiction treatment program that, along with the medication, provides therapy and other support tools that strengthen the person’s capability to deal with triggers and cravings.

Using naloxone to treat opiate overdose can result in severe withdrawal symptoms. The better way to manage the potential for overdose is to get treatment, which can include naloxone, that results in long-term recovery from addiction. Any medication does not constitute effective treatment in and of itself; comprehensive therapy is always needed.

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