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Definition

An opiate overdose happens when someone takes too much of an opioid drug. These drugs include heroin, fentanyl and prescription pain medicines such as oxycodone (OxyContin), hydrocodone (Vicodin) and morphine. Opiate overdose can be life-threatening and needs emergency treatment right away.

Opioids slow down the body’s functions, especially breathing. In an overdose, a person may stop breathing altogether. Sometimes, overdose happens by accident — especially when opioids are mixed with alcohol, benzodiazepines (anxiety medications) or other drugs.

Alternative names

Opioid overdose; Narcotic overdose; Fentanyl overdose; Heroin overdose; Prescription painkiller overdose

Symptoms

The most dangerous sign of an opioid use disorder is slow or stopped breathing. Without enough oxygen, the body and brain can shut down.

Common symptoms of an opiate overdose include:

• Bluish lips, skin or fingernails
• Cold, clammy skin
• Gurgling or choking sounds
• No response when called or touched
• Passing out or losing consciousness
• Pinpoint pupils (very small pupils)
• Very slow or no breathing

Mixing opioids with benzodiazepines, such as Xanax, Ativan or Valium, significantly increases the risk of overdose. People who have benzodiazepine addiction or are in benzo withdrawal are especially vulnerable.

Causes

A drug overdose can happen when:

• A person takes too much of an opioid drug
• A person unknowingly takes opioids, such as fake pills or drugs laced with fentanyl
• Opioids are mixed with alcohol, sedatives or anxiety medications
• Someone uses opioids after a period of not using (lower tolerance)
• The drug is more potent than expected (for example, fentanyl instead of heroin)

People with dependence on anxiety medication may also take opioid medication without realizing the danger of mixing the two.

Treatment

Opiate overdose is a medical emergency. Call 911 right away.

While waiting for help:

• Give naloxone (Narcan) if available. It can reverse the overdose.
• If the person is not breathing, begin rescue breathing or CPR.
• Stay with the person until emergency help arrives.
• Try to wake the person by calling their name or rubbing their chest firmly.

In the hospital, treatment for substance abuse may include:

• Breathing support (oxygen or a breathing machine)
• IV fluids
• Monitoring of heart, lungs and brain
• More doses of naloxone

Outlook (Prognosis)

If treated quickly, many people recover from an opiate overdose. However, without oxygen, brain damage or death can happen in just a few minutes. Using naloxone as soon as possible can save a life.

People who survive a substance use disorder may need long-term help for opioid addiction or polysubstance use, especially if they are also dependent on benzodiazepines or other drugs.

Related specialties

• Emergency Medicine
• Addiction Medicine

This entry was written by Jennifer Cruz-Urbano, marketing specialist, and reviewed for accuracy by Rachel Waters, Manager Regional Business Development, and David Fields, Executive Director FRC. Generative AI was leveraged as part of the content creation process.