Opioid Overdose and Naloxone: A Practical Checklist
Opioid Overdose and Naloxone: what is worth doing, what is worth avoiding, and when to stop and see a doctor.
How to recognize an opioid overdose and use naloxone, a medicine that can quickly reverse it. Naloxone given by a bystander can save a life in the minutes before emergency help arrives, and it is now sold over the counter.
Key takeaways
- Signs of overdose: pinpoint pupils, unresponsiveness, slow or stopped breathing, choking or gurgling sounds, blue or gray lips and fingertips
- Naloxone forms: nasal spray or injection
- Most useful single change: Call 911 first, then give naloxone.
- Commonest mistake: Leaving the person alone to "sleep it off".
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
Do
- Call 911 first, then give naloxone
- Try to keep the person breathing and lay them on their side to prevent choking
- Stay with the person until emergency help arrives
- Keep naloxone at home and carry it if you or someone you know uses opioids
- Learn your state's Good Samaritan law, which in many states protects people who call for help
Do not
- Leaving the person alone to "sleep it off"
- Putting the person in a cold bath or trying to make them vomit
- Assuming the person is safe once they wake up
The numbers behind the list
Where the items above come from.
| Measure | Figure |
|---|---|
| Signs of overdose | pinpoint pupils, unresponsiveness, slow or stopped breathing, choking or gurgling sounds, blue or gray lips and fingertips |
| Naloxone forms | nasal spray or injection |
| Over the counter | FDA approved naloxone nasal spray for sale without a prescription in 2023 |
| If no response | a second dose may be needed after 2 to 3 minutes |
| Wears off | naloxone can wear off before the opioid does, so the overdose can return |
If you change one thing
Call 911 first, then give naloxone. It heads the list. If you take nothing else from this page, take that.
Related topics
- Opioids for Long-Term Pain: What Published Guidance Supports (Chronic Pain)
- The Evidence on Living with Severe Allergy, Without the Hype (Allergies)
- Getting Help From a Pharmacy: What the Evidence Actually Says (Using Health Services)
- Acetaminophen Safety: What the Evidence Actually Says (Liver Health)
Where to go next
- Opioid Overdose and Naloxone for Beginners: Where to Start
- Opioid Overdose and Naloxone: Common Questions Answered
- Opioid Overdose and Naloxone — the reference entry
- Substance Use: The Complete Guide
- Fentanyl Risks: What the Evidence Actually Says
- The Evidence on Alcohol Use Disorder, Without the Hype
When to speak to a doctor
Call 911 right away if someone is unresponsive, has slow or stopped breathing, or has blue lips, even if you have given naloxone. For help finding treatment, call the SAMHSA National Helpline at 1-800-662-4357, free and confidential, 24 hours a day.
Where this comes from
- CDC — Preventing Opioid Overdose
- FDA — Information about Naloxone and Nalmefene
- SAMHSA — Opioid Overdose Prevention Toolkit
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.
Spotted something wrong? Report an error on this page. We correct on the page and say what changed.
