Opioids: Signs of overdose and how to respond

What are opioids? 

Opioids is an umbrella term for natural or synthetic drugs that are derived from – or related to – the opium poppy.  

Commonly used opioids include oxycodone, morphine, codeine, heroin, fentanyl, methadone and opium. 

Opioids attach to receptors in the central nervous system, reducing pain signals to the brain. Opioids dull the senses, induce relaxation and euphoria. They depress (slow down) breathing and the heart rate.  

In high doses, opioids depress the body’s natural urge to breathe. When someone is having an overdose, they can stop breathing and may die. Even if a person does not die from overdose, they can sustain brain damage. 

Signs of an opioid overdose 

Signs of opioid overdose can include: 

• No response to stimuli 
• Shallow/stopped breathing 
• Can’t be woken up  
• Unusual snoring/gurgling sounds  
• Blue/grey lips or fingertips  
• Floppy arms and legs 

If you cannot get a response from someone, do not assume they are asleep. Unusual or deep snoring is a common sign of overdose. Do not let people at risk ‘sleep it off’. 

To check for vital signs, remember ABC: 

1. Alert: Does the person respond to your voice? 
2. Breathing: Noisy? Shallow? Slow? Stopped? Strange snoring?  
3. Colour: For fair-skinned people, blue or pale lips or fingertips? For darker skinned people, grayish or ashen lips and skin colour. 

If you see any of these signs, you should immediately move to activate the response plan for opioid overdose. 

How to respond to an opioid overdose 

Sometimes it can take hours for someone to die from an opioid overdose. Taking action as soon as possible could save a life.  

If you think someone has overdosed, knowing how to respond is crucial. 

• Before you act, check for dangers such as needles. 
• If you have naloxone/Narcan, administer it (see more below).
• Call an ambulance, tell the operator your location, and stay on the line. 
• Try to get a response from the person by calling their name, and/or rubbing your knuckles firmly against their sternum (chest bone). 
• If you can’t get a response, put them in the recovery position, allowing their airways to open. 
• Do NOT give the person anything to eat or drink, or try to induce vomiting. 
• Stay with them until help arrives – do not leave them alone. 

Using naloxone/Narcan 

Naloxone (also known as Narcan) is a medication that can temporarily reverse an opioid overdose. If you have access, you should.   

1. Assemble the naloxone ready for use. 
2. Inject the full amount into the outer thigh or upper arm (or use nasal spray). 
3. Record the time that you have given the naloxone. Provide this information to paramedics when they arrive. 
4. If the person is not breathing, apply rescue breathing (2 breathes every 5 seconds).  
5. If there has been no response after 3-5 minutes, give another dose of naloxone. Remember to record the time of administration.  

Remember, naloxone will only temporarily reverse an overdose. It is important to still seek emergency help as soon as possible. 

Learn more about naloxone or download our naloxone fact sheet. 

If you don’t have naloxone/Narcan

The emergency services operator will talk you through steps such as: 

• If the person is breathing, leave them in recovery position and monitor their breathing. 
• If the person is not breathing, apply rescue breathing and continue until they start to breathe on their own or the ambulance arrives.