An overdose is a serious and potentially life-threatening condition that can lead to harmful or even fatal effects.

Knowing the signs of an overdose, understanding the risks, learning how to respond quickly, and taking steps to prevent overdoses can save lives.

What Is an Overdose?

An overdose occurs when someone consumes more of a drug than their body can handle. In the U.S., overdose deaths have changed a lot over the years.

Today, most deaths are linked to illegal synthetic opioids, like fentanyl. These drugs are very strong and can be deadly in tiny amounts. Over the years, deaths from these opioids (not including methadone) have gone up 103 times.

Other drugs are also causing more deaths:

• Methamphetamine and other stimulants: deaths went up 64 times.
  
• Cocaine: deaths went up 7.6 times.
  
• Prescription opioids: deaths went up 4.1 times.
  
• Heroin: deaths went up 2.5 times.

The trend shows that newer, stronger synthetic drugs are the biggest cause of the overdose crisis, and stimulants are becoming more dangerous too.

Signs & Symptoms of an Overdose

The signs and symptoms of an overdose depend on the type of drug involved. Here’s a breakdown of common symptoms associated with overdoses from various substances, supported by scientific research:

Opioid Overdose (e.g., Heroin, Fentanyl, Prescription Painkillers)

Key Symptoms:

• Pinpoint pupils: Small, constricted pupils.
  
• Slow or stopped breathing: Leading to low oxygen levels in the blood.
  
• Unresponsiveness or unconsciousness: The person may not wake up even when shaken or spoken to.
  
• Blue lips or nails: Indicating a lack of oxygen.
  
• Muscle spasms or seizures: In some cases.
  
• Decreased heart rate and low blood pressure: Resulting from slowed bodily functions.

These symptoms are part of what’s known as the “opioid toxidrome triad”: pinpoint pupils, respiratory depression, and altered consciousness.

Stimulant Overdose (e.g., Methamphetamine, Cocaine)

Key Symptoms:

• Increased heart rate and blood pressure: Due to stimulant effects on the cardiovascular system.
  
• Agitation or aggression: Heightened nervous system activity.
  
• Hyperthermia: Elevated body temperature.
  
• Seizures: Resulting from overstimulation of the brain.
  
• Chest pain: Potentially indicating heart strain.

Stimulant overdoses can lead to severe complications like heart attacks or strokes.

Benzodiazepine Overdose (e.g., Diazepam, Alprazolam)

Key Symptoms:

• Drowsiness or sedation: Leading to impaired coordination.
  
• Slurred speech and unsteady gait: Difficulty in movement and communication.
  
• Confusion or memory problems: Cognitive impairments.
  
• Respiratory depression: Slowed breathing, which can be life-threatening.
  
• Cardiac issues: Such as low blood pressure and heart rate.

Severe cases can result in coma or death, especially when combined with other depressants like alcohol.

Tricyclic Antidepressant (TCA) Overdose (e.g., Amitriptyline)

Key Symptoms:

• Dilated pupils: Enlarged pupils.
  
• Dry mouth and blurred vision: Due to anticholinergic effects.
  
• Rapid heart rate: Tachycardia.
  
• Seizures: Resulting from central nervous system effects.
  
• Cardiac arrhythmias: Irregular heartbeats, which can be fatal.

TCAs have a narrow therapeutic index, meaning the difference between a therapeutic and toxic dose is small. 

Acetaminophen (Paracetamol) Overdose

Key Symptoms:

• Initial nonspecific symptoms: Such as nausea, vomiting, and abdominal pain within the first 24 hours.
  
• Jaundice: Yellowing of the skin and eyes due to liver damage.
  
• Confusion or altered mental state: Resulting from liver failure.
  
• Bleeding tendencies: Due to impaired blood clotting.
  
• Kidney failure: In severe cases.

Without prompt treatment, acetaminophen overdose can lead to liver failure and death.

What to Do in the Event of an Overdose

An overdose can be life-threatening. Acting quickly can save your life or the life of your loved ones. 

1. Call for help immediately

• Dial your local emergency number (like 911 in the U.S.).
  
• Tell them it’s a possible drug overdose and give details: the drug, how much, and when it was taken.

2. Check breathing and responsiveness

• If the person is unresponsive, try to wake them by shouting or gently shaking them.
  
• If they are not breathing or breathing very slowly, start CPR if you know how.

3. Use naloxone if it’s an opioid overdose

• Naloxone (Narcan) can reverse opioid overdoses temporarily.¹
  
• Follow the instructions on the spray or injection.

4. Keep them safe and comfortable

• Lay them on their side in the recovery position if they are unconscious but breathing.
  
• Keep their airway clear and watch their breathing until help arrives.

5. Do not give them food or drink

• This could make things worse if they vomit or lose consciousness.

6. Stay with them until help comes

• Monitor their breathing and pulse.
  
• Be ready to give emergency responders all the information you know.

Acting quickly, calling for help, and using naloxone (if appropriate) can save a life. Overdoses can happen to anyone, so being prepared and knowing what to do is very important.

Preventing Overdose

Below are ways to reduce the risk:

1. Follow the doctor’s instructions

• Take prescription medicines exactly as prescribed.
  
• Do not take more than the recommended dose.

2. Do not mix drugs

• Don’t combine alcohol, prescription drugs, or illegal drugs.
  
• Mixing substances increases the risk of serious side effects or overdose.

3. Know what you’re taking

• Be careful with drugs bought online or from unknown sources.

• They can be stronger than expected or contain dangerous chemicals like fentanyl.

4. Store drugs safely

• Keep medicines out of reach of children or anyone who might use them by mistake.

5. Use harm reduction tools if needed

• For people who use drugs, having naloxone nearby can reverse opioid overdoses.
  
• Using clean, tested supplies reduces risk when using drugs.

The Role of Fentanyl in the Overdose Crisis

Fentanyl is a synthetic opioid that is 50 to 100 times stronger than morphine. It is legally prescribed for severe pain, but is also illegally manufactured and sold.

Fentanyl has become a leading cause of drug overdose deaths in the United States. In 2023, fentanyl was involved in approximately 72,776 overdose deaths, making it the most common drug involved in such fatalities according to the National Institute of Drug Abuse. 

Fentanyl and Stimulants

Recent studies indicate a concerning trend where fentanyl is increasingly found in combination with stimulants like methamphetamine and cocaine. 

From 2010 to 2021, overdose deaths involving both fentanyl and stimulants rose more than 50-fold, from 0.6% to 32.3% of all overdose deaths in the U.S.²

Effects on Different Demographics

The rise in fentanyl-related overdose deaths also affects various age groups and communities differently. For instance, among youth aged 15 to 24, fatal overdoses involving synthetic opioids alone increased by 168% from 2018 to 2022.³

Global Perspective

Internationally, fentanyl has significantly impacted overdose death rates. In Canada, fentanyl was involved in 74% of opioid toxicity deaths in 2024, a 42% increase since 2016.⁴

Fentanyl’s potency, widespread availability, and presence in combination with other substances make it a significant public health concern. Efforts to combat this crisis include increasing access to naloxone, expanding treatment options, and enhancing public education on the dangers of fentanyl.

Get Help: Treatment and Support Resources

If you struggle with drug use, seek help from healthcare professionals, support groups, or treatment programs. Early treatment and support lowers the chance of overdose.

Medical Treatment

• Doctors can provide medications for opioid use disorder, like methadone or buprenorphine, which reduce cravings and withdrawal symptoms.
  
• Hospitals and clinics can treat overdoses and manage complications safely.

Counseling and Therapy

• Individual or group therapy can help people understand why they use drugs and learn new coping skills.
  
• Cognitive Behavioral Therapy (CBT) is one approach shown to reduce relapse.

Support Groups

• Groups like Narcotics Anonymous (NA) or Alcoholics Anonymous (AA) offer peer support.
  
• Talking to people with similar experiences can make recovery easier.

Harm Reduction Services

• Programs provide clean supplies, safe-use education, and medications to prevent fatal overdoses.
  
• These services help reduce risk while someone works toward treatment.

South Coast Counseling can help by providing personalized treatment plans, counseling services, and support resources to guide you safely through recovery. We focus on your safety, health, and long-term well-being.

Sources:

1. Jordan, M. R., & Morrisonponce, D. (2024, May 5). Naloxone. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK441910/
2. ‌Overdose deaths from fentanyl laced stimulants have risen 50-fold since 2010. (2023, September 13). Www.uclahealth.org. https://www.uclahealth.org/news/release/overdose-deaths-fentanyl-laced-stimulants-have-risen-50-fold
3. ‌Majority of Youth Overdose Deaths from 2018 to 2022 Were Driven by Fentanyl Alone. (2018). NYU Langone News. https://nyulangone.org/news/majority-youth-overdose-deaths-2018-2022-were-driven-fentanyl-alone
4. ‌Government of Canada. (2025, March 7). Opioid- and stimulant-related harms in Canada. Health Infobase; Government of Canada. https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants/