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Respond to an Overdose

Be there for your friends. Learn how to spot the signs of an opioid overdose, respond to an overdose, and use naloxone to reverse an overdose.

Woman shows naloxone to the camera.

Signs of an opioid overdose

Your friend may be overdosing if:

They can’t wake up. Even when you call their name or shake them firmly.

They are breathing very slowly or not at all. 

They are turning blue, gray, or purple. Check around their lips and fingernails. 

They look ashen or feel cold to the touch. 

How to help a friend who is overdosing 

Illustration of phone with 911 dialed.

Call 911

If your friend is unresponsive, not breathing, or turning blue or gray, call 911 right away. 

Illustration of naloxone spray.

Give naloxone

Lay your friend flat on the ground. Give one dose of naloxone every 2-3 minutes until their breathing is normal again. They should breathe once every 3-5 seconds. Do this even if you aren’t sure your friend took opioids. 

Illustration of lungs.

Give rescue breaths

After you give the first dose of naloxone, tip your friend’s chin back, and provide one rescue breath every five seconds. Check that their chest is rising and falling with each breath that you give.

Illustration of red cross symbol.

Stay until help arrives

When your friend wakes up, they may be confused or feel sick. They should get medical attention and not take any more drugs. Naloxone wears off within 30-90 minutes. When it wears off, they may begin overdosing again. 

Illustration of star.

When all is said and done, remember to check in with yourself. You cared for your friend in a big way, and you deserve care too. 

How to give naloxone

Naloxone, also known as Narcan, is a medication that reverses opioid overdoses and saves lives.

arrow pointing down.

Nasal spray naloxone

Illustration of naloxone packaging and nasal spray.

1. Open the packaging

Do not test the nasal spray. The canister only has one dose and cannot be reused.

Illustration of hand demonstration how to hold naloxone.

2. Hold the canister

Place your thumb on the bottom of the plunger and your first and middle fingers on either side of the nozzle. 

Illustration of naloxone spray being used.

3. Insert the nozzle into your friend’s nostril

Your fingers on either side of the nozzle should touch the bottom of their nose. 

Illustration of naloxone spray in nose.

4. Press the plunger all the way

Then remove the canister from their nostril. If your friend doesn’t wake up within 2-3 minutes, give them naloxone again. 

Intermuscular
injection naloxone

Illustration of naloxone with cap.

1. Open the packaging

Remove the caps from both the vial and syringe. 

Illustration of needle drawing out naloxone.

2. Insert the needle into the vial

Go through the rubber seal. Turn the vial upside down and fill the syringe. 

Illustration of human diagram of areas to administrate naloxone.

3. Insert the needle into a large muscle

Go through clothing if necessary.

Illustration of needle with naloxone being injected.

4. Inject the full dose of naloxone

Remove and recap the needle after giving the dose. If your friend doesn’t wake up within 2-3 minutes, give them naloxone again. 

Digital wallet card

Save this image to your device for a quick-reference guide on how to recognize an overdose and respond using nasal spray naloxone. 

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FAQS

Fentanyl is a synthetic opioid up to 50 times stronger than heroin.

Legal fentanyl is carefully manufactured, regulated, and prescribed by doctors to manage pain.

Illegal fentanyl is unregulated. It is extremely unpredictable and can vary in potency based on the maker or the batch. Compared to other illegal opioids, it is also cheaper to produce, easier to smuggle and mix into other drugs, and more profitable to sell. It is sold in both pill and powder forms. 

Illegal fentanyl does not have a unique color, taste, or smell to identify it. It may appear white, off-white, or brownish in color—like heroin, cocaine, or pressed pills. It is not possible to tell by a pill or powder’s appearance, taste, or smell whether it has fentanyl in it. 

Fentanyl goes by many names. Some common ones to know are blues, fent, fenty, fetty, mexis, M-30s or 30s, percs, or skittles. Even if a pill or powder isn’t called fentanyl, it can still have fentanyl in it. 

Illegal fentanyl is harmful, but medical experts agree you cannot overdose by touching fentanyl. Overdoses happen when fentanyl is ingested (swallowed, snorted, injected, etc.) and enters the bloodstream. 

Illegal fentanyl is not the only powerful drug found in today’s drug supply. In many places in the U.S. and Canada, other synthetic opioids and non-opioids are being added to drugs. These additives can increase the risk of an overdose and decrease the effectiveness of naloxone. This is one reason to always call 911 if you think your friend is overdosing. If naloxone won’t wake them up, they may need a different treatment, and they will need it quickly.

Synthetic opioids

  • Sufentanil – a synthetic opioid about 10 times stronger than fentanyl. 
  • Carfentanil – a synthetic opioid about 100 times stronger than fentanyl.
  • Isotononitazene – a strong synthetic opioid sometimes referred to as ISO.

Non-opioids

  • Xylazine – a non-opioid veterinary tranquilizer not approved for human use.
  • Etizolam – a non-opioid drug like benzodiazepines, which depresses the central nervous system.

Naloxone, also known as Narcan, is a life-saving medication that reverses opioid overdoses. It is available as a nasal spray or intramuscular injection.

Anyone! It’s simple, safe, and legal. You do not need special training to give someone naloxone.

If you use naloxone on someone who has not taken opioids, it will not hurt them. If a person has taken opioids, naloxone may cause withdrawal symptoms. They may wake up experiencing body aches, fever, irritability, or nausea, but they will be alive.

It is legal for anyone in Washington to get, carry, and use naloxone. Naloxone is available to buy over the counter at pharmacies like Rite-Aid, Walgreens, and CVS. Prices range from $40 to $50. Many communities also have resources that make naloxone available for free.

Find a place near you to pick up naloxone. 

Naloxone blocks the effects of opioids. It helps reverse an opioid overdose to wake someone up. Naloxone has no effect on someone who is not on opioids. It does not work to treat the effects of other drugs or alcohol.

Naloxone starts working right away. If you give someone who is overdosing naloxone and see no response within 2-3 minutes, give another dose. Naloxone wears off within 30-90 minutes. That’s why it’s important to call for emergency medical back-up and not leave until help arrives. Someone can begin to overdose again if the naloxone wears off before they receive medical help.

If you don’t call 911, stay with your friend in case the naloxone wears off and they overdose again. They might feel bad withdrawal symptoms. Let them know that if they use more opioids during this time, they will not reduce their withdrawal symptoms. They will only make it more likely that they overdose for a second time.

Carry naloxone, so you’re always prepared.

Yes, naloxone works on fentanyl. In fact, it is the best way we know of to reverse a fentanyl overdose. Because fentanyl is such a strong opioid, it may take multiple doses of naloxone to reverse an overdose. Wait 2-3 minutes between doses. It does not work any better or faster to administer multiple doses at once.

Tips to keep you and your friends safe:

  • Assume drugs you get anywhere other than a pharmacy or dispensary contain fentanyl.
  • Use fentanyl testing strips (FTS) to check if the drugs you have contain fentanyl. Places to access testing strips:
  • Try to stick to a buddy system when taking drugs.
  • Think of this the same way as a designated driver. That way, one person is always alert and can look for signs of overdose.
  • If you can’t use a buddy system, call Never Use Alone at 887-696-1996.
    • This nationwide toll-free call center is available 24/7/365.
    • Volunteers stay on the phone and call 911 in the event a caller becomes unresponsive.
  • Go low and slow.
    • Start by taking a very small amount of a drug and give it time to see how the dose affects you.
  • Avoid mixing drugs or mixing drugs and alcohol.
    • It makes an overdose more likely.

Share these resources about opioids, naloxone, and preventing overdoses with friends: