An Addicts Guide to Overdose

Last Edited: March 31, 2024
Patricia Howard, LMFT, CADC
Clinically Reviewed
Andrew Lancaster, LPC, MAC
All of the information on this page has been reviewed and certified by an addiction professional.

50,000 people die from drug overdose every year.
It just takes one overdose to change your life forever.

An overdose is your body’s response to receiving too much of a substance or mix of substances. It can be intentional (some use it as a means for suicide) or accidental. This can be done using illicit drugs, alcohol, prescription medications, etc. In most cases the best thing you can do is call 911 because in most cases overdoses are fatal. Just because someone has survived multiple overdoses in the past, doesn’t mean the next one won’t kill them.

In fatal cases, most addicts die of respiratory failure. This means they can’t breath, starving their heart, brain and other organs of oxygen. It’s not a pretty way to go and it’s always better to call 911.

What is a Drug Overdose?

Simply put, a drug overdose occurs when you take more of a substance (or combination of substances) than your body can process. Overdoses can be accidental or intentional, and they can involve illegal drugs, prescription medications, or a combination of both. It’s essential to understand that an overdose can happen to anyone – it doesn’t discriminate based on age, race, or social standing.

Phases of an Overdose

  1. Initial Intake and Toxicity: The first phase of an overdose begins as soon as the substance enters your body. Depending on the drug, this could mean anything from drowsiness and mild disorientation to immediate respiratory distress. Your body begins to react to the toxic levels of the substance.
  2. Acute Reaction: In this phase, the body’s reaction to the drug becomes more pronounced. This could manifest as severe symptoms like vomiting, seizures, extreme confusion, rapid heart rate, and difficulty breathing. For many, this is the phase where it becomes evident that something is seriously wrong.
  3. Life-Threatening Symptoms: As the overdose progresses, you may experience life-threatening symptoms. These include loss of consciousness, severe respiratory depression (slow and ineffective breathing), and cyanosis (bluish skin due to lack of oxygen). In opioid overdoses, for instance, breathing can slow down or stop altogether, leading to hypoxia – a condition where not enough oxygen reaches the brain.
  4. Emergency Medical Intervention: This phase is critical – it’s where prompt medical intervention can mean the difference between life and death. Emergency services can administer treatments like naloxone (for opioid overdoses), activated charcoal (for some types of drug ingestion), or provide respiratory support.
  5. Recovery or Long-term Consequences: Surviving an overdose often leads to a recovery phase, which might involve hospitalization and long-term treatment for any damage sustained during the overdose. In some cases, there can be lasting physical or neurological damage.

Recognizing the Signs of an Overdose

It’s vital to recognize the signs of an overdose, which can vary depending on the type of drug. Common signs include:

  • Extreme confusion or inability to wake up
  • Vomiting
  • Seizures
  • Slow, irregular, or stopped breathing
  • Clammy, cold skin or bluish lips and nails
  • Abnormally slow or fast heart rate
  • Chest pain or pressure

In opioid overdoses, a telltale sign is ‘pinpoint pupils’ – the pupils become very small.

Why Overdoses Happen

Several factors can contribute to a drug overdose:

  • Tolerance: Your body builds tolerance to a drug over time, requiring higher doses to achieve the same effect. This can lead to taking dangerously high amounts.
  • Relapse: After a period of sobriety, your body’s tolerance for the drug decreases. If relapse occurs, there’s a high risk of overdosing by consuming the amount you used previously.
  • Quality and Purity: Especially with illegal drugs, you can never be sure of the drug’s potency or what it’s been mixed with.
  • Polydrug Use: Using multiple substances simultaneously can exacerbate the effects of each, increasing the risk of an overdose.

Responding to an Overdose

If you suspect someone is overdosing, act quickly:

  • Call emergency services immediately. Don’t wait to see if symptoms improve.
  • Try to keep the person awake and breathing.
  • Lay the person on their side to prevent choking.
  • Stay with the person until help arrives.
  • Be honest with emergency responders about what substances were taken.

Depressant Overdose

A person can overdose on depressants. This occurs when the person uses enough of a drug to produce life-threatening symptoms or even death. What happens is their breathing often slows or stops. This can decrease the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can have short and long-term effects on the nervous system, including coma and permanent brain damage.

Opioid Overdose

Opioid’s are no joke as they’re one of the easiest substances to overdose on. The human body has opioid receptors in several different areas, including the brain, central and peripheral nervous systems, and the gastrointestinal tract (see image below). When using an opioid, these receptors are activated and slow the body down. When the body becomes overwhelmed by opioids, all of these receptors are blocked, and it can’t perform other essential functions such as breathing.

Alcohol Overdose

An alcohol overdose occurs when there is so much alcohol in the bloodstream that areas of the brain controlling basic life-support functions—such as breathing, heart rate, and temperature control—begin to shut down. Symptoms of alcohol overdose include mental confusion, difficulty remaining conscious, vomiting, seizures, trouble breathing, slow heart rate, clammy skin, dulled responses such as no gag reflex (which prevents choking), and extremely low body temperature. Alcohol overdose can lead to permanent brain damage or death.

Stimulant Overdose

Few people are aware that you can also overdose on stimulants, which is sometimes referred to as ‘overamping’. Symptoms of overamping can include extreme anxiety, paranoia, panic, hallucinations, extreme agitation, aggressiveness, restlessness, and hypervigilance. In some cases, a stimulant overdose can cause stimulant psychosis leading to paranoia, auditory and visual hallucinations and delusions of persecution. Some people will also have suicidal thoughts.

Overdose Statistics

Overdose statistics are tracked throughout the United States, and statistics show that:

  • In 2021, more than 100,000 people died from an overdose.
  • The majority of these deaths involved synthetic opioids (primarily fentanyl), which accounted for 70,601 deaths in 2021.
  • In 2021, 53,495 overdose deaths involved stimulants such as cocaine and psychostimulants (primarily methamphetamine).
  • Prescription opioids were involved in 16,706 overdose deaths in 2021.
  • Heroin was involved in 9,173 overdose deaths in 2021.
  • Nearly 70% of heroin-involved overdose deaths also involved synthetic opioids, such as fentanyl.
  • In 2021, 24,486 overdose deaths involved cocaine.
  • Benzodiazepines were involved in more than 12,499 overdose deaths in 2021. The majority of these deaths also involved opioids.
  • In 2021, 69% of overdoses occurred among males.

Prevention: The First Line of Defense

The best way to prevent an overdose is to seek help for substance use disorder. If you’re using prescription medications, use them only as directed by a healthcare provider. For those struggling with addiction, remember, it’s never too late to reach out for help. There are numerous resources and support systems available to assist you on the path to recovery.

Understanding the harsh reality of drug overdoses is vital for anyone battling addiction. An overdose is a medical emergency that requires immediate action. Recognizing the signs and responding swiftly can save lives. However, the ultimate goal should always be prevention through seeking help and support for substance use disorder. Remember, choosing to seek help is a sign of strength, not weakness. Your life is worth the effort.

Suboxone and Naloxone

Suboxone and Naloxone play crucial roles in opioid addiction treatment but serve different purposes. Suboxone is a combination drug containing buprenorphine and naloxone, designed for the long-term treatment of opioid dependence. Buprenorphine acts as a partial opioid agonist to reduce cravings and withdrawal symptoms, while naloxone, an opioid antagonist, counters opioid effects to discourage misuse. Naloxone, when used alone, is an emergency medication specifically for reversing opioid overdoses, rapidly blocking opioid receptors to counteract life-threatening respiratory depression. While Suboxone supports recovery and maintenance, naloxone is a critical rescue drug, saving lives in overdose situations.


Q: What Exactly Constitutes a Drug or Alcohol Overdose?

A: A drug or alcohol overdose occurs when a person consumes a substance in a quantity or concentration that the body cannot process, leading to potentially life-threatening symptoms. It can happen with both prescription medications and illicit drugs, as well as with alcohol. Overdoses can be accidental or intentional.

Q: What are the Common Signs of a Drug or Alcohol Overdose?

A: Common signs of an overdose include severe disorientation, loss of consciousness, nausea and vomiting, seizures, difficulty breathing, irregular or slowed heartbeat, clammy skin, and in the case of opioid overdose, pinpoint pupils. In alcohol overdoses, symptoms also include confusion, vomiting, seizures, slow or irregular breathing, and hypothermia (low body temperature).

Q: Can Mixing Different Substances Increase the Risk of Overdose?

A: Yes, mixing different substances, such as taking drugs with alcohol or combining multiple drugs, significantly increases the risk of an overdose. Different substances can interact in unpredictable ways, often potentiating each other’s effects and increasing the risk of severe or life-threatening complications.

Q: How Should You Respond to a Suspected Overdose?

A: If you suspect someone is experiencing an overdose, call emergency services immediately. While waiting for help, try to keep the person awake and breathing, lay them on their side to prevent choking, and provide first responders with as much information as possible about the substances taken. Do not attempt to make the person vomit, as this can lead to choking or further injury.

Q: Is Recovery Possible After an Overdose?

A: Recovery after an overdose is possible, especially with prompt medical intervention. The chances of recovery depend on various factors, including the amount and type of substance taken, the speed of medical response, and the individual’s overall health. Surviving an overdose can be a critical wake-up call and an opportunity to seek long-term treatment for substance abuse.