Overdose - what to do in an emergency

What is an overdose?#

An overdose is when someone takes a toxic (poisonous) amount of alcohol, drugs or medicine. Not all overdoses are fatal or life threatening, but you should always seek medical advice if you suspect an overdose has occurred.

If someone needs urgent medical attention, call your local emergency number (for example 911 in the US and Canada, 112 across the EU and many countries, 999 in the UK, or 000 in Australia) and ask for an ambulance immediately.

Symptoms#

Symptoms of a drug overdose or alcohol poisoning may include:

• nausea and vomiting
• severe stomach pain and abdominal cramps
• diarrhoea
• chest pain
• dizziness, loss of balance or loss of co-ordination
• being unresponsive but awake, or a limp body
• seizures (fitting)
• drowsiness, confusion, agitation or paranoia
• slow or erratic pulse
• difficulty breathing, shallow or erratic breathing, or not breathing at all
• choking, gurgling or deep snoring sounds
• hallucinations or visual disturbances
• blue fingernails or lips
• a pale or clammy face
• loss of consciousness.

If a person is physically unwell or unconscious, they need urgent medical attention. Call your local emergency number (for example 911 in the US and Canada, 112 across the EU and many countries, 999 in the UK, or 000 in Australia) and ask for an ambulance.

Making the emergency call#

Emergency phone operators are trained to help you and can advise what to do while you wait for help to arrive. Police do not routinely attend alcohol poisoning or drug overdose emergencies, but you should tell the operator if you think someone might harm themselves or others.

When you call your local emergency number (for example 911 in the US and Canada, 112 across the EU and many countries, 999 in the UK, or 000 in Australia) , you will be asked which service you need. Tell the operator you need an ambulance. You will then be asked for information such as:

• the location you need the ambulance to reach - give the address if you know it, or describe nearby street names, parks or landmarks if you do not
• details of the situation and what has happened
• how many people need medical assistance
• the person’s age and sex
• whether the person is conscious or breathing
• what the person has taken, if known.

The operator will arrange help while you keep talking, even if you do not hear them do so. Answer their questions, as this helps paramedics prepare before they arrive. The operator may give you first aid instructions over the phone. Tell the operator if you have naloxone on hand - naloxone is a medication used to reverse the effects of opioid drugs such as heroin and morphine. Do not hang up until the operator tells you to.

At the emergency department#

Treatment for a drug overdose or alcohol poisoning starts as soon as the person arrives. On arrival, a triage nurse assesses how serious their condition is. Triage guides staff to see patients according to how sick they are, so that those with life-threatening problems are seen first. In general, triage has five levels:

• Level 1 - immediate - life-threatening
• Level 2 - emergency - could become life-threatening
• Level 3 - urgent - not life-threatening
• Level 4 - semi-urgent - not life-threatening
• Level 5 - non-urgent - needs treatment when time permits.

If you are with someone who has overdosed and they cannot speak for themselves, emergency staff will need your help. They may ask many questions to work out the best treatment, such as:

• the drug or drugs taken, including any alcohol, drugs or medications
• the dose, and when and how it was taken, and what it was taken with
• existing or past health problems
• any medications or treatments the person is currently receiving
• known allergies and family health history
• whether the person is pregnant or breastfeeding
• any other important information.

The emergency team will do a full assessment, which may include blood tests, observation and a psychological review, along with a physical examination and a medical history.

Treatment#

Treatment for an overdose depends on the drug or drugs taken and the effect on the person, including any medical complications. It may include removing drugs from the body, for example using activated charcoal, and giving an antidote such as naloxone for an opioid overdose. If the person can be treated in the emergency department, staff will monitor their condition. They may then suggest:

• treatment at home with a follow-up appointment with a doctor or another service
• a short stay in a unit attached to the emergency department
• admission to hospital if the problem is serious or needs special care.

Naloxone for opioid overdose#

Naloxone is a lifesaving medication that can reverse the effects of an opioid overdose. In many places, community members can obtain naloxone with a prescription or over the counter from a pharmacy, and some programs supply free take-home naloxone to people at risk of experiencing or witnessing an opioid overdose, as well as to their families, carers and supporters.

Training is often available on how to recognize the signs of an opioid overdose and how to respond using naloxone, including how to administer it and provide aftercare.

Getting more help#

Many helplines support people in need. Whether you are in crisis or just want advice, services can offer information, support and, in some cases, referral. These commonly include:

• a poisons information line for advice when poisoning or suspected poisoning occurs, and for prevention information
• confidential drug and alcohol counselling, information and referral
• support for people concerned about a relative or friend who is using drugs
• counselling for anyone affected by suicide
• services for young people experiencing problems related to substance use, mental health or related issues.

Key points#

• An overdose is taking a toxic amount of alcohol, drugs or medicine, and any suspected overdose needs medical advice.
• If someone is unwell or unconscious, call your local emergency number and ask for an ambulance.
• Tell the operator what was taken and whether you have naloxone on hand.
• Naloxone can reverse an opioid overdose and is available in many places with a prescription or over the counter.
• Emergency staff use triage to treat the most serious cases first, and treatment depends on the drugs taken and their effects.

Where to get help#