Opioid Overdose

What are opioids?

From: MedlinePlus, National Library of Medicine

Opioids, sometimes called narcotics, are a type of drug. They include strong prescription pain relievers such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid.

A health care provider may give you a prescription opioid to reduce pain after you have had a major injury or surgery. You may get them if you have severe pain from health conditions like cancer. Some providers prescribe them for chronic pain.

Prescription opioids used for pain relief are generally safe when taken for a short time and as prescribed by your provider. However, people who take opioids are at risk for opioid use disorder (OUD) and overdose. These risks increase when these medicines are misused. Misuse can include taking more than your prescribed dose or taking it more often, using it to get high, or taking someone else's opioids.

What is an opioid overdose?

From: MedlinePlus, National Library of Medicine

Opioids affect the part of the brain that regulates breathing. When people take high doses of opioids, it can lead to an overdose, with the slowing or stopping of breathing and sometimes death.

What causes an opioid overdose?

From: MedlinePlus, National Library of Medicine

An opioid overdose can happen for a variety of reasons, including if you:

• Take an opioid to get high.
• Take an extra dose of a prescription opioid or take it too often (either accidentally or on purpose).
• Mix an opioid with other medicines, illegal drugs, or alcohol. An overdose can be fatal when mixing an opioid and certain anxiety treatment medicines, such as Xanax or Valium.
• Take an opioid medicine that was prescribed for someone else. Children are especially at risk of an accidental overdose if they take medicine not intended for them.

There is also a risk of overdose if you are getting medications for opioid use disorder (MOUD). MOUD is a treatment for OUD. Many of the medicines used for MOUD are also controlled substances that can be misused.

Who is at risk of an opioid overdose?

From: MedlinePlus, National Library of Medicine

Anyone who takes an opioid can be at risk of an overdose, but you are at higher risk if you:

• Take illegal opioids
• Take more opioid medicine than you are prescribed
• Combine opioids with other medicines and/or alcohol
• Have certain medical conditions, such as sleep apnea, or reduced kidney or liver function
• Are over 65 years old

What are the signs of an opioid overdose?

From: MedlinePlus, National Library of Medicine

The signs of an opioid overdose include:

• Very small pupils of the eyes
• Falling asleep or loss of consciousness
• Slow, shallow breathing
• Choking or gurgling sounds
• Vomiting
• Limp body
• Pale, blue, or cold skin
• Faint heartbeat
• Purple lips and fingernails

What should I do if I think that someone is having an opioid overdose?

From: MedlinePlus, National Library of Medicine

If you think someone is having an opioid overdose:

• call the local emergency number (112 in India) immediately.
• Give the person naloxone, if it is available. Naloxone is a safe medication that can quickly stop an opioid overdose. There are two forms. One is a nasal spray that you spray info the nose. The other type is injected into the muscle under the skin, or into the veins. Naloxone works by blocking the effects of the opioids on the body. It's important to read the product instructions and check the expiration date before you give it to someone.
• Try to keep the person awake and breathing.
• Lay the person on their side to prevent choking.
• Stay with the person until emergency workers arrive.

Naloxone won't harm someone if they're overdosing on drugs other than opioids, so it's best to use it if you think someone is overdosing.

Can an opioid overdose be prevented?

From: MedlinePlus, National Library of Medicine

If you are taking opioid pain medicine, there are steps you can take to help prevent an opioid overdose:

• Take your medicine exactly as prescribed by your provider. Do not take more medicine at once or take medicine more often than you are supposed to.
• Never mix the pain medicines with alcohol, sleeping pills, or illegal substances.
• Store your medicine safely where children or pets can't reach it. Consider using a medicine lockbox. Besides keeping children safe, it also prevents someone who lives with you or visits your house from stealing your medicines.
• Dispose of unused medicine promptly.

It is also important to teach your family and friends how to respond to an overdose. If you are at higher risk of an overdose, you will want get naloxone and carry it with you wherever you go. You can buy naloxone at a pharmacy.

Which doctor should you see?

The suggested department for discussing Opioid Overdose is General Medicine, with a general physician / internal medicine as the relevant type of clinician. Emergency department now if this condition is suspected or newly occurring.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• Which findings are most important in deciding the next step?
• Could more than one problem explain the symptoms?
• Who will coordinate referrals and review the results?

Treatment discussions and follow-up

Where the source describes treatments, these are an overview of possible care, not a prescription for an individual. Ask which option applies to the confirmed diagnosis, what benefit is expected, what adverse effects to watch for and how progress will be assessed. Availability, approvals and local practice can differ from the country described in the source.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

When to seek emergency help

If this acute condition is suspected or the person is acutely unwell, seek urgent emergency assessment rather than waiting for a routine specialist appointment. Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.