Do you know what an overdose looks like? Do you know what to do if you observe someone who is overdosing? If you participate in International Overdose Awareness Day on August 31, you will have this important information and much more. At Cottonwood, in Tucson, Arizona, we treat people with substance use disorders, and we know that many people who eventually receive treatment and recover first experience an overdose. Being able to survive this terrifying ordeal gives them the chance to make different choices.
Purpose of Overdose Awareness Day
Not only does Overdose Awareness Day create an opportunity to teach people more about overdose signs and response, but it also provides people who have lost someone to overdose with the chance to publicly mourn their loved ones. In addition, it:
- Reminds people who use drugs and people who are in recovery from substance use disorders that they matter
- Gives people the chance to talk about available support services
- Prevents future overdoses by promoting evidence-based practices
- Gives people the chance to show their loved ones that they are a safe person to talk to, if they are struggling with substance use
- Increasing public awareness about the dangers of illegally made fentanyl, which is often disguised as other drugs
- Promoting mental health as a component of recovery from substance use disorders
- Providing hope for people who are currently in active addiction, but want to enter recovery
Preventing an Overdose
While the most obvious way to avoid an overdose is to refrain from substance use, this may not be something that a person is ready to do. Harm reduction is the practice of making choices that reduce the likelihood of a person experiencing harm from substance use.
Some common harm reduction practices that can reduce the risk of overdose include:
- Making sure you are not sleep-deprived or dehydrated when drinking or using any drugs
- Remembering that if you get medications from anyone besides a pharmacist, you cannot be sure what you are getting
- Using fentanyl test strips to check that your supply has not been laced with fentanyl without your knowledge
- Refraining from taking different types of drugs at the same time
- Recognizing that if you have been abstinent from drug use and then relapse, your tolerance is likely to be considerably lower
- Understanding that asthma, sleep apnea, heart conditions, or conditions that decrease your oxygen levels will place you at greater risk for overdose
- Never use alone, so that there is someone with you to call for help, if you do begin to overdose
- Keeping a supply of naloxone or nalmefene on hand to reverse an overdose
Signs of Overdose
The signs that a person is overdosing can vary, depending on what drug they have been using.
Opioids
The majority of overdoses in 2025 are from fentanyl and other opioids. Sometimes, when a person is using illegal substances, they may not even know that they have ingested fentanyl, and this is one of the underlying causes of overdoses. Fentanyl is incredibly potent, and if someone thinks they have taken something else and doses according to what they think they are using, but they are actually taking fentanyl, they end up with a dose that is much, much higher than they expect. When someone is overdosing on opioids, they are likely to experience:
- Slow breathing or not breathing
- Choking, gurgling, or snoring sounds
- Unable to be woken
- Blue tinge to lips or nails
- Cold, clammy skin
- Small pupils
Alcohol
Because alcohol is legal, people often underestimate how dangerous it can be. When a person is experiencing alcohol poisoning, they are likely to exhibit the following symptoms:
- Vomiting
- Poor coordination
- Slurred speech
- Aggressiveness
- Seizures
- Unconsciousness
Stimulants
If someone is overdosing on a stimulant, such as cocaine, it is going to look different from an alcohol or opioid overdose. Signs that someone is “overamping”, or overdosing on a stimulant, include:
- Paranoia/panic
- Hallucinations
- Nausea
- Seizures
- Chest pain/heart attack
- Stroke
How to Respond to an Overdose
Overdoses from alcohol and opioids can look very similar. Even if you don’t know what substance is causing someone to overdose, if you observe that they are showing the signs of overdose, the steps are the same:
- Call 911. Administer naloxone or nalmefene if there is any chance that they could be overdosing on an opioid. These are both known as opioid overdose reversal medications (OORMs), and they are available at pharmacies in all 50 states without a prescription. Nalmefene stays in the body longer than naloxone but may also cause longer withdrawal symptoms in people who have high opioid tolerance. Both medications will start to reverse the overdose quickly, but the person still needs immediate medical attention, as the medication can wear off before the opioids are out of their system, which will cause them to resume overdosing. If they are not overdosing on an opioid, naloxone and nalmefene will not cause them harm.
- Stay with the person. Administer rescue breaths if the person is not breathing on their own. If the person starts breathing again, roll them onto their side with their top leg bent to keep them in the position. This is called the recovery position.
- Administer an additional dose. If they have not responded to the naloxone in 2-3 minutes, give them another dose of naloxone or nalmefene, as more than one dose may be required to stop the overdose.
- Avoid the following: Do not put the person in a bath or shower. Do not inject them with anything besides OORMs. Do not try to make the person vomit, as they may choke or inhale the vomit into their lungs, and this can be fatal.
At Cottonwood, we want everyone who struggles with substance use to have the opportunity to enter recovery. We treat people who are addicted to alcohol, marijuana, opioids, stimulants, prescription drugs, and more.
