Signs and Symptoms of Medication Overdose You Should Recognize

Knowing the signs of a medication overdose could save a life-yours or someone else’s. Every year, tens of thousands of people in the U.S. die from overdoses, and many of these deaths happen because no one recognized the warning signs in time. It’s not always obvious. Someone might just look like they’re passed out, or maybe they’re breathing too slowly. But those small details matter. A delay of even a few minutes can mean the difference between recovery and death.

What Does a Medication Overdose Look Like?

An overdose happens when your body can’t handle the amount of a drug you’ve taken. It doesn’t matter if it’s a prescription painkiller, a sleeping pill, cocaine, or even a common pain reliever like acetaminophen. Too much of anything can overwhelm your system. The symptoms vary depending on the drug, but there are some universal red flags.

If someone is unresponsive, breathing very slowly (less than 10 breaths per minute), or has blue lips or fingernails, that’s an emergency. Their skin may feel cold and clammy. They might make gurgling or snoring sounds-like they’re choking, but they’re not awake. This isn’t sleep. This is the body shutting down because it’s not getting enough oxygen.

Opioid Overdose: The Silent Killer

Opioids-including fentanyl, heroin, oxycodone, and morphine-are behind most overdose deaths. In 2022, synthetic opioids like fentanyl were involved in over 73,000 deaths in the U.S. alone. Fentanyl is so strong that even a tiny amount-smaller than a grain of salt-can kill someone who isn’t used to it.

The classic signs of an opioid overdose are called the opioid triad:

• Pinpoint pupils (the black part of the eye shrinks to almost nothing)
• Unconsciousness (they won’t wake up, even when shaken or shouted at)
• Slow or stopped breathing (fewer than 12 breaths per minute)

People who overdose on opioids often look like they’re just deeply asleep. But if you try to wake them and they don’t respond, don’t wait. Call for help immediately. Many people die because someone thought they’d “sleep it off.” That’s a deadly mistake. In 29% of fatal overdoses, the person was left alone to “sleep,” and by the time help arrived, it was too late.

Stimulant Overdose: When the Body Overheats

Drugs like cocaine, methamphetamine, and even prescription ADHD meds like Adderall can cause a different kind of overdose. Instead of slowing you down, they push your body into overdrive.

Symptoms include:

• Extreme agitation or paranoia
• High body temperature (over 104°F or 40°C)
• Fast, irregular heartbeat
• Seizures
• High blood pressure (over 180 mmHg systolic)

People having a stimulant overdose might be sweating heavily, confused, or yelling uncontrollably. Their skin may be hot and red instead of pale. They can have a heart attack or stroke even if they’re young and otherwise healthy. If someone is having seizures or their body feels hot to the touch, this is life-threatening. Don’t try to cool them with ice water or a cold shower-that can cause shock. Instead, get them to emergency care right away.

Depressant Overdose: Alcohol and Benzodiazepines

Alcohol, Xanax, Valium, and other sedatives depress the central nervous system. Too much can cause breathing to slow until it stops. Alcohol poisoning is one of the most common forms of overdose, especially among younger people.

Signs of a depressant overdose include:

• Slurred speech
• Loss of coordination (stumbling, falling)
• Vomiting while unconscious
• Slow, irregular breathing
• Low body temperature

One of the most dangerous signs is vomiting while unconscious. That’s when the person can choke on their own vomit. If someone is passed out after drinking or taking sedatives, turn them onto their side. This is called the recovery position. It keeps their airway open. Never leave them alone. Don’t give them coffee or put them in a cold shower. Those myths can kill.

Polysubstance Overdose: When Drugs Mix

Most overdoses today aren’t from one drug. Over half of all overdose deaths in 2022 involved multiple substances-usually opioids mixed with stimulants like cocaine or benzodiazepines. Fentanyl is often mixed into other drugs without the user’s knowledge. Fake pills made to look like oxycodone or Xanax frequently contain fentanyl. One pill can be lethal.

When drugs mix, symptoms become unpredictable. Someone might have slow breathing from opioids but a racing heart from stimulants. Their pupils might be pinpoint, but their body is hot. This makes it harder to recognize, but the same emergency rules apply: if they’re unresponsive or breathing poorly, call for help immediately.

What to Do If You Suspect an Overdose

Time is everything. Here’s what you do-right now:

1. Call emergency services-dial 000 in Australia, 911 in the U.S. Don’t wait. Don’t text. Call.
2. If you have naloxone, use it. Naloxone (brand name Narcan) reverses opioid overdoses. It’s safe-even if the person didn’t take opioids. Give one spray into the nose or inject into the muscle. If they don’t respond in 2-3 minutes, give a second dose.
3. Put them on their side. This prevents choking if they vomit.
4. Stay with them. Even if they wake up, they can crash again. Medical help is still needed.
5. Don’t try home remedies. Ice baths, coffee, or slapping them won’t help. They can make things worse.

Many people hesitate to call for help because they’re scared of getting in trouble. But in Australia and most U.S. states, Good Samaritan laws protect people who call for help during an overdose. Your action could save a life-and you won’t be punished for it.

How to Prevent Overdose

Prevention isn’t just about avoiding drugs. It’s about reducing risk when people do use them.

• Use fentanyl test strips. These cost about $2 each and can detect fentanyl in pills or powder. If it’s positive, don’t use it-or use a much smaller amount.
• Don’t use alone. If someone is with you, they can call for help if something goes wrong.
• Know your tolerance. If you haven’t used in a week or more, your body’s tolerance drops. The same dose you used before could now kill you.
• Carry naloxone. If you or someone you know uses opioids, keep naloxone on hand. It’s now available over-the-counter at pharmacies without a prescription.

The CDC found that communities that distributed naloxone for free saw a 14% drop in overdose deaths. That’s not just a statistic-it’s people alive because someone had the courage to act.

What Happens After an Overdose?

Surviving an overdose doesn’t mean the danger is over. The brain can be damaged from lack of oxygen. People often need to stay in the hospital for observation. Many also need treatment for addiction. That’s okay. Overdose isn’t a moral failure-it’s a medical event. Treatment works. Support is available.

If you or someone you know needs help, call the national helpline: 1-800-662-HELP (4357) in the U.S., or visit the Alcohol and Drug Foundation in Australia. These services are free, confidential, and open 24/7.

The tide is turning. More people are carrying naloxone. More pharmacies stock it without a prescription. More communities are training people to respond. But until everyone knows the signs, people will keep dying. You don’t need to be a doctor to save a life. You just need to know what to look for-and what to do.