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What does a drug overdose look like?

April 12, 2024

Overdoses on opioids, including fentanyl, can be identified by a combination of three signs and symptoms:

  • Pinpoint pupils

  • Falling asleep or loss of consciousness

  • Slow, shallow breathing

If you suspect that a person has overdosed on an opioid, call 911, administer naloxone, and place the person in the recovery position (if they are still breathing) to prevent asphyxiation on vomit. If a person is not breathing, perform CPR.

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The big three signs of an opioid overdose, such as one from fentanyl, are slow to no breathing, unconsciousness, and pinpoint pupils. Here's how you can check for those three:

For slow to no breathing, you're going to place your hand on the person's chest to feel for the rise and fall of their breath. You can also place your hand under their nose or over their mouth and feel for their warm breath.

To check for unconsciousness, you're going to start by shouting the person's name and asking if they can hear you. If they don't respond to you verbally engaging with them, you're going to cause some painful stimuli. To do that, you're going to give them what's called a trap pinch. You're going to pinch the corner between their neck and their shoulder as hard as you can. If you try that on yourself, it hurts, so if you do that to somebody who might be overdosing, they're not going to respond.

The third sign that you're going to check for, which is the telltale sign of an opioid overdose, is pinpoint pupils. Here's how you're going to check for that: You can use a flashlight like the one on your smartphone. The person's probably going to be unconscious, so you're going to lift their eyelid and shine the flashlight into their eye for three to five seconds. When you move the flashlight away, normal people, you will see their pupil get bigger when the light is no longer in their eye. Someone with a fentanyl overdose, their pupil is going to remain pinpoint, very tiny in the middle of their eye.

It is absolutely critical that you call 9-1-1 when somebody is overdosed because that ensures that they get the medical attention they need, and that could very much save their life. Many states have what's called a Good Samaritan law, which protects people who call 9-1-1 when they're in possession of drugs from being arrested for having those drugs in the moment. Because these laws are meant to encourage people to do the right thing when someone's overdosing.

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