Common Signs of Overdose: Using Narcan Nasal Spray & Getting Help

In the U.S. alone, 106,699 lives were estimated to be lost by drug overdose in 2021. While that is a staggering number, there is a widely available opioid overdose-reversing medicine that offers hope for many in light of the opioid epidemic. Frequently referred to as Narcan, naloxone is meant to be used at the first signs of overdose, says the Centers for Disease Control and Prevention (CDC). Available as a nasal spray (Narcan) or an injection, this medication is safe, effective and can be used without any medical training.

As the CDC explains, "With the right tools, bystanders can act to prevent overdose deaths. Anyone can carry naloxone, give it to someone experiencing an overdose, and potentially save a life."

We can take action with naloxone — and together, we can make a difference.

Knowledge Is Power: Hope in Overdose Prevention

Some people frequently in contact with those who have a drug addiction make a point of carrying naloxone, just like others who have severe allergies carry an EpiPen injection. Hopefully, you and your loved ones never have to use naloxone, but with the widespread opioid epidemic infiltrating the country, it's best to know as much as you can. But before you administer naloxone, you have to be able to recognize the signs and symptoms of an overdose.

Here's what to look for — and information that could be life-saving for a loved one or even a stranger.

Understanding Overdose

The word itself might make you think of simply taking too much medication. While that can be true, an "overdose" generally refers to taking a toxic amount of medication that ends up overwhelming the body's typical function. The National Harm Reduction Coalition explains that opioids act on receptors that can slow breathing, leading to low oxygen levels — a process that can take minutes to hours depending on the dose — and ultimately, vital organs that are deprived of oxygen will stop working, such as the heart and lungs.

"While people have been 'found dead with a needle in their arm,' more often there is time to intervene between when an overdose starts and before a victim dies," the coalition explains. Overdoses, which can happen with a variety of prescription and illegal opioid drugs, are rarely immediate, which means that someone equipped with naloxone, a bit of knowledge and a sense of urgency can reverse this process.

Common Signs of Overdose

Recognizing the common signs of overdose as quickly as possible can be a matter of life or death, so it's essential to learn and memorize them for future reference. The American Addiction Centers (AAC) and the CDC recommend watching for these signs:

• Small, constricted pupils (also called "pinpoint" pupils) that don't respond to changes in light

• Unresponsiveness or loss of consciousness

• Slow, shallow breathing or completely stopped breathing

• Choking, gurgling or snoring sounds

• Limp body

• Blue, cold or pale skin (especially lips and fingertips)

As the AAC explains, the substance itself might change the symptoms the person shows. If you suspect even one of these signs is linked to an overdose, move quickly to administer naloxone and call for help.

Administering Narcan Nasal Spray With Signs of Overdose

Administering naloxone isn't difficult, but it comes with a few must-know processes. Here's what to do if you are assisting someone in distress during an overdose.

1. First, remove the nasal spray from the box, and peel back the tab to open it. Do not spray it to test it; there is only one dose per spray cartridge.
2. Next, hold the spray cartridge with your thumb on the plunger, and your first and middle fingers on the sides of the nozzle.
3. Lay the person on their back, supporting their neck and head. Insert the nasal spray nozzle into the nostril, and firmly press the plunger.
4. Call 911 immediately after giving the first dose.
5. Move the person to their side after giving the medicine. You can give extra doses every two to three minutes until they become responsive.

What to Do If Someone Overdoses: Seeking Medical Assistance

Narcan nasal spray isn't a substitute for emergency medical attention, but rather a tool to buy some time while medical services arrive. Therefore, you should call 9-1-1 immediately after administering the first dose of naloxone.

You can also have another person or bystander calling while you administer naloxone, or vice versa. Both should be happening as soon as possible. You can also consider transporting the person to the nearest hospital if that might be faster than waiting for the ambulance to arrive. Though it can be a distressing situation, quick action is essential. By learning to identify the signs, administer Narcan nasal spray and seek prompt emergency medical care, you can help save a life.

Through widespread education and increased access to Narcan, we can work together as a community, and country, to save lives that would otherwise be lost to the opioid addiction epidemic.

Clinically reviewed on December 18, 2023.