Overdose

Although celebrity overdoses that lead to death often make headlines, any overdose is a scary and unnecessary experience. It can be important for family and friends to understand why overdoses occur (so they can look for signs that an overdose may be imminent), what an overdose looks like (so they can seek help quickly) and what to do when they happen (so they can best help their loved one survive).

What is an overdose? In the context of approved prescription medications, a dose is an amount of a substance that, for the majority of individuals, will have a desired effect. Depending on the person’s sex, age, weight, tolerance of the substance, and numerous other factors, a physician will adjust the dose of the medication accordingly. Few illicit substances have “recommended doses,” so an overdose, in this context, is loosely defined as a dangerous amount of the substance that is above the user’s normal dose. Why might an overdose occur?

• Mixing substances: An overdose may occur when a user mixes substances with opposite effects. For example, mixing some “uppers” (central nervous system stimulants) with certain “downers” (central nervous system depressants) may negate each other’s effects. The user may become frustrated that the second substance is not having the desired effect and will take more of it in an effort to achieve that effect; because the body still recognizes the complete amount, an overdose may result.
• Relapsing at the old amount: Many recovering addicts who relapse on their old substance of abuse will return to the same dose/amount that they were using when they quit. Depending on how long the period of sobriety has been, the person’s body may no longer be as tolerant of/dependent on the substance, which causes an overdose (To learn more about the effects of specific substances, visit the Drugs page). In other words, while the body was substance free, it recalibrated itself to need less of the substance to achieve the same effect; however, addicts often do not consider this during relapse.
• Intentional overdoses: Often times, addictions are used to mask some other pain or traumatic experience in a person’s life. Sometimes, an addict may impulsively use a higher dose when they feel especially low; in these cases, they may or may not be fully aware of the possible dangers associated with doing so. However, in other cases, addicts may be very aware that the dose can do severe physical damage or lead to death, but have become so hopeless and despondent that they feel they have no other option.

Can I do anything to avoid or prevent an overdose?

• If you know that your loved one is mixing substances, consider talking to them about it. Even if you can’t convince them to seek help for their problem, making sure they understand the risks of mixing substances can help prevent a short-term disaster and show them that your ultimate concern is their safety.
• If your loved one is recovering, discuss the possibility of relapse with them, and make sure they understand how their body has adjusted. Go with them to a doctor’s appointment and ask the physician to explain the risks.
• In the case of intentional overdoses, you should monitor your loved one for other signs of mental illness, especially depression (Read Dual Diagnosis: When Addiction and Mental Health Collide).

What are some specific symptoms of an overdose?

• Cocaine/Crack: Heartbeat abnormalities, excessive sweating, high blood pressure
• Methamphetamine: Convulsions, rapid heart rate/breathing, high temperature, change in mental status or behavior (like confusion, paranoia, anxiety, or aggression)
• Opiates/Heroin: Slowed heart rate, difficulty breathing, acting disoriented, unconsciousness, tiny pupils
• Alcohol Poisoning: A bluish color to the skin, slowed breathing, seizures, low body temperature, vomiting

What should I do if I suspect that someone has overdosed?

• Remain as calm as possible
• Determine the substance(s) that caused the overdose
• Gauge their behavior and symptoms
• Call for help (they will want the above information)
• Clear the area of anything hazardous (in case the person has a seizure)
• Keep them warm
• Stay with the person until help arrives.