Responding to an Opioid Overdose
In North Carolina, five people die every day from an opioid related overdose.
Since 2020, the United States has experienced a 30-40% increase in fatal overdoses. The most effective way to combat these growing numbers is by recognizing and responding to an overdose.
Opioids can come in a variety of forms. They are prescription medications like hydrocodone, oxycodone and morphine. They are also illicit substances like heroin and synthetic fentanyl. Opioids all affect the body in the same way by activating the opioid receptors in the brain. When these receptors are overwhelmed by opioids, the body responds by slowing down function. This leads to respiratory depression, reduced oxygen flow and slowed heart rate.
How to Recognize an Opioid Overdose
A person experiencing an opioid overdose is unresponsive and not breathing or struggling to breathe. The coloring in their face and fingernail beds will change as they lose oxygen.
Signs of opioid overdose
Does not wake up; remains unresponsive even if you shake them or call their name
Small pupils
Slow or no breathing
Snoring sound
Blue, grey, or pale skin color around their lips and fingernail beds
TIP: To test if the person is overdosing, make sure they are unresponsive to painful stimuli.
Provide a Sternum Rub by making a fist with your hand, rub your knuckles down the front of their rib cage (sternum) up and down to initiate a response. If they do not wake up, continue with the following steps.
How to Give Naloxone (Intramuscular)
Remove colorful cap of the Naloxone vial and hold upside down.
Remove cap of the syringe and insert the needle into the gray plunger on the vial.
With the vial upside down, pull back the plunger and draw up 1mL (1cc) of naloxone, the entire dose.
When the syringe is loaded with Naloxone, inject it into a muscle on the upper arm, thigh or butt.
How to Give Naloxone (Nasal)
Peel back tab to remove Narcan.
Hold Narcan with your thumb on the middle button and first and middle finger on either side of the nozzle.
Insert the nozzle into either nostril until your fingers are up against the nose, tilt head back while supporting the neck.
Press the button firmly to give the full dose.
Rescue Breaths
If the person is not breathing on their own, begin rescue breaths immediately after administering the dose.
Make sure nothing is in the person’s mouth blocking their airway. If there is any blockage take your pointer and middle finger to do a sweep of the mouth.
Place one hand on the chin and tilt the head back. With the other hand pinch the nose closed.
Administer two slow breaths and look for the chest to rise. Continue administering 1 breath every 5 seconds.
If the person is not responding in 2 minutes, give a second dose of naloxone and continue rescue breathing until they begin breathing again or help arrives.
Rescue Position
If you have to leave someone alone at any time, like to call for help or to get Naloxone, make sure that they are in the rescue position.
Put the person on their left side with the top leg and right arm crossed over their body. The right arm provides support to keep the person on their side. Place the left hand under the person's head. This makes it difficult for the person to roll over, and lessens the chances that they will choke on vomit.
After Care
When a person wakes up from an overdose, they may be disoriented, sick, and upset.
It's important to stay with the person until the Narcan wears off. This can take 30-90 minutes.
They may want to use after an overdose, but remind them that Naloxone does not make opioids disappear! It's possible to go back into an overdose once the Narcan wears off.
