Understanding Overdose

Unfortunately, we continue to experience an epidemic of drug overdoses within the US and across the globe. Overdose-related deaths have increased by 31% from 2019 to 2020, highlighting an alarming spike in what are otherwise preventable deaths. If you or someone you know has a substance use disorder, it is imperative that you understand what overdose is and how to recognize the symptoms of one so you can prevent any further harm and potentially save a life.

If you believe someone is experiencing a drug overdose, please stop reading and seek medical attention.

Overdoses are considered a medical emergency and, in many cases, can be a potentially life-threatening situation. Generally, this means that the consumption of substances was beyond the medication’s guidelines or beyond the body’s tolerance level to manage safely. This can result in critical body systems being unable to function appropriately without medical intervention.

Depending on the type of substance, there are many different symptoms of an overdose. Additionally, there are many other factors that can impact how and when an overdose can occur. Here are some of the most important factors and symptoms to be aware of, as they often require emergency medical intervention.

Factors that can influence overdose:

High-risk symptoms of overdose:

  • Unable to stay awake
  • Drowsiness
  • Unable to be woken up
  • Seizure activity
  • Vomiting
  • Rapid, slow, or no heart rate
  • Shallow breathing
  • Blue/purple looking skin
  • Extreme weakness
  • Mental stupor

Overdoses are placed within two main categories: accidental and intentional. Many times, an overdose is accidental due to mistiming dosages of a medication, overconsumption of medication without awareness of the potential danger, or even using multiple substances at one time, which can overwhelm the body’s ability to regulate itself and ultimately experience an overdose event.

Intentional overdoses are attempts at ending one’s life through the overuse of a substance to not wake up, which also is a medical emergency that requires immediate care to reduce the chance of long-term harm or death.

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Recognizing Overdose by Substance

Almost any substance can result in an overdose. Even substances that we consume every day, like caffeine, can cause an overdose, although it usually requires so much that it is unlikely to occur. For the purposes of keeping to substances that are more likely to cause an overdose, those generally fall within the categories of alcohol, Opioids, Sedatives, Stimulants, Cannabis, and Synthetic/Designer drugs.


Alcohol overdose is generally referred to as alcohol poisoning in the medical community. This event occurs when alcohol in the bloodstream grows to very high levels. Typically, anything above .16% (that is, .16% of your blood containing alcohol) results in serious symptoms like loss of consciousness, blackouts, and impairment of cognitive functioning. When .30% is reached, this is often where loss of life is a serious risk as the body is completely unable to function.

Compare those numbers to what is considered driving under the influence (typically .8%), combined with the fact reaching this level of intoxication can be achieved with just one or two standard alcoholic beverages, and it’s easy to see how deadly alcohol can be. Alcohol poisoning is not uncommon for those who consume multiple alcoholic beverages a day over time.

Standard Drink Sizes

Symptoms of Alcohol Overdose:

  • Unconsciousness
  • Drowsiness
  • Seizures
  • Vomiting
  • Slowed heart rate
  • Irregular breathing
  • Clammy/blue skin
  • Extreme weakness
  • Unable to be woken up
  • Mental stupor


Opioid overdose is the largest representation of drug-related overdoses within the US. Overdoses involving Opioids are common when synthetic Opiates like Fentanyl or Heroin are being used. Opioid-related overdoses can range in severity, with many non-fatal overdoses occurring more often than fatal events. Even still, the Opioid Epidemic in the US still poses a major threat to public health.

The Opioid Epidemic within the US has resulted in multiple waves of public health initiatives to spread awareness of Opioid overdoses as well educating others on ways to help in case of emergency. One of the most effective strategies for preventing overdoses has been the use of Narcan, also known as Naloxone. Narcan can quickly reverse the effects of an Opioid overdose while waiting on emergency services to arrive. If you or someone you know has an Opioid use disorder, it’s highly encouraged to have Narcan available in case of an overdose.

Symptoms of an Opioid overdose include:

  • Unable to stay awake
  • Snoring/gurgling sounds
  • Unconscious
  • Small “pinpoint” pupils
  • Vomiting
  • Slow/no heart rate
  • Slow/no breathing
  • Blue/purple skin
  • Limp body
  • Pale/clammy skin


Many substances can cause a state of sedation when abused due to how they interact with the central nervous system (CNS). Many systems are regulated by the CNS, which helps explain why overdoses of other substances, such as alcohol and Opiates, can result in critical body systems failing.

Sedative-specific medications are used to sedate the body to reduce stress and assist with sleep and are often quite powerful in their effect. Generally, these medications are most often seen in the Benzodiazepines class (Xanax, Valium, Klonopin) and less commonly among Barbiturates (phenobarbital).

Sedatives are designed to be short-term solutions due to the serious risk of dependence that can form when consumed for too long. Due to their potential impact, using more than the recommended dose or in shorter periods than advised can quickly result in overdose symptoms. Sedative overdoses can result in coma and death without immediate emergency service intervention.

Symptoms of Sedative Overdose:

  • Unconscious
  • Drowsiness
  • Unable to be woken up
  • Slurred speech
  • Vomiting
  • Slow heart rate
  • Slow/no breathing
  • Blue skin
  • Extreme weakness
  • Mental stupor

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Stimulants refer to a broad category of substances, with the most well-known being Methamphetamines, Cocaine, Crack Cocaine, and Amphetamine-based ADHD medications (Adderall). Stimulants generally have a quick onset once they are consumed, and the effects usually wear off quickly as well. This pattern often results in continued use that grows over time, which can lead to overdose events.

Due to the potential euphoric effects of Stimulants, the urge for continued use becomes difficult to ignore and can create situations in which high-risk overdose events may occur. While not all stimulant overdoses are fatal in nature, it’s important to be aware that when using non-prescription Stimulants, there is a risk that other substances, such as Opiates, may also be used in their creation. This can result in a mixed substance overdose potential. Medical attention is necessary to address both the physical and behavioral health conditions that are experienced during a Stimulant overdose.

Symptoms of Stimulant Overdose:

  • Mood swings
  • Confusion
  • Anxiety/paranoia
  • Irritability/aggression
  • Tremors
  • Vomiting
  • Chest pains
  • High blood pressure
  • Psychosis
  • Hallucinations


Cannabis, or Marijuana, is a substance that many people find harmless to consume. Cannabis has been considered the world’s most-used illicit substance, though it has gained legality in some places.

Cannabis developed today is strikingly different than what older generations experienced, with significant increases in potency now found in most of today’s Cannabis supply. With that increased potency are more examples of Cannabis toxicity, or Cannabis overdose symptoms, being seen in hospital settings. Though not as common as the other substances on this list, it is still something to be aware of to ensure proper care is provided as needed.

Symptoms of Cannabis Overdose:

  • Respiratory distress
  • Anxiety/panic
  • Rapid heart rate
  • Muscle jerking
  • Delirium
  • Low blood pressure
  • Vomiting
  • Paranoia
  • Psychosis
  • Hallucinations

Synthetic Drugs

Synthetic, or “designer,” drugs refer to a wide-ranging category of manmade drugs. Some well-known examples include: MDMA (Molly, Ecstasy), Spice (K2), Bath Salts, Flakka, DMT, and LSD variations. Many variations of these substances can be found on the internet or even in local convenience stores due to there being little to no regulation guiding their production.

All these substances are considered highly dangerous as there is rarely any standardization to them. One tab or dose could contain significantly less or significantly more chemical properties than another, which means there is a serious risk of overdose surrounding these drugs. Due to the high potency and risk of these substances, overdoses involving them can even result in long-term changes to the individual’s psychological functioning and, in some cases, can even be fatal without proper care.

Symptoms of Synthetic Drug Overdose:

  • Rapid breathing
  • Anxiety/panic
  • Rapid heart rate
  • Inability to sleep
  • High body temperature
  • High blood pressure
  • Vomiting
  • Seizures
  • Psychosis
  • Hallucinations

Find Addiction Support

It is imperative that if you or someone you know is experiencing overdose symptoms, you find treatment as soon as possible to prevent any serious life-threatening conditions from occurring. For many, starting the treatment process is the scariest step; however, it’s not the last. Once overdose symptoms are safely managed, and a safe detoxification process is complete, the next step toward recovery can begin. To learn more about the recovery process, contact a treatment provider today.

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Travis Pantiel, LMHC, MCAP

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  • Travis Pantiel is a Licensed Mental Health Counselor and a National Board-Certified Counselor with specialized expertise in the co-occurring disorder treatment field.

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Reviewed by Doctor of Addiction Medicine

Dr. Ashish Bhatt, MD

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  • Addiction Center’s Medical Content Director, Dr. Ashish Bhatt, MD, MRO is an accomplished physician, addiction medicine specialist, and psychiatrist with over 20 years of medical and administrative leadership.

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