Opioid Overdose

Opiates and opioids are central nervous system (CNS) depressants.

Common Opiates and Opioids

  • Heroin
  • Morphine
  • Codeine
  • Methadone
  • Hydrocodone (Vicodin®, Lortab®)
  • Oxycodone (Percocet®)

A Naloxone dose of two milligrams is recommended and typically takes three to five minutes for the full effect. Patients must be closely monitored for re-occurrence of problems requiring additional doses.

What are some signs of an Opioid Overdose?

  • Unconsciousness
  • Very small pupils
  • Slow or shallow breathing
  • Vomiting
  • An inability to speak
  • Faint heartbeat
  • Limp arms and legs
  • Pale skin
  • Purple lips and fingernails

To Administer Naloxone

Follow the instructions for the naloxone product you have available. Common products may be intranasal or intramuscular. If there is no response after 2 to 3 minutes, give another dose if available and continue care.

  1. Assemble the nasal atomizer if required.
  2. Place the patient on their back.
  3. Tilt the head back and briskly spray half of the Naloxone up one side of the nose with 1 cc.
  4. Spray half up the other side of the nose with 1 cc.

If a definite pulse is present but breathing is absent or abnormal, give rescue breathing or bag-mask ventilation and administer naloxone if available. If there is no pulse, start CPR with 30 compressions and 2 breaths immediately, use the AED as soon as available, and consider naloxone only if it does not delay CPR or defibrillation. If there’s no change in three to five minutes, administer another dose of Naloxone and continue CPR or rescue breathing. If the second dose of Naloxone doesn’t revive them, something else is wrong. Either there are no opioids in their system, or the opioids are unusually strong and require more Naloxone.

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