Opioid Overdose Checklist

Opioid Overdose Checklist

1. Check for These Signs (Any One = Emergency)

Breathing

• □ Slow or shallow breathing

• □ Long pauses between breaths

• □ Gurgling or snoring (“death rattle”)

• □ Not breathing at all

Responsiveness

• □ Won’t wake up

• □ Doesn’t respond to shouting or shaking

• □ Body limp

Eyes / Skin

• □ Pinpoint pupils

• □ Blue or gray lips or nails

• □ Pale, cold, or clammy skin

Heartbeat

• □ Very slow pulse

• □ No detectable pulse

2. What To Do Immediately

Step 1 — Call 911

• □ Say: “Suspected opioid overdose. Not breathing/slow breathing.”

Step 2 — Give Naloxone

• □ Spray Narcan or inject naloxone (IM)

• □ If no response in 2–3 minutes, give a second dose

Step 3 — Start Rescue Breathing (If not breathing normally)

• □ Tilt head back

• □ Pinch nose

• □ 1 breath every 5 seconds

Step 4 — Keep Them Safe

• □ Roll onto their side (recovery position)

• □ Stay with them until help arrives

• □ Be prepared for withdrawal when naloxone works

3. Aftercare (Once They Wake Up)

• □ Reassure them — withdrawal feels awful but is temporary

• □ Encourage medical evaluation

• □ Continue monitoring — overdose can return after naloxone wears off

• □ Consider connecting them with safer-use or treatment options