What are the signs of an opiate overdose?

Here’s a direct, clinical, no-nonsense list of the signs of an opioid overdose. These are the ones that matter in real-world situations.

Major Signs of an Opioid Overdose

1. Breathing problems (the most important sign)

• Slow, shallow, or irregular breathing

• Breaths spaced far apart

• No breathing

• Snoring or gurgling (“death rattle”) sounds

2. Extreme unresponsiveness

• Won’t wake up

• Doesn’t respond to shouting or shaking

• Limp body

3. Pinpoint pupils

• Extremely small pupils (“pinpoints”)

  Very reliable sign if opioids are the main cause

4. Cyanosis (lack of oxygen)

• Blue or gray lips

• Blue fingernails

• Pale or ashy skin tone

5. Cold, clammy skin

• Skin feels cool or sweaty

• Weak or absent pulse

6. Slow or stopped heart rate

• Weak pulse

• No detectable pulse in severe cases

Secondary Signs (Not always present, but common)

• Vomiting

• Seizure-like movements

• Choking sounds

• Very slow to no response when you rub the sternum (sternal rub)

FAST Action Steps (what to do)

If you see ANY of the above:

1. Call 911 immediately

2. Administer naloxone (Narcan) if available

3. Rescue breathing if not breathing

4. Stay with them until help arrives