What Happens to Your Body During Drug OverdoseAnna Ciulla
Since 1999, overdose rates in the United States have been steadily increasing. In fact, the last few years have had the highest overdose rates in the history of the country, in part due to the rise of synthetic opiates like fentanyl. The statistics are alarming, and experts claim that we’re currently in the grips of a legitimate national crisis with fentanyl, heroin, and prescription painkillers.
Given this dark reality, it’s important that members of the population know exactly what happens to the body during an overdose, how long an overdose lasts, and how to spot a drug overdose. The window of time to treat an overdose is typically short, and any wasted time while reacting can exacerbate the long-term effects of the overdose, or, in many cases, lead to death.
What is an Overdose?
So what exactly is an overdose, and how do we distinguish it from an instance of taking a large but non-lethal quantity of a drug?
In the simplest terms, an overdose occurs when a person has consumed enough of a drug that their metabolism is incapable of detoxifying it fast enough. Of course, everyone’s metabolism is different—a fact based on their unique biological makeup, age, and history of drug use—which makes it very difficult to predict how much of a given drug will induce an overdose for an individual.
Accidental overdoses, especially among young children and mentally impaired adults, is unfortunately common. In both cases, overdose usually occurs when drugs are left within their reach. Young children, especially between 6 months and 3 years old, will put almost anything in their mouth, often leading to tragedy.
Accidental overdose among chronic drug users makes up the largest portion of overall overdose rates. This usually occurs when users, who have developed tolerances to a drug after long-term use, mistakenly believe they can take more of a given drug than they physically can. This lapse in judgment is often fatal.
Teenagers and adults are the most susceptible demographic to intentional overdose. Sometimes, the overdose is knowingly induced as a suicide attempt. In other cases, individuals attempt to purposefully overdose to achieve a high.
Overdose statistics have always been alarming, but in the last few years, the numbers have been rising in ways that have baffled experts. Here’s a quick snapshot of the current state of overdoses.
- In 2017, the CDC reported 70,237 overdose deaths in the United States
- The states with the highest overdose rates include West Virginia (57.8 for every 100,000), Ohio (46.3), and Pennsylvania (44.3)
- Most alarmingly, the rate of overdoses that were attributed to synthetic opiates increased by 45% from 2016 to 2017
- The rate of male overdoses are significantly higher than females
Spotting a Drug Overdose
Each drug has a different effect on the body. When an overdose occurs, the standard side-effects are usually exacerbated to a degree where they become severely harmful or lethal. During an overdose, new side-effects may also arise, an ominous sign which should encourage users to seek immediate medical intervention.
In general, people who have induced an overdose will experience:
- Cool and sweaty skin, or hot and dry skin
- Intense confusion or sleepiness
- Comas, which can be especially dangerous if a person vomits and then inhales the vomit into their lungs
- Unusual vital signs—such as pulse, breathing rate, blood pressure, or temperature—that are either decreased, increased or is absent entirely
If you notice any of these symptoms for yourself, or in someone else, it’s a sign that medical intervention should be sought immediately.
Among overdose deaths, most of the involved drugs fall into one of three categories: opiates, stimulants, and sedatives. With that in mind, let’s take a look at the specific physical side effects associated with each type of overdose.
Stimulants such as cocaine or methamphetamine produce intense physical dependencies in users. Because the effects of cocaine only last around 30 minutes, users will continue taking the drug at dangerously short intervals in order to maintain a high. When a tolerance builds, and the amount of cocaine intermittently taken increases, the chance for an overdose increases. The most common stimulant overdoses involve cocaine and methamphetamine.
Stimulants directly affect the central nervous system. When a large amount of a stimulant is ingested, the cells in the nervous system become overwhelmed and incapable of communicating muscle movements. This results in one of the most common symptoms of stimulant overdose: seizures.
Stimulants also dramatically increase the rate of blood flow. This alters blood pressure and leads to an increased heart rate. In overdose cases, the heart rate will increase to the point of cardiac arrest or stroke. In other cases, aneurysms result from ruptured blood vessels in the brain.
The effects of a methamphetamine overdose are perhaps the most conspicuous. When injected intravenously—the most dangerous way a user can consume meth—at high quantities, the overloaded central nervous system causes a total loss of muscle control along with wild and erratic behavior.
When overdosing on prescription painkillers or opiates like morphine, heroin, or any of the synthetic variants like fentanyl, the first thing affected is the respiratory system. A user will find it difficult to intake air, and breathing will become intensely shallow. This effect is exacerbated when opiates are consumed simultaneously with alcohol.
- The most common opiate overdoses involve synthetic opiates like fentanyl, prescription drugs like methadone, and illegal drugs like heroin
Because of the frequency of opiate overdoses, medical professionals have developed what they call the “opiate overdose triad.” The triad identifies the three common symptoms of opiate overdoses and provides people with an easy-to-remember list of warning signs.
The triad includes:
- Respiratory depression, meaning that the user has difficulty breathing, is taking shallow breaths or is incapable of taking in air
- Pinpoint pupils, meaning that the user’s pupils have narrowed to an extremely small point
The sedatives drug class includes alcohol, and prescription drugs like Benzodiazepines (Benzos), Alprazolam (Xanax) and Diazepam (Valium). Similar to a stimulant overdose, a sedative overdose directly affects the central nervous system. However, in the case of sedative overdose, the bodily systems slow down dramatically.
- The most common sedative overdoses involve prescription drugs like Benzodiazepines (Xanax)
Among the different drug classes, those who abuse sedatives are the least likely to experience an accidental overdose. However, they are often turned to for intentional overdose attempts. This is because of a mistaken perception that a sedative overdose will be painless. However, during the course of sedative overdose, many individuals vomit, which means that the drug is partially purged from the system but not before respiratory function slows. Oxygen deprivation means that users often survive but experience intense brain damage.
There are a variety of other ways that the body reacts to a sedative overdose. These symptoms may include:
- Intense dizziness or fainting spells
- Decreased heart rate
- Cold skin
- Bluish tinge to skin, lips, fingers
- Slurred speech
- Difficulty breathing
Who is Most Likely to Witness an Overdose?
If you’re the sole witness to an overdose, the responsibility to contact the proper medical officials falls on you. In the vast majority of cases, the person experiencing the overdose is incapacitated and incapable of calling for help, and without the right medical intervention, they might fall victim to the drug.
According to the World Health Organization, there are three categories of people who are most likely to witness an overdose. These include:
- The family and friends of a drug user
- Other people who are at risk of overdose
- Workers—like police, emergency service workers, health-care professionals, and outreach workers—whose occupation brings them into close contact with users
If you fall into one of these categories (and even if you don’t) it’s important to know how to properly respond to an overdose. Many people who fall victim to a drug overdose could have been saved if swift action was taken by those in the vicinity or by medical professionals.
How to Respond to a Drug Overdose
If you believe you’re witnessing a drug overdose based on the symptoms described above, then it’s up to you to take swift and immediate action. There are generally three steps that are involved in overdose response.
Even if you’re forced to perform the second or third step of the overdose response, it’s still vital that you call 911. In many cases, people don’t have the resources at home to comprehensively respond to an overdose. Without medical intervention, many users will succumb to the symptoms.
When you call 911, let the operator know everything you know about the overdose case. Ideally, this includes the drug taken, the quantity taken, and how long ago the drug was consumed. These three factors help medical professionals properly assess an overdose case.
While emergency responders make their way to you, do not leave the overdosing individual alone unless you absolutely have to. This way, you can make adjustments to their head or body in case they start vomiting.
If you must leave before 911 arrives, adjust the person so that they’re in the recovery position. Lean them onto their side, with one hand underneath their head for their support and a bent, extended knee to prevent them from rolling onto their stomach.
Perform Rescue Breathing
In many overdose cases, especially those involving sedatives, the danger comes from a lack of oxygen. By performing rescue breathing or otherwise clearing the airway of a person experiencing an overdose, they are given access to the oxygen they need.
Rescue breathing should be attempted while the person is flat on their back. Place one hand beneath their neck and tilt the chin upwards. If you see that there is something, like gum, blocking airflow, be sure to remove it.
- Help expand the airway by tilting the chin up
- Pinch the nose closed and place your mouth over the person’s experiencing the overdose
- Blow a significant amount of air into their mouth, enough to make their chest rise and fall
- After the breath, turn their head to make sure that the chest has risen; if not, increase the tilt of the chin, which will further open up the passageway
- Continue this process, breathing into their lungs, every five seconds
Do not stop the rescue breathing process until the person starts to breathe on their own, an ambulance arrives, someone else can take over, or if you are too tired to continue.
Naloxone (or Narcan) can be used to briefly halt overdose symptoms in opiate users. It works by blocking opiates from reaching receptors in the brain.
It’s important to remember that Naloxone is only effective for 30 to 90 minutes. After that point, the symptoms of overdose may return. However, this window of time is hopefully long enough to rush the overdosing person to a hospital and get them the comprehensive medical attention they need.
After an Overdose
Assuming a user receives the proper medical attention and survives the overdose, the next step is to perform a psychiatric evaluation to determine the danger of another overdose occurring. Hopefully, the frightening experience of an overdose is enough to convince an individual to seek medical treatment and enter a rehab program.
If a loved one has recently experienced an overdose and you’re afraid that they may return to harmful drug use, find a time to talk to them about your concerns. Try to avoid accusatory or judgmental speech. After an overdose, many people feel especially vulnerable, and if they feel that they are being judged they may retreat back into drug use.
In many cases, a professionally assisted intervention may be necessary. Professional interventionists have experience dealing with people who are deep in the cycle of drug abuse and know how to help family members prepare statements and formulate a plan to usher the user into an inpatient drug rehab program.
- Center for Disease Control and Prevention. Drug Overdose Deaths in the United States, 1999-2017. 2017.
- Harm Reduction Coalition. What is an overdose? 2018.
- National Institute on Drug Abuse. Opioid Overdose Crisis. 2019.