Substance guides

Signs of a drug overdose: How to recognize and respond

Published March 15, 2026 · 8 min read · Updated April 2026

Reviewed for accuracy by licensed clinical professionals. Editorial process.

Recognizing an overdose quickly and responding correctly saves lives. The signs differ depending on the substance, but the response — call 911 first — is universal.

Opioid overdose (heroin, fentanyl, pills)

Signs: pinpoint pupils, unconscious or unresponsive, slow or stopped breathing, gurgling or choking sounds, blue or purple lips and fingertips, limp body. Response: call 911. Administer naloxone (Narcan) if available — spray one dose into one nostril. If no response after 2-3 minutes, give a second dose. Fentanyl may require 3+ doses due to its extreme potency. Place the person in the recovery position (on their side). Begin rescue breathing or CPR if they stop breathing. Stay with them — naloxone wears off in 30-90 minutes and the overdose can return.

Stimulant overdose (cocaine, meth, amphetamines)

Signs: chest pain, irregular or racing heartbeat, extreme agitation or paranoia, seizures, high body temperature, profuse sweating, confusion or psychosis, loss of consciousness. Response: call 911. Keep the person calm if possible. Cool them if body temperature is high (cool cloths, move to shade). Do not restrain them unless they are in immediate physical danger. Place in recovery position if unconscious. There is no reversal agent for stimulant overdose — medical support is essential.

Alcohol overdose

Signs: unconscious and cannot be awakened, slow or irregular breathing, vomiting while unconscious, pale or blue skin, low body temperature, seizures. Response: call 911. Place in recovery position. Monitor breathing. Read our complete alcohol poisoning guide.

Benzodiazepine overdose

Signs: extreme sedation, slurred speech, confusion, slow breathing, loss of consciousness. Benzodiazepine overdose alone is rarely fatal but becomes extremely dangerous when combined with opioids or alcohol. Flumazenil is the reversal agent but is only administered in emergency medical settings.

Good Samaritan laws

Most states have Good Samaritan laws that protect you from prosecution for drug possession when you call 911 to report an overdose. The priority is saving a life. Do not let fear of legal consequences prevent you from calling.

Find a location near you

Shelby County Treatment Center

Alabaster, AL

Call 205-216-0200

Lighthouse of Tallapoosa County Inc

Alexander City, AL

Call 256-234-4894

South Central Alabama MHC

Andalusia, AL

Call 334-428-5050

Anniston Fellowship House Inc

Anniston, AL

Call 256-236-7229

Browse all facilities →

Authoritative sources

This article references guidelines from: SAMHSA · NIDA · ASAM

Frequently asked questions

How do I know if someone is overdosing?

Key universal signs: unresponsive to stimulation, slow or stopped breathing, blue lips or fingertips, and loss of consciousness. When in doubt, call 911 — it is always better to be wrong than to wait.

Can you overdose on fentanyl from touching it?

Passive skin contact with fentanyl is extremely unlikely to cause overdose based on current scientific evidence. Overdose occurs from ingestion, injection, inhalation, or mucous membrane contact.

Where can I get free Narcan?

Many pharmacies sell naloxone (Narcan) over the counter without a prescription. Community organizations and health departments often distribute it free. NEXT Distro offers free mail-order naloxone.

Disclaimer: Informational only. Not medical advice. SAMHSA: 1-800-662-4357.