Substance guides

Signs of opioid overdose: How to recognize and respond

Published October 17, 2024 · 7 min read · Updated April 2026

Reviewed for accuracy by licensed clinical professionals.

Opioid overdose kills through respiratory depression. Recognizing the signs and responding immediately saves lives.

The signs

Unresponsiveness (cannot be woken by shouting or sternal rub). Slow, shallow, or stopped breathing (fewer than 8 breaths per minute). Gurgling or snoring sounds (airway obstruction). Blue or gray lips and fingertips (cyanosis). Pinpoint pupils. Pale, clammy skin. Limpness.

Response steps

1. Call 911 immediately. 2. Administer naloxone (Narcan) if available. 3. Begin rescue breathing if they are not breathing. 4. Place in recovery position (on their side). 5. Stay until emergency services arrive. 6. If no response to naloxone in 2-3 minutes, give a second dose.

After naloxone works

The person may wake confused and in withdrawal. They may be agitated. Do NOT let them leave. Naloxone wears off in 30-90 minutes and they may re-overdose. Wait for paramedics.

Good Samaritan protection

Most states protect you from drug charges when calling 911 for an overdose.

Authoritative sources

This article references guidelines from: NIDA · SAMHSA · CDC

Frequently asked questions

What does an opioid overdose look like?

Unresponsive, slow or stopped breathing, blue lips, pinpoint pupils, limpness, and gurgling sounds.

What do I do for an opioid overdose?

Call 911. Give naloxone. Begin rescue breathing. Recovery position. Stay until help arrives.

Can I get in trouble for calling 911 for an overdose?

Most states have Good Samaritan laws protecting you from drug possession charges when reporting an overdose.

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