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Drug Overdose: Prevention & Response

An overdose is a medical emergency — and often a preventable one. Learn the signs, how to use naloxone (sold over the counter), how to lower the risks, and where to find treatment that works. Recovery is possible.

Possible opioid overdose? Act fast. Signs include being unconscious or unable to wake up; slow, shallow or stopped breathing, or choking, gurgling or snoring sounds; lips or fingernails turning blue or purple (on darker skin, the skin may look pale, grayish or ashen); and tiny “pinpoint” pupils (CDC, SAMHSA).

  1. Give naloxone (Narcan) if you have it and call 911 (CDC). Follow the directions on the package — over-the-counter naloxone has them on its Drug Facts label (SAMHSA). If you aren’t sure it’s an overdose, treat it like one: naloxone won’t harm someone who has taken something other than opioids, and with strong opioids such as fentanyl more than one dose may be needed (CDC, CDC).
  2. Support their breathing. Give rescue breaths if you can; if you aren’t trained, follow the 911 operator’s instructions (SAMHSA). If the person is not breathing, start CPR and give naloxone without interrupting CPR (MedlinePlus).
  3. Recovery position: once they are breathing, roll them onto their side with the top leg bent, to help prevent choking (SAMHSA, CDC).
  4. Stay with them until help arrives (CDC). Naloxone wears off after 30–90 minutes and the overdose can come back, so the person still needs medical care even if they wake up (SAMHSA, NIDA).

Stimulant overdose (cocaine, methamphetamine) can look different: the person is often awake and may be dangerously overheated, agitated or confused, with chest pain or tightness, a racing heart or seizures. Call 911 — always if someone loses consciousness, has a high body temperature, has a long or repeated seizure, or shows signs of a heart attack or stroke. If opioids could also be involved, give naloxone too, and help the person stay cool and calm while you wait (CDC, SAMHSA).

Alcohol overdose (alcohol poisoning): confusion, trouble staying conscious or being unable to wake, vomiting, seizures, slow or irregular breathing, clammy skin, very low body temperature, or bluish or pale skin. Call 911 right away — don’t wait for every symptom. Never assume someone will be fine “sleeping it off”: blood alcohol can keep rising after they pass out, and they can choke on vomit. Don’t leave them alone; if they are lying down, roll them onto their side. Cold showers, coffee and walking don’t help (NIAAA).

Child got into medicine? Call Poison Help at 1-800-222-1222 (CDC, Poison Control). Call 911 if anyone can’t be woken up or isn’t breathing normally (MedlinePlus).

Thoughts of suicide, or a mental health or substance use crisis? Call or text 988, free and confidential, 24/7 (988 Lifeline). But if someone is overdosing and breathing slowly or not at all, call 911 (SAMHSA).

Don’t let fear stop you from calling. California law protects a person who, in good faith, seeks medical help for someone overdosing — and the person who overdosed — from being charged with being under the influence or possessing drugs for personal use (Cal. Health & Safety Code § 11376.5). See the step-by-step section below for details.

What is an overdose?

An overdose happens when someone takes more of a drug than their body can handle. The substances overpower the brain and other organs so they can’t work normally. In an opioid overdose, breathing slows or stops, starving the brain and heart of oxygen; without help, an overdose can be fatal (SAMHSA). Stimulant overdose (sometimes called “overamping”) often affects several organs at once, including the heart (SAMHSA). Overdoses don’t only happen to people who use illegal drugs: prescription medicines can be involved too, especially when instructions are misunderstood or medicines are mixed with alcohol (SAMHSA, NIAAA), and young children can be poisoned by medicine they find (CDC). An opioid overdose can be reversed with naloxone (CDC).

We use person-first words such as “person who uses drugs” and “person with a substance use disorder”. Addiction is a chronic, treatable medical condition, people can and do recover, and stigmatizing language can stop people from seeking treatment (NIDA).

How common is it?

In CDC’s latest provisional figures (data available October 4, 2026), an estimated 66,478 people in the United States died of a drug overdose in the 12 months ending May 2026, down from an estimated 75,094 in the 12 months ending May 2025. These are CDC’s “predicted” provisional counts, adjusted for incomplete reporting because overdose deaths often need lengthy investigations; they are updated monthly and subject to change (CDC, NCHS, CDC provisional data). Fewer deaths is real progress — and every one of those numbers was a person.

In 2023, about 105,000 people died of a drug overdose (CDC). About 69% of those deaths involved synthetic opioids other than methadone, mainly illegally made fentanyl (CDC), and nearly 35,000 involved stimulants such as methamphetamine (CDC).

Fentanyl’s role

Fentanyl is a lab-made opioid that is far more potent than morphine or heroin; even a small amount can cause a fatal overdose. Most of the fentanyl driving the overdose crisis is made illegally (NIDA). It is sold as powder or pressed into counterfeit pills made to look like prescription medicines such as oxycodone or alprazolam (Xanax) — real pharmaceutical fentanyl does not come as a pill (CDC). It is also mixed into heroin, cocaine, methamphetamine and the animal sedative xylazine (“tranq”), often without the buyer knowing. You can’t tell if a drug or pill contains fentanyl by looking at, tasting or smelling it (NIDA). Many deaths involving stimulants also involve an opioid, suggesting some people are buying stimulants without knowing they contain fentanyl (SAMHSA).

Who is at higher risk?

Overdose risk goes up when someone (SAMHSA):

  • has lost tolerance — for example, after a period of not using, such as a hospital stay, detox, treatment or jail — and uses the amount they used to;
  • returns to use after leaving jail or prison or a health care setting where medication for opioid use disorder wasn’t provided, or after a naltrexone injection has worn off;
  • mixes substances, especially opioids with alcohol or benzodiazepines (sedating anxiety or sleep medicines);
  • uses alone, with no one there who can give naloxone;
  • takes a drug much stronger than usual, or from an unregulated source with unknown contents;
  • has lung or heart conditions such as asthma or sleep apnea;
  • misunderstands prescription instructions, or there is a prescribing or pharmacy error.

People who have had one opioid overdose are more likely to have another (CDC), and the risk of a fatal overdose remains high even a year later (SAMHSA). People who are given methadone or buprenorphine while in prison or jail are less likely to overdose after release (NIDA).

Mixing substances, including alcohol

Alcohol together with opioids or sedating medicines — sleep aids, benzodiazepines, even over-the-counter antihistamines — raises the risk of overdose. Like alcohol, opioids suppress the parts of the brain that control breathing, and together they can cause an overdose even with moderate amounts of alcohol (NIAAA). Taking more than one drug, on purpose or unknowingly, increases the risk of serious harm or death (NIDA). Naloxone may work less well when sedating substances such as alcohol, benzodiazepines or xylazine are also involved — but still give it (SAMHSA).

Accidental overdoses in children

Unintentional medicine overdoses are the leading cause of emergency department visits in young children (CDC). Children may be able to open safety caps, so CDC advises putting every medicine, vitamin and supplement — gummies included — up, away and out of sight after every use; asking visitors to keep bags with medicine out of reach; and saving Poison Help (1-800-222-1222) in your phones (CDC). Some medicines, including fentanyl, buprenorphine, methadone and other opioid products, can kill with a single dose if taken by someone they weren’t prescribed for, which is why the FDA asks for fast disposal when they’re no longer needed (FDA). See “Safe storage and disposal” below.

Older adults and medication mix-ups

Older adults often have several health conditions and take many medicines, which raises the risk of side effects and mistakes. The National Institute on Aging suggests keeping an up-to-date list of every medicine and supplement, using one pharmacy, following the label exactly (never taking extra in the hope it will work better), using pill boxes or reminders, not taking medicine in the dark, and checking active ingredients so you don’t double up — for example, two products that both contain acetaminophen (NIA). Anyone can become addicted to prescription pain medicines (NIA), and overdose response guidance notes that women, older people and people without obvious signs of opioid use are undertreated with naloxone (SAMHSA). People taking opioid medicines prescribed by a doctor are among those who should carry naloxone (CDPH).

Related guides: for what to do when someone can’t be woken up, see our Coma guide. Mental health matters in recovery too — see our Depression and Anxiety guides.

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Emergency care for an overdose; naloxone for anyone at risk (over the counter since 2023); medications for opioid use disorder — methadone, buprenorphine or naltrexone — with counseling; harm reduction services; and safe disposal of unused medicines through take-back programs. Naloxone: $19 through California’s CalRx program (from January 1, 2026), and free or low-cost from local organizations and syringe services programs. Medicaid (Medi-Cal) must cover MOUD and related counseling; Marketplace plans cover substance use treatment. SAMHSA’s Helpline and drug take-back are free. Treatment program prices being researched. Naloxone can restore breathing within minutes, but the person still needs medical care. Methadone and buprenorphine lower the risk of overdose death; all three medicines can be taken safely for months or years.
Chiropractic No role in responding to an overdose or treating a substance use disorder. We found no clinical trials. Not a treatment for overdose or addiction, so no cost is listed. No evidence it prevents or treats overdose or addiction. Ordinary back pain can be cared for separately.
Acupuncture Ear (auricular) acupuncture using the NADA protocol is offered in some addiction programs as an add-on to treatment — never instead of medication for opioid use disorder. Cost estimate being researched. Weak evidence. A Cochrane review found no evidence it helps cocaine dependence; small, low-quality studies hint it may help some people stay in treatment or ease craving.
Herbal medicine No herb or supplement treats addiction or reverses an overdose. Kratom is sold as a “natural” remedy for opioid withdrawal, but the FDA warns against it. Not recommended, so no cost is listed. Kratom can itself cause seizures, liver damage and a substance use disorder, and acts on the same brain receptors as opioids. Talk to a clinician about proven medicines instead.
Massage therapy Hands-on bodywork for comfort and stress relief during recovery, alongside treatment. Cost estimate being researched. Very little research: one small trial suggested it eased alcohol withdrawal in a detox unit; another found no clear benefit for people in methadone treatment. A low-risk extra, not a treatment.
MBHA Wellness Coach Carrying naloxone, never using alone, fentanyl test strips, safe storage and disposal of medicines, supporting a loved one, reducing stigma, peer support and connecting to mental health care. Cost estimate being researched. SAMHSA’s Helpline, 988 and peer groups such as SMART Recovery are free. Practical habits that lower the risk of dying from an overdose and make it easier to reach treatment — alongside, not instead of, medical care.

Approach 1 of 6

Conventional medicine (AMA)

Conventional care covers three things: emergency treatment of an overdose, tools that prevent overdose deaths (naloxone, harm reduction and safe disposal), and treatment of substance use disorders — especially the three FDA-approved medications for opioid use disorder (MOUD). Treatment can reduce the risk of overdose and help people who have survived one build a healthier life (SAMHSA).

1. Emergency care

An overdose needs immediate medical attention: call 911 and give naloxone if opioids could be involved (SAMHSA). There is no medicine that reverses a stimulant overdose the way naloxone reverses an opioid overdose, but emergency teams have medicines and treatments to manage its effects (SAMHSA), such as high blood pressure, seizures and heart rhythm problems (CDC). Alcohol poisoning is also a 911 emergency (NIAAA). In the emergency department, buprenorphine can be started after an opioid overdose to ease withdrawal and cravings, which can help people begin long-term treatment (NIDA).

2. Naloxone (Narcan) — for everyone

  • What it does: naloxone rapidly reverses an opioid overdose by blocking the effects of opioids, and can restore normal breathing. It has no effect on someone without opioids in their system and is not a treatment for opioid use disorder (NIDA). It is safe and small enough to carry, and anyone can use it without medical training (CDC).
  • Over the counter since 2023: in March 2023 the FDA approved Narcan nasal spray as the first naloxone product for sale without a prescription — in drug stores, convenience and grocery stores, gas stations and online (FDA, 2023). It is now sold over the counter in all 50 states (CDC). Other forms, including injectable naloxone, still need a prescription or standing order (CDPH).
  • How to use it: read the product instructions and check the expiration date ahead of time, and get trained if you can (NIDA); over-the-counter products have directions on the Drug Facts label (SAMHSA). We don’t give dosing here — follow the package directions. More than one dose may be needed with strong opioids such as fentanyl (CDC).
  • Withdrawal on waking: a person who is physically dependent on opioids may wake into withdrawal — body aches, sweating, nausea, a fast heart rate, irritability. It is uncomfortable but usually not life-threatening, and far less dangerous than the overdose (NIDA, FDA). Be kind and reassuring; surviving an overdose can be traumatic (SAMHSA).
  • Who should carry it: anyone, but especially people with opioid use disorder, people taking prescribed opioids, people who use opioids and benzodiazepines together, people who use drugs, and the people around them. You can’t give naloxone to yourself, so let others know where yours is. Bystanders are present at almost half of fatal overdoses in California (CDPH).
  • Storing it: follow the maker’s instructions; keep it in its box, away from light, freezing and high heat. Expired naloxone is better than none (CDPH).

3. Medications for opioid use disorder (MOUD)

Opioid use disorder is a chronic, treatable condition, and people recover from it. Three FDA-approved medications — methadone, buprenorphine and naltrexone — help people stop or reduce opioid use. People treated with methadone or buprenorphine are less likely to overdose or die than people who are not treated. Yet fewer than 1 in 5 people with opioid use disorder receive these medicines (NIDA). All three are safe to take for months, years or even a lifetime, and adding counseling and psychosocial support may give extra benefit for some people (SAMHSA). See “Treatment and recovery” below for how each one works and where to get it. We don’t list doses: these medicines are prescribed and adjusted by a clinician.

4. Counseling and other treatment

Counseling and behavioral therapies are part of treatment, and Medicaid’s required MOUD benefit includes them (CMS, 2024). There are no FDA-approved medicines for stimulant use disorder, but contingency management — a behavioral approach — is a proven, effective way to support recovery from stimulant use disorder (SAMHSA). Naltrexone is also approved for alcohol use disorder (NIDA).

5. Harm reduction services

Harm reduction is an evidence-based, practical public health approach that helps people who use drugs, and their families, live healthier, self-directed lives. Services can include syringe services programs, drug checking, naloxone, MOUD, links to other treatment, testing and treatment for HIV and viral hepatitis, and wound care (SAMHSA). Methadone and buprenorphine also make people less likely to inject or share injection equipment, lowering the risk of HIV and hepatitis C (NIDA). Fentanyl test strips are covered under the Wellness Coach approach.

6. Clearing out unused medicines

The best way to get rid of most unused or expired medicines, prescription or over-the-counter, is a drug take-back location (often a pharmacy or police station) or a prepaid mail-back envelope (FDA). The DEA also holds National Prescription Drug Take Back Days, where people can turn in medicines safely and anonymously, and has a collection site locator (DEA). Details are in “Safe storage and disposal” below.

What it costs

  • Naloxone: California residents can buy naloxone nasal spray through the state’s CalRx program for $19 (effective January 1, 2026). It is also free or low-cost from local organizations with naloxone programs and from syringe services programs, and people who use drugs without a local resource may be able to get it by mail through NEXT Distro (CDPH). The state’s Naloxone Distribution Project gives free naloxone to qualifying community organizations (CDPH). If you have insurance, check whether it covers naloxone; some drug companies have assistance programs (NIDA). Store prices for other products: being researched.
  • Medicaid (Medi-Cal): federal law now permanently requires state Medicaid programs to cover all FDA-approved medications for opioid use disorder, including methadone, plus the counseling and behavioral therapies that go with them; only a few states and territories (not California) received exemptions (CMS, 2024).
  • Private insurance: all Marketplace plans cover substance use disorder treatment as an essential health benefit and can’t deny coverage or charge more for a pre-existing substance use condition (HealthCare.gov).
  • No insurance: SAMHSA’s National Helpline is free and can refer you to state-funded treatment programs, sliding-scale facilities, or programs that accept Medicare or Medicaid (SAMHSA).
  • Disposal: take-back days are anonymous (DEA).
  • Treatment program, clinic visit and medicine prices: MBHA cost estimate being researched.

How well it works — what to expect

Naloxone can restore normal breathing within about 2 to 3 minutes (CDC), and when widely available and used, overdose reversal medicines can reduce overdose deaths (SAMHSA). Methadone and buprenorphine lower the risk of overdose and death and help people stay in treatment (NIDA). Opioid use disorder is a chronic, treatable condition from which people can recover (NIDA).

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Chiropractic care has no role in responding to an overdose or treating a substance use disorder. A PubMed search for studies of chiropractic care and addiction, substance use, opioid use disorder or overdose found surveys and observational studies, but no clinical trials of chiropractic treatment for these conditions. For an overdose, call 911 and give naloxone (CDC); for opioid use disorder, effective FDA-approved medicines exist (NIDA).

If you also have back pain

For people with opioid use disorder who live with pain, the American Society of Addiction Medicine recommends trying medication-free treatments such as physical or behavioral therapy, or non-opioid pain medicines, first (NIDA). It’s fine to get care for ordinary back pain — see our Back Problems guide — but tell your clinicians about every medicine you take, and don’t let it replace addiction treatment.

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Some addiction treatment programs offer auricular (ear) acupuncture. The National Acupuncture Detoxification Association (NADA) trains people in a standardized ear acupuncture protocol used for substance use, trauma and mental health conditions (NADA), and it has become the most widely used such protocol in the U.S. (Baker & Chang, 2016). It is used as an add-on within treatment programs. It does not reverse an overdose, and it is never a substitute for medication for opioid use disorder.

What the research says

  • Cocaine: a Cochrane review of 7 trials (1,433 people), all of generally low quality, found no evidence that auricular acupuncture is effective for cocaine dependence; the evidence was inconclusive (Cochrane review, 2006).
  • Opioid use disorder, NADA protocol: a 2016 review found only 4 trials. Despite methodological problems, they suggested the protocol may not reduce acute craving or withdrawal, but might help as an add-on to keep people in treatment. The authors called their conclusions tentative (Baker & Chang, 2016).
  • Opioid use disorder, other acupuncture: a 2018 analysis of 9 studies (1,063 people) found acupuncture might ease craving, sleep problems and depression compared with no or sham treatment, but the included studies were few and of low quality (Chen et al., 2018).

In short: the evidence is weak. If a program you trust offers ear acupuncture and you find it calming, it can sit alongside — never in place of — proven treatment.

Safety

Relatively few complications have been reported. Problems have come from non-sterile needles and poor technique; the FDA requires acupuncture needles to be sterile and single-use (NCCIH). Use a trained practitioner and tell your treatment team.

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

No herb or supplement reverses an overdose or treats addiction. The FDA-approved medicines for opioid use disorder are methadone, buprenorphine and naltrexone (NIDA). “Natural” does not always mean safe, and supplements can interact with medicines (NCCIH).

Kratom — a serious warning

Kratom (Mitragyna speciosa) is a Southeast Asian tree whose leaf products are sold online and in stores, and people often use it to self-treat opioid use disorder and opioid withdrawal (FDA). The FDA says:

  • there are no prescription or over-the-counter drugs containing kratom legally on the market, and kratom is not lawfully sold as a dietary supplement or food additive;
  • consumers should not use kratom, because of the risk of serious harms including liver toxicity, seizures and substance use disorder; people have developed cravings, tolerance and withdrawal;
  • its main compounds act on the same brain receptors as opioids and may cause sedation and slowed breathing that can lead to death; in rare cases deaths have been linked to kratom, usually combined with other drugs;
  • some kratom products have been contaminated with Salmonella or heavy metals, and newborns exposed before birth have shown withdrawal signs (FDA).

The FDA has also warned about concentrated 7-OH (7-hydroxymitragynine) products: 7-OH is a minor compound in natural kratom but acts on opioid receptors much more potently than kratom’s main compound (FDA). If you are using kratom or 7-OH to manage opioid withdrawal, talk with a clinician about proven medicines — buprenorphine can be prescribed by many doctors, nurse practitioners and physician assistants, including by telehealth (NIDA).

Mixing anything sedating raises overdose risk. Alcohol, sleep aids and even over-the-counter antihistamines can add to the breathing-slowing effects of opioids (NIAAA). Tell your prescriber and pharmacist about every medicine, herb and supplement you take (NCCIH). We don’t list doses here.

Approach 5 of 6

Massage therapy

Massage can be a comforting, low-risk way to ease stress during recovery, but it is not a treatment for addiction or overdose, and research is very limited.

What the research says

  • In a small randomized trial of 50 people in a hospital alcohol detox unit, seated back, neck and head massage lowered pulse rate and withdrawal scores early in detox compared with rest; the authors said it “shows promise” as an add-on to medical detox (Reader et al., 2005).
  • In a small randomized trial of 51 people with chronic pain at a methadone treatment center, weekly Swedish massage did not produce an overall clinically meaningful improvement in pain, anxiety, depression or treatment engagement (Wiest et al., 2015).

Safety

The risk of harm from massage appears to be low, though rare serious problems such as a blood clot, nerve injury or bone fracture have been reported. In the 45 states (and D.C.) that regulate massage therapy, therapists must be licensed or certified (NCCIH).

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

An MBHA Wellness Coach focuses on the everyday steps that keep people alive and make it easier to reach treatment. The goal is safety and support, without judgment.

Carry naloxone — and tell people where it is

Keep naloxone on hand if you or someone you love uses drugs or takes opioid medicine, stored as the package directs (CDPH). Families should keep it nearby, ask their loved one to carry it, and let friends know where it is (NIDA). Learn the signs of overdose and how to respond (SAMHSA).

Never use alone

Using alone means no one can give naloxone or call 911. If you use drugs, use with a trusted person who is alert, stagger use in a group so someone can respond, or have someone check on you (SAMHSA). The Never Use Alone line (1-800-484-3731 or 1-877-696-1996, 24/7) is a confidential, peer-run service: a volunteer takes your location and alerts EMS if you stop responding. Operators have lived experience and won’t judge or lecture you (Never Use Alone).

Test, start low, go slow

  • Fentanyl test strips are small paper strips that check for fentanyl in many kinds of drugs and pills. They may miss fentanyl if the small sample tested doesn’t contain it, and may not detect related drugs such as carfentanil. They are legal in most states and available from health departments, syringe services programs, drug stores and online (NIDA). They are inexpensive and typically give results within 5 minutes; even if a test is negative, take care (CDC).
  • After a break, or with a new supply, start with a small amount, use slowly, and avoid mixing with alcohol or sedating medicines. Rest, eat and stay hydrated (SAMHSA).

Store and dispose of medicines safely

Put opioid and other medicines away, out of sight and reach, and clear out what you no longer need through a take-back program (FDA, CDC). See “Safe storage and disposal” below.

Supporting someone you love

Peer support

SMART Recovery offers free recovery meetings led by trained facilitators, plus an app and free worksheets (SMART Recovery). Narcotics Anonymous meetings are run by and for people recovering from addiction; its message is that any addict can stop using and find a new way to live, and it has published guidance on members who receive medication-assisted treatment (Narcotics Anonymous).

Mental health care

A coach can help you find care for mental health concerns such as depression or anxiety — see our Depression and Anxiety guides. For a suicidal, mental health or substance use crisis, call or text 988 (988 Lifeline, SAMHSA).

Another approach

What to do in an overdose, step by step

Opioid overdose (or you aren’t sure)

  1. Check for a response. Call the person’s name. If they don’t wake, rub your knuckles on their upper lip or the center of their chest (SAMHSA).
  2. Give naloxone and call 911. If you aren’t sure, treat it like an overdose — you could save a life (CDC). Follow the package directions (SAMHSA). On the phone, you can simply say “someone is unresponsive and not breathing”, give the exact address, and follow the dispatcher’s instructions (SAMHSA).
  3. Support breathing. The goal is to restore breathing — breathing matters more than waking up. Give rescue breaths if you can, or follow the 911 operator’s instructions (SAMHSA). If the person isn’t breathing, do CPR and give naloxone without interrupting it (MedlinePlus). If they don’t respond to naloxone — for example because the sedative xylazine is involved — keep giving rescue breaths until EMS arrive (SAMHSA).
  4. Recovery position. When breathing returns, or if you must step away, roll the person onto their side with the top leg bent, and watch their breathing closely (SAMHSA).
  5. Stay. Stay until emergency help arrives (CDC). If the person refuses further care, stay with them for at least 4 hours after the last naloxone, or leave them with someone who has naloxone (SAMHSA, CDC).

Don’t slap the person, put them in a cold bath or shower, inject them with anything (such as saltwater, milk or stimulants), or try to make them vomit — these can cause more harm (SAMHSA). Never give an unconscious person food or drink (MedlinePlus).

Stimulant overdose

Call 911. While you wait: give naloxone and start rescue breathing if opioids could be involved; stay with the person; move them somewhere calm with less noise and touching; and help them cool down with water, a sports drink or a cool, wet washcloth. Fresh air or a less crowded spot may help, but stay nearby until help arrives (CDC).

Alcohol poisoning

Call 911 and don’t leave the person alone. Keep them sitting or partly upright on the ground rather than in a chair; if they are vomiting, have them lean forward; if they are unconscious or lying down, roll them onto one side. Tell responders what and how much they drank, any other drugs, and any health conditions or medicines you know about (NIAAA).

California’s Good Samaritan protections

  • Calling for help: under Health and Safety Code section 11376.5, it is not a crime to be under the influence of, or possess for personal use, drugs or paraphernalia if you seek medical help in good faith for someone experiencing a drug-related overdose and don’t obstruct medical or law enforcement personnel. The person who overdosed is protected in the same way when they, or anyone at the scene, seek help in good faith. A “drug-related overdose” includes drugs combined with alcohol (Cal. Health & Safety Code § 11376.5).
  • The limits: the law gives no other protections. It does not cover selling, giving or exchanging drugs, giving drugs to someone by force, or offenses such as driving under the influence (§ 11376.5).
  • Giving naloxone: anyone who gives an opioid antagonist such as naloxone in good faith, and not for pay, to someone who is or seems to be overdosing is not liable for civil damages, except for gross negligence or willful misconduct (Cal. Civil Code § 1714.22). California’s Good Samaritan law protects people giving emergency care, including naloxone (CDPH).

Most states have similar laws (CDC). This is general information, not legal advice.

Another approach

Treatment and recovery

Opioid use disorder is a chronic, treatable medical condition from which people recover (NIDA). There is more than one path to recovery.

The three medicines for opioid use disorder

  • Methadone has been used for more than 50 years. It acts on the same receptors as other opioids but more slowly and for longer, easing withdrawal and cravings without an intense high. For opioid use disorder it is available only from approved opioid treatment programs, which people usually visit daily or almost daily at first (NIDA).
  • Buprenorphine also eases cravings and withdrawal and can block other opioids. It comes as tablets or film under the tongue or in the cheek (some combined with naloxone), extended-release injections and implants. Many doctors, nurse practitioners and physician assistants can prescribe it — no special clinic needed — including by telehealth (NIDA).
  • Naltrexone blocks opioid receptors so opioids no longer produce pleasure, and may reduce cravings. It is a monthly long-acting injection that any health care provider can prescribe, and it is not addictive. People usually need to stop opioids for 7 to 10 days before starting it (NIDA). After an injection wears off, tolerance is lower, so overdose risk rises if someone returns to use (SAMHSA).

Methadone and buprenorphine can be equally effective at reducing opioid use; methadone may keep some people in treatment longer. Taken as prescribed, they don’t cause the high of other opioids. They do cause physical dependence, so they should be tapered slowly rather than stopped suddenly. Methadone or buprenorphine is recommended during pregnancy, and both are safe during breastfeeding (NIDA). Stigma, distance from clinics and pharmacies that don’t stock buprenorphine can get in the way — telehealth can help (NIDA).

Finding treatment

Recovery is possible

Today we know addiction is a chronic, treatable medical condition, and that people can recover and go on to lead healthy lives (NIDA). Medicine, counseling, peer support, mental health care and the steady support of family and friends can all be part of that path. If you or someone you love is struggling, reaching out today is a strong first step.

Another approach

Safe storage and disposal of medicines

Storing medicines safely

  • Put every medicine, vitamin and supplement (including gummies) away after every use, in a place children can’t reach or see; don’t leave them on counters or bedside tables (CDC).
  • Relock caps each time — children may be able to open safety caps (CDC).
  • Ask visitors to keep purses and bags with medicine up and away (CDC).
  • Keep an up-to-date medicine list, use one pharmacy, and read labels in good light (NIA).
  • Keep naloxone where adults can find it fast, and make sure everyone in the home knows where it is (CDPH).

Getting rid of unused medicines

  1. Best: a drug take-back location (often a pharmacy or police station) or a prepaid drug mail-back envelope (FDA), or a DEA National Take Back Day site (DEA).
  2. If take-back isn’t available and the medicine is on the FDA flush list — which includes medicines containing fentanyl, buprenorphine, methadone, oxycodone, hydrocodone or morphine — flush it right away. These medicines are sought after for misuse and can cause death from one dose if taken by the wrong person (FDA).
  3. Otherwise: mix the medicine (don’t crush tablets or capsules) with something unappealing such as dirt, cat litter or used coffee grounds, seal it in a plastic bag, put it in the household trash, and scratch out personal information on empty bottles (FDA).

Some products, such as sprays, have their own disposal instructions — check the label or ask your pharmacist (FDA). Unused naloxone can go to a pharmacy or take-back program; a used nasal spray can go back in its box and into the trash (CDPH).

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This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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