Drug Abuse

What happens when you overdose on drugs?

There is nothing more frightening than finding your loved one in the grip of a life-threatening drug overdose. It’s something you dread and desperately hope never happens, but you need to be prepared for the eventuality. It hangs over your head and your loved one living with a drug addiction.

Worldwide, overdose deaths are rising at an alarming rate. Opioids account for the highest number of drug-related overdose deaths, where over 70 percent involve synthetic opioids such as fentanyl and methadone. Over 50 000 deaths from opioid-related overdoses were recorded in 2019 in the United States alone.

It is essential to understand what happens when someone overdoses on drugs, what danger signs to look for, and what you should do to save their life.


How do you overdose on drugs?

A drug overdose occurs when too much of one or more toxic substances floods your central nervous system, and your brain becomes overwhelmed. It cannot send vital signals to the rest of your body, and organs start to shut down. Symptoms of an overdose depend on the type of drug in your system, but the most fatal is respiratory failure.

Most drug overdoses are accidental. They usually happen when you underestimate how much of the drug your body can tolerate or take a combination of substances that devastates your central nervous system. Drug overdoses cause long-term health problems and can be fatal.

What happens when you overdose on drugs?

A drug overdose is an extremely frightening event. What happens to your body depends on what you are on, but respiratory failure is the most common cause of death. Multiple organs are affected when your body and brain are overwhelmed by drugs. Your central nervous system goes into distress, and you experience difficulties with your heart rate, blood pressure and breathing.

Here is the sequence of events of an untreated drug overdose:

  • your heart rate increases
  • your body temperature increases
  • you start to sweat, tremble and shake
  • you become disorientated and confused
  • you feel nauseous, vomit or lose control of your bowels
  • you begin to hallucinate
  • you become agitated, restless or paranoid
  • your lips and fingers turn blue
  • you struggle to breath
  • you have a seizure, collapse or lose consciousness
  • you slip into a coma
  • your heart stops

Stimulant drugs are known by the following street names; crack cocaine, ICE, meth, crystal meth, speed, rock and uppers.

What happens when you overdose on opioids?

Opioids affect blood flow in your central nervous system, meaning insufficient oxygen reaches your brain and tissues to meet your needs. Your brain becomes hypoxic if it doesn’t receive enough oxygen. The short-term symptoms are shortness of breath, headaches and dry mouth.

Opioid overdose causes you to go into respiratory distress; your breathing becomes shallow, you become confused and disorientated, unresponsive and lose consciousness.

If your brain does not receive an adequate supply of oxygen, it becomes anoxic. Brain cells die after four minutes of oxygen deprivation. If you survive an opioid drug overdose, you could suffer from hypoxic brain damage. The symptoms are memory loss, impaired vision and hearing, poor coordination, balance and movement, and difficulties speaking, reading and writing.

Opioids are used for chronic pain relief. Prescription opioids include codeine, hydrocodone (Vicodin), oxycodone (OxyContin) and morphine. The class of drugs also includes illegal street drugs such as heroin and fentanyl.

What happens when you overdose on stimulant drugs?

Stimulant drugs include cocaine, amphetamines and methamphetamines. These drugs increase your blood pressure and body temperature and speed up your heart and breathing rate. A stimulant overdose causes your body to overheat or develop hyperthermia, resulting in seizures, a stroke or heart attack.

Signs you have flooded your brain with too much of the stimulant drug include rapid or heavy breathing, tremors, shaking, sweating, high fever, muscle pains or cramps, agitation, hallucination and panic. Severe symptoms can be fatal. If you survive a stimulant overdose, you may develop long-term chronic medical complications.

Stimulant drugs are known by the following street names; crack cocaine, ICE, meth, crystal meth, speed, rock and uppers.

What happens when you overdose on depressant drugs?

Depressant drugs slow brain activity and are used to treat various mental conditions, including anxiety disorder, panic disorder, acute stress disorder, insomnia and seizures. When you have high depressant toxicity, you become dizzy, drowsy, confused and anxious. Your vision becomes blurred, speech is slurred, and you experience breathing difficulties and muscle weakness.

Severe symptoms of an overdose include tremors, slowed reflexes, blue lips and fingernails, erratic behaviour, paranoia, hallucinations, coma and possibly death. Respiratory distress is life-threatening and can cause permanent brain damage. A fatal outcome is respiratory failure and death.

Depressant drugs come in many forms and are more commonly known as tranquillisers, antipsychotics or benzos (benzodiazepines). They are used to treat symptoms of mental illnesses. Barbiturates (sleeping pills and sedatives) fall into this substance group.

How can you tell if someone has passed out or overdosed?

It’s not easy to tell if someone has passed out from being too high or overdosed and slipped into a coma. All too often, people using drugs are left to “sleep it off” when in fact, they are moments away from a fatal outcome.

If you are worried, call an ambulance immediately because every second counts to save their life. Without immediate medical help, someone who has overdosed can suffer a massive seizure, suffer permanent brain damage, choke on their vomit, slip into a coma and die.

You lose consciousness when you pass out, but there are no obvious signs of respiratory distress or failure. Someone who has overdosed will show the following danger signs:

  • irregular breathing; slow, shallow, deep or rapid
  • blue or blackish-purple lips and fingertips
  • gasping, gurgling, choking sounds
  • drooling, vomiting, foaming around the mouth
  • vomiting blood or blood in urine or stools
  • loss of bladder control, urinate or defecate
  • pale, clammy, hot or dry skin
  • very limp body, lifeless
  • feeble, erratic pulse
  • chest pain
  • seizures, convulsions
  • hallucinations
  • agitated, confused, disorientated

body temperature changes, too hot or cold

What should you do if someone overdoses on drugs?

First of all, stay calm. It won’t help if you panic and delay getting the urgent help the person needs.

Call for an ambulance if the person has collapsed, lost consciousness or stopped breathing. Get them to a hospital as fast as you can if an ambulance is not immediately available. The primary cause of overdose deaths is respiratory failure. The sooner the person is treated, the less likely they will suffer brain damage from oxygen deprivation.

Keep talking to keep them awake. If the person is not responding, don’t slap or punch them out of panic.

Place them in the recovery position to open up their airways and stop them from choking on vomit.

Apply chest compressions (CPR) if they are not breathing.

Give the person nasal spray or injectable naloxone (Narcan) if it is available.

Collect any evidence of pills or illegal street drugs the person has been using and any other information to assist the medical team when they receive the patient.

How is a drug overdose treated?

Emergency treatment
Naloxone (Narcan) is a life-saving treatment for opioid overdose. It comes in the form of a nasal spray or injection. Narcan works by blocking the effects of opioids, pushing the drug out of the opiate receptors in the brain. Naloxone works in minutes, but the effect wears off within 30 to 90 minutes. If the first one hasn’t revived you or medical help has not arrived, you will need another dose.

Hospital treatment
Stomach pump/suction:
You will have your stomach pumped to remove the dangerous substances in your digestive system. The medical term is gastric lavage and is a routine process when someone has overdosed on drugs. A tube is put into your mouth or nose and threaded through your oesophagus into your stomach. All the content is suctioned out until your gastrointestinal tract is thoroughly clean, the medical team uses the tube-and-suction technique because stomach content is very corrosive, and your oesophagus can be badly damaged if you vomit.

Having your stomach pumped after a drug overdose does not hurt, but it is very uncomfortable. It is a risky procedure; if stomach fluid leaks into your lungs or airways, it causes aspiration pneumonia.

Activated charcoal:
Activated charcoal is used to absorb excess toxins in your bloodstream. It comes in a powder form and is mixed into a liquid. You drink it if you can, or it’s passed through a tube directly into your stomach. Activated charcoal binds to the drugs or poison in your stomach and helps your body eliminate the toxic substances.

Post overdose treatment
If you survive a drug overdose, it’s essential you receive counselling after the event. It’s usually a wake-up call that you have a life-threatening addiction, and you will benefit from participating in an integrated addiction treatment programme at an inpatient or outpatient rehab facility.

You’ll be in the care of an addiction specialist team who a medical detox, monitor medication prescribed for anxiety or depression, and facilitate various forms of psychotherapy (talk therapy). A psychiatric evaluation is essential if you intentionally overdosed on prescription or street drugs.

What causes a drug overdose?

Most drug overdoses are accidental; some are intentional where a person attempts suicide. Accidental overdose is a life-threatening consequence of drug addiction, defined as a “chronic, relapsing mental disorder characterised by compulsive drug seeking, despite long-lasting brain changes and negative consequences”.
Various scenarios lead to drug overdoses:

Drug tolerance is unpredictable and overestimated
How much it takes to overdose is unpredictable. What your friend can tolerate can put you into a hospital or a grave. You can overdose the first time you use a street drug, even if you use a small amount.
People overestimate their tolerance for drugs when they relapse. When you stop using drugs, your brain gets used to not dealing with the harmful substance and your tolerance level decreases. If you relapse and take the same amount of the drug you used when you had an active addiction, you will likely overdose.
How you use prescription and street drugs makes a big difference; smoking, snorting, drinking or injecting your drug of choice can be the difference between life and death. Injecting drugs is the more risky ways of getting drugs into your body, not only because you’re in danger of developing chronic health complications, but you can inject too much too quickly and fatally overdose.

People use prescription drugs, street drugs and alcohol at the same time
Combining prescription drugs or narcotics with alcohol can be fatal. If you take a stimulant drug (Adderall, cocaine, khat) with a depressant substance (marijuana, alcohol, Valium, Xanax), the two compete against each other and cause serious health complications.

Street drugs are cut and laced with harmful additives
Street drugs are often cut with fillers that can cause long-term health problems. Drug dealers use anything from sucrose and starch to flour, chalk and talcum powder to bulk up the drugs. These harmful additives build up in your blood vessels, increasing your risk of bacterial infections, deadly diseases (HIV or hepatitis C), a stroke or heart attack.
Dealers cut street drugs with these fillers to increase profitability, but it decreases potency. You don’t know what is in the drugs you’re taking and that makes things unpredictable. Take heroin, for example; you get used to taking a certain amount of the drug in its less potent form. If you switch to or accidentally use pure heroin, you’re in trouble.
Dealers also lace drugs with mood-altering substances that are extremely dangerous and can be fatal. For instance, heroin and cocaine is often laced with fentanyl. It’s a synthetic opioid and one of the most harmful cutting agents because it is up to one hundred times more potent than morphine.

Did you know?
Street drugs like heroin and cocaine are often laced with tranquilisers, arsenic, cocaine, morphine, Molly, fentanyl or Angel Dust.

We’re here to help
Contact us today if you’d like a confidential and free chat with one of our highly-trained addiction professionals at Recovery Centre at White River in South Africa.

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