Can You Overdose on Opiates?
Opiates are drugs such as morphine or codeine that may be prescribed to treat pain or to suppress coughing. At high doses, opiates slow breathing, which can lead to overdose and death.1, 3
Recovery from addiction or overdose can happen with the help of a quality opiate rehab or treatment center.
Learn more about overdosing on opiates, including:
- Signs and symptoms.
- Risk factors for overdose.
- Overdose treatment.
- Recovery options for overdose and addiction.
Signs and Symptoms
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An opiate overdose has 3 main signs, which are sometimes referred to as the “opioid overdose triad.” The symptoms to watch for are:
- Pinpoint pupils.
- Slowed breathing.3
Some other symptoms of an opiate overdose include:
- Pale or clammy skin.
- Limpness in the limbs.
- Blue or purple lips or nails.
- Being unable to speak.
- Having a slow or absent pulse.4, 7
Call 911 if you observe these symptoms in another person or believe you may be overdosing.
If you are able to tell the 911 operator the person’s age, weight, condition, and what he or she took as well as the time it was taken, you can help the operators provide the best assistance possible. Do not delay in seeking assistance if you are not able to get this information.7 Quick treatment can prevent death from an overdose.3
If the person is not breathing or his or her breathing is weak, begin CPR while you wait for emergency medical services to arrive.4
Risk Factors for Overdose
People who are dependent on opiates have the highest risk of overdosing.3
Other risk factors include:
- Using opiates and alcohol together.3
- Using opiates or heroin that has been combined with fentanyl.2
- Using benzodiazepines, which includes drugs such as Xanax, Ativan, and Valium.1 These drugs slow breathing and can contribute to an overdose.
- Combining opiates with cocaine (commonly called a speedball).2
- IV opiate use.3
- Relapsing following detox, incarceration, or a period of abstinence.3 People tend to return to their previous dose, and since they do not have the tolerance they once possessed, that dose may be lethal.
- Having other medical conditions, such as HIV/AIDS and liver or lung diseases.3
- Being a younger age. Children are vulnerable to accidental overdoses if they take medications that are not for them.4
The drugs most commonly involved in opioid overdoses include methadone, oxycodone (such as OxyContin), and hydrocodone (such as Vicodin).9 Many prescription opioids are combined with acetaminophen (Tylenol), and high doses of acetaminophen can also be harmful.7
Opiate Overdose Treatment
Opiate overdoses are treated with an injection of naloxone, an antidote.
Opiate overdoses are generally treated with an injection of naloxone (Narcan), which is an antidote to reverse an opioid overdose.3 Many states now allow people who are using opioids or their loved ones to get prescriptions to carry naloxone so that it can be administered immediately after an overdose occurs.2
In an emergency room, a person who has overdosed on opiates may be treated with:
- Activated charcoal.
- Testing to monitor breathing and heart functioning.
- Airway/breathing support.7
If the person overdosed on a medication that was combined with acetaminophen or aspirin, they may require additional medical intervention to prevent or minimize potential complications such as liver damage and serum acid/base imbalances.7
Can You Die From an Opiate Overdose?
Who Answers? to learn more about programs that can help you or your loved one recover from an opiate overdose or addiction.
In 2014, more than 28,000 deaths were related to opioids, which was more than any prior year.2 Overdoses from prescription opioids are one factor driving the increase in overdose deaths.2
One possible danger of an overdose is a hypoxic brain injury, or injury to the brain from being deprived of oxygen.5 Some people may also enter a coma after an opioid overdose and require hospital admission.8 Breathing problems, including aspiration pneumonia or acute lung injury, can lead to a more complicated recovery from an overdose.8
If the person who overdosed is treated quickly, there may not be any long-term effects, and they may be back to normal in a day or so.7
Recovering From an Overdose
Many people survive and recover from opioid overdoses. But an overdose is usually a sign that a person has an opiate addiction or dependence. If you think you have a problem, it is critical to seek treatment.
An opiate rehab program may take 1 to 6 months to complete, depending on the length and severity of the drug abuse. Counseling and behavioral treatments are usually part of the recovery process and include cognitive behavioral therapy (CBT), motivational interviewing (MI), and family-based approaches.
Often, people with opioid use disorders begin their treatment in detox, where they will be medically supervised throughout withdrawal. Opioid withdrawal can be painful and make a person quite ill. Medical supervision can help manage these symptoms and, by making the withdrawal process more comfortable, can help decrease the risk of immediate relapse and facilitate the transition from detox into longer-term substance abuse therapy.
- Inpatient recovery: Inpatient opiate rehab, or residential treatment, may last from a few weeks to a few months. The person gets help through the remaining withdrawal symptoms and learns important skills to aid them in building their recovery. Services usually include individual and group therapy, 12-step meetings, addiction education, and other therapeutic activities such as meditation and yoga.
- Intensive outpatient. The time commitment for intensive outpatient or IOP averages 3 days per week for about 3 hours per day. It can include group, family, or individual therapy and allows participants to live at home.
- 12-step programs: Twelve-step programs can be a source of ongoing support and a pathway to long-term recovery for many. These programs, which include Narcotics Anonymous, use the step-by-step approach originally developed by Alcoholics Anonymous.
- Partial hospitalization. Partial hospitalization or day treatment programs are outpatient rehab programs[/link] that typically meet 3-5 days per week for about 5 hours per day. They include group therapy sessions, skills groups, and often meetings with a psychiatrist or other medical professional.
Other Considerations for Treatment
- Mental health diagnosis: Many people who have substance use disorders have co-occurring mental health disorders, so it is crucial to have any mental health conditions treated simultaneously with your opiate abuse to prevent relapse.
- Medications: Many people benefit from medication-assisted treatment, which involves the use of medications such as methadone, buprenorphine, or naltrexone. These medications reduce cravings and withdrawal symptoms and can be used to help a person detox or remain abstinent from opiates.
- Accreditation: Find a recovery center that has a current, active license from state and local government. Check your local government’s website to determine if it provides a list of state-licensed mental health and addiction services and facilities. You can also check the websites of several accreditation bodies, such as the Commission on Accreditation of Rehabilitation Facilities (CARF), Council on Standards (COA), and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
Find a Recovery Center
Recovering from an opioid addiction is possible. You can look to the many celebrities who have recovered for inspiration, such as Robert Downey Jr., Nikki Sixx, and Eric Clapton.
. National Alliance of Advocates for Buprenorphine Treatment. (n.d.). Opiates/opioids.
. Centers for Disease Control. (2016). Injury prevention & control: Opioid overdose.
. World Health Organization. (2014). Information sheet on opioid overdose.
. Substance Abuse and Mental Health Services Administration. (2016). Opioid Overdose.
. Veilleux, J. C., Colvin, P. J., Anderson, J., York, C., & Heinz, A. J. (2010). A review of opioid dependence treatment: pharmacological and psychosocial interventions to treat opioid addiction. Clinical psychology review, 30(2), 155-166.
. Lankenau, S. E., Teti, M., Silva, K., Bloom, J. J., Harocopos, A., & Treese, M. (2012). Initiation into Prescription Opioid Misuse among Young Injection Drug Users. The International Journal on Drug Policy, 23(1), 37-44.
. Heller, J. L. (2015). Hydrocodone/oxycodone overdose: MedlinePlus Medical Encyclopedia.
. Grigorakos, L., Sakagianni, K., Tsigou, E., Apostolakos, G., Nikolopoulos, G., & Veldekis, D. (2009). Outcome of acute heroin overdose requiring intensive care unit admission. Journal of opioid management, 6(3), 227-231.
. Centers for Disease Control. (2016). Prescription Opioid Overdose Data. Retrieved August 23, 2016.