Overdose Prevention

Signs of Opioid Overdose

An opioid overdose rarely looks like the movies. It looks like someone sleeping too deeply, snoring strangely, or “really out of it” — which is exactly why people wait when they shouldn’t. This page is the recognition checklist. If what you’re seeing matches, don’t wait to be certain.

If someone may be overdosing

1

Call 911.

2

Give naloxone if available.

3

Follow the 911 operator’s instructions.

4

Place the person on their side if you can do so safely.

5

Stay until emergency help arrives.

If you are not sure, treat it like an overdose and call 911.

The three things to know

Overdose can look like sleep

Deep sleep, heavy intoxication, loud snoring — overdose hides inside all three. “Sleeping it off” is how overdoses become deaths. If you can’t wake them, it’s not sleep.

Breathing is the warning sign

Slow, shallow, irregular, or stopped breathing is the core of an opioid overdose. Everything else on this page points back to breathing.

Naloxone helps — 911 is still needed

Naloxone can reverse an opioid overdose, and it’s temporary. Emergency medical help is part of the response every time.

The Signs

Response

—Won’t wake up — unresponsive to shouting, shaking, or rubbing knuckles hard on their breastbone.
—Can’t speak, or limp body.
—Vomiting.

Breathing

—Breathing that is slow, shallow, or stopped.

—Choking, gurgling, rattling, or unusual snoring sounds.

Color and pupils

—Blue, purple, or gray tint to skin — check lips and fingernails first; on darker skin, gray or ashen tone and pale lips/nailbeds.

—Skin that is pale, cold, or clammy.

—Pinpoint pupils, if you can see them.

Bottom line: You do not need every sign. Unresponsive plus troubled breathing is enough. Act.

Do this, not that

  • Call 911 first or while giving naloxone.

  • Give naloxone if you have it — a second dose after 2–3 minutes if there’s no response.

  • Put them on their side (knees bent, top arm under the head) so they can’t choke.

  • Stay until help arrives — symptoms can return as naloxone wears off.

  • Don’t let them “sleep it off.” Blood levels can keep rising after they pass out.

  • Don’t put them in a shower, ice bath, or cold water.

  • Don’t try to make them vomit.

  • Don’t inject them with anything except for intramuscular naloxone if it’s available.

  • Don’t leave, even if they wake up.

The hesitations, answered

“What if I’m wrong?”

Naloxone does no harm to someone who hasn’t taken opioids, and 911 operators handle uncertain calls all day. Being wrong costs embarrassment. Waiting costs lives.

“They’d be angry I called.”

Anger is survivable. The alternative isn’t. Make the call.

“I’m afraid of getting in trouble.”

Fear of trouble should never delay a 911 call — a life is on the line, and minutes decide it. Make the call, every time.

The five-minute preparation

Get naloxone free, 24/7, at the Public Health Vending Machine (6103 39th Ave.) — and learn to use it before the night you need it. Free training takes minutes. If opioids are anywhere in your life or your household, being ready is the single most protective thing you can do.

Common Questions

Overdose recognition and response content aligns with current CDC and SAMHSA guidance. Reviewed by Hope Council staff. July 27th, 2026