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Prescription Opioid Overdose

WHAT YOU NEED TO KNOW:

What do I need to know about an opioid overdose?

An overdose means you used too much of an opioid pain medicine, such as oxycodone or fentanyl. An opioid overdose is a life-threatening emergency that needs immediate medical care.

What can lead to an opioid overdose?

  • Misuse of a prescribed opioid may mean you use it to get high instead of to relieve pain. This can lead to tolerance and increasing doses. Misuse can also mean you use an opioid prescribed for someone else. Even a small amount may be too much for you.
  • Tolerance means your body gets used to the amount you use. You keep needing more to get the effects you want. You may be increasing the dose because of continued pain. If you start to use the opioid to get high, you need more over time to get the same feeling.
  • Loss of tolerance happens when you stop using the opioid after you used it for a long time. When you stop, your body loses tolerance to it. An overdose can happen if you use the drug again. This happens even if you take a dose that is the same as or smaller than before.
  • Accidental use of too much opioid can happen from any of the following:
    • You do not understand the directions. You take too much at one time, or take an extra dose.
    • Your prescribed amount is higher than your body can handle.
    • You continue to take the opioid when you no longer have pain. You thought you had to take all of the prescribed medicine.
  • Combining the opioid with alcohol, drugs, or certain medicines. Any of these can increase the opioid's effects, leading to an overdose.

What are the signs and symptoms of an opioid overdose?

  • Not waking, even when someone shakes you
  • Not breathing, breathing very slowly, or gurgling sounds as you try to breathe
  • Pale or clammy skin
  • Blue or gray fingernails or lips
  • Limp body

What is overmedication?

Overmedication means you used more of the opioid than your body can handle. It is not an overdose, but it can lead to an overdose if not stopped or treated. The following are signs and symptoms to watch for:

  • Extreme drowsiness, trouble staying awake, or trouble speaking
  • Trouble waking
  • Slurred speech or confusion
  • A slower heartbeat than usual
  • Breathing that is shallow or slower than usual
  • Small pupils that look like pinpoints

How is an opioid overdose diagnosed and treated?

Healthcare providers will check your pupils and breathing. The amount of oxygen and carbon dioxide in your blood will be measured. Other tests may check the amount of opioid in your blood, or the effect on your health. If you are awake and aware, providers will ask about your opioid use. Treatment may include any of the following:

  • Oxygen may be needed if you are not breathing, or if your breathing is slow.
  • Naloxone is a medicine used to reverse the effects of opioids.
  • Counseling and support may be recommended. You may need information on how to use an opioid safely. A counselor or therapist can help if your overdose happened because you are abusing opioids. He or she can help you stop safely.

What can I do to prevent or stop another overdose?

You may need to take a different kind of pain medicine after a surgery or injury. You can also talk to your healthcare provider about ways to manage pain without medicine. If you do need to take an opioid, the following can help prevent or stop an overdose:

  • Learn the signs of an overdose so you know how to respond. Tell others about these signs so they will know what to do if needed. Talk to your healthcare provider about naloxone. You may be able to keep naloxone at home in case of an overdose. Your family and friends can also be trained on how to give it to you if needed.
  • Talk to your provider about signs or symptoms of a problem. Tell your provider if you think you are developing opioid tolerance or dependence. Dependence means you feel you need it to function mentally or physically. You may have an urge to use it, or to increase the amount you take. Work with your provider to stop or lower the amount safely. Ask about counseling or medicines to treat or prevent an overdose.
  • Do not mix opioids with other medicines or alcohol. The combination can cause an overdose, or cause you to stop breathing. Alcohol, sleeping pills, and medicines such as antihistamines can make you sleepy. A combination with opioids can lead to a coma.
  • Do not take opioids that belong to someone else. The kind or amount that person takes may not be safe for you. You can overdose even if the other person takes that same amount of the opioid regularly.
  • Take prescribed opioids exactly as directed. Do not take more than the recommended amount. Do not take it more often or for longer than recommended. If you use a pain patch, be sure to remove the old patch before you place a new one. Do not expose your pain patch to direct sunlight on a hot day. This can increase the dose you receive. Talk to your doctor or a pharmacist if you have any questions about your medicine. Opioids often come with a Medication Guide to help you use it safely. Ask your pharmacists for a copy if you do not get one when you fill the prescription.

What do I need to know about opioid safety?

  • Talk to your healthcare provider if you want to stop taking an opioid. Your pain may go away before you finish the prescription. That is okay. Your provider will help you lower the dose slowly if you have been taking it longer than 2 weeks. A sudden stop may cause dangerous side effects.
  • Follow instructions for what to do with prescription opioids you do not use. Your healthcare provider will give you instructions for how to dispose of it safely. This helps make sure no one else takes it.
  • Keep opioids out of the reach of children. A child can easily overdose on even a small amount of any opioid. Store opioids in a locked cabinet or in a location that children cannot get to.

Call your local emergency number (911 in the US), or have someone else call if:

  • You have a seizure.
  • You cannot be woken.
  • You are not breathing, or your breathing is very slow.
  • You are making choking or gurgling sounds when you breathe.
  • Your body is limp.

When should I or someone close to me call my doctor?

  • Your breathing is slow or shallow.
  • Your heartbeat is slower than usual.
  • You have pale or clammy skin.
  • You have blue fingernails or lips.
  • Your speech is slurred, or you are confused.
  • You are dizzy or stumble when you walk.
  • You are extremely drowsy, or you have trouble staying awake or speaking.
  • You cannot stop vomiting.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© Copyright IBM Corporation 2018 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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