Someone may be overdosing. Here's what to do.

Signs

• Pinpoint pupils
• Will not wake up or respond to a loud voice or a firm rub on the breastbone
• Slow, shallow, or stopped breathing; gurgling or snoring
• Blue or gray lips and fingertips
• Limp body

What to do now

1. Call 911.
2. Give naloxone: one spray in one nostril. If no response in 2 to 3 minutes, give another dose in the other nostril.
3. Give rescue breaths if trained, or place the person in the recovery position.
4. Stay until help arrives. Naloxone can wear off before the opioid does.

Signs

• Extreme drowsiness or cannot be woken
• Confusion, slurred speech, poor coordination
• Slow or irregular breathing
• Vomiting while drowsy

What to do now

1. Call 911 if the person cannot be woken or is breathing slowly.
2. Give naloxone if opioids or street pills could be involved. It is harmless otherwise.
3. Place them in the recovery position so they cannot choke on vomit.
4. Do not let them sleep it off alone.

Signs

• Chest pain or a racing, irregular heartbeat
• Very hot skin or not sweating in heat
• Severe agitation, paranoia, or confusion
• Seizure, collapse, or signs of stroke

What to do now

1. Call 911.
2. Move them somewhere cool and calm; cool the skin with water. Do not restrain them.
3. If they become unresponsive, give naloxone, since stimulants are often contaminated with fentanyl.
4. If they have a seizure, clear the area and time it; do not put anything in their mouth.

Signs

• Extreme panic or terror
• Dangerous behavior or no awareness of danger
• Very high temperature, seizure, or chest pain
• Unresponsive or breathing poorly

What to do now

1. Call 911 for any physical danger sign or if they could harm themselves or others.
2. Move them to a quiet, safe place and speak calmly. Do not leave them alone.
3. Place an unresponsive person in the recovery position.
4. Give naloxone if they are unresponsive and opioids could be involved.

Signs

• Cannot be woken
• Slow, noisy, or stopped breathing
• Chest pain, seizure, or very high temperature
• Blue or gray lips

What to do now

1. Call 911 and tell them what you see.
2. If they are unresponsive or breathing poorly, give naloxone. It is safe even if no opioid was taken.
3. Place them in the recovery position.
4. Stay with them and keep any packaging or pills for the paramedics.