Drug Overdose: How to Recognize, Respond, and Prevent It

What is a drug overdose?

A drug overdose happens when a person takes more of a substance than the body can safely process, overwhelming vital systems such as breathing and heart function. Overdoses can be accidental, which is by far the most common, or intentional. They can involve a single substance or, increasingly in New Jersey, a dangerous combination of drugs.

The opioid crisis has driven overdose deaths to historic highs. Illicit fentanyl, a synthetic opioid up to 50 times stronger than heroin, now contaminates a large share of the street drug supply, including counterfeit pills and even cocaine. Many people who overdose never knew fentanyl was present. This is why overdose awareness matters for everyone, not only those with a known opioid disorder.

How to recognize an opioid overdose

Opioid overdoses follow a recognizable pattern. The hallmark is slowed or stopped breathing, because opioids suppress the brainstem signal that tells the body to breathe. If you see these signs, treat it as a life-threatening emergency and act immediately.

• Breathing that is slow, shallow, or has stopped entirely
• Pinpoint pupils that appear unusually small
• Blue or grayish lips, fingertips, or skin
• Unresponsiveness and inability to be woken, even with a sternal rub
• Gurgling, choking, or a snore-like 'death rattle' sound
• Limp body and clammy, cold skin

What to do during an overdose

Quick action is the single biggest factor in surviving an overdose. New Jersey's Overdose Prevention Act provides legal protection for the person who calls for help and for the person overdosing, so fear of arrest should never stop you from dialing 911.

• Call 911 immediately and stay on the line
• Administer naloxone (Narcan) if available and repeat after two to three minutes if there is no response
• Lay the person on their side in the recovery position to prevent choking
• Begin rescue breathing or CPR if you are trained and breathing has stopped
• Stay with the person until emergency responders arrive, because naloxone can wear off before the opioid does

Naloxone access in New Jersey

Naloxone reverses an opioid overdose by knocking opioids off the brain's receptors and restoring breathing. It is safe, has no potential for misuse, and will not harm someone who is not actually overdosing on opioids. Under New Jersey's standing order, naloxone is available at pharmacies statewide without an individual prescription, and many community programs distribute it free of charge.

Every household touched by addiction in Monmouth County should keep naloxone on hand the same way they keep a fire extinguisher. It is the most effective overdose-reversal tool available, and it buys the minutes that emergency responders need to arrive.

Preventing the next overdose through treatment

Surviving an overdose is the beginning of a window, not the end of a crisis. The risk of a second overdose is highest in the days and weeks after the first, and the period right after detox is especially dangerous because tolerance has dropped while cravings remain. The most reliable way to prevent the next overdose is to enter treatment.

At The Archangel Centers, we coordinate medical detox with licensed partners and then move clients into structured programming where the underlying disorder is treated, not just the immediate emergency. Medication-assisted treatment, therapy, and overdose-prevention education together dramatically lower the chance of another life-threatening event.