How to Respond to a Suspected Overdose While Waiting for Help

When someone overdoses, every second counts. You might be the only person who can save their life before emergency services arrive. This isn’t theoretical - it’s real. In 2021, over 107,000 people in the U.S. died from drug overdoses. Most of those deaths happened because no one knew what to do. But here’s the truth: overdose response isn’t about being a medical expert. It’s about knowing three simple things: call for help, keep them breathing, and stay with them.

Step 1: Call for Help Immediately

Before you do anything else - before checking their breathing, before reaching for naloxone - call emergency services. In the UK, dial 999. In the U.S., dial 911. Don’t wait. Don’t think they’ll wake up on their own. Don’t assume someone else will call. If you’re alone, put the phone on speaker and keep talking while you act. Paramedics can guide you. They’ve heard it all. They’d rather you call too early than too late.

Studies show that calling for help reduces death risk by 35%. Even if you’re scared, even if you think they’re just passed out, call anyway. Many overdose deaths happen because bystanders delay calling - they’re afraid of police, or they think the person will be fine. That’s a deadly myth. The brain starts dying after four minutes without oxygen. You don’t have time to hesitate.

Step 2: Check Breathing and Airway

Now, check if they’re breathing. Look for chest movement. Listen for breaths. Feel for air on your cheek. Don’t rely on whether they’re moving or making noise. Gasping, snoring, or irregular breathing? That’s not normal. That’s a sign they’re not getting enough oxygen. This is called agonal breathing - it’s the body’s last gasp before stopping completely.

If they’re breathing normally, roll them into the recovery position. This keeps their airway open and prevents choking. To do it: gently roll them onto their left side. Bend their top leg at the knee so it’s at a 90-degree angle. This stops them from rolling back. Tilt their head back slightly so the chin lifts. This opens the airway. Place their bottom arm under their head. Now, check again. Are they still breathing? Good. Stay with them. Watch their chest. If breathing slows or stops, you’ll need to act fast.

Step 3: Start Rescue Breathing If They’re Not Breathing

If they’re not breathing - or only gasping - start rescue breathing right away. You don’t need a mask. You don’t need special equipment. Just use your mouth. Pinch their nose shut. Tilt their head back. Lift their chin. Take a normal breath, seal your lips over theirs, and blow for about one second. Watch for their chest to rise. If it doesn’t, reposition their head and try again. Give one breath every 5 to 6 seconds. That’s about 10 to 12 breaths per minute. Don’t overinflate. You’re not trying to blow up a balloon. Too much air pushes into the stomach and causes vomiting. That’s dangerous.

Rescue breathing alone can keep someone alive for 10 to 15 minutes. You don’t need chest compressions unless they’ve stopped having a pulse. In opioid overdoses, breathing stops before the heart does. So focus on breaths, not pumps. Keep going. Even if you’re tired. Even if your arms ache. Your breath is their lifeline.

Step 4: Use Naloxone If Available - But Only for Opioids

If you have naloxone (Narcan), use it - but only if you suspect an opioid overdose. That includes heroin, fentanyl, oxycodone, or prescription painkillers. Naloxone doesn’t work on alcohol, cocaine, meth, or benzodiazepines. Giving it won’t hurt, but it won’t help either. So if you’re unsure, give it anyway. The risk of giving naloxone when it’s not needed is very low. The risk of not giving it when it’s needed? Death.

Most naloxone comes in a nasal spray. Spray half the dose into one nostril. If they’re still not breathing after 2 to 3 minutes, give the second half in the other nostril. Don’t wait. Don’t think it’s working because they moved. Naloxone can wear off in 30 to 90 minutes. The overdose might come back. That’s why calling 999 is still critical - even after you give naloxone.

Remember: naloxone is not a cure. It’s a pause button. It buys time. You still need medical help.

Step 5: Monitor and Stay With Them

Don’t leave them alone. Not for a second. Even if they wake up. Even if they seem fine. They might slip back into unconsciousness. Check their breathing every 2 to 3 minutes. Watch for changes in skin color - blue lips or fingertips mean low oxygen. Keep them warm. Don’t put them in a cold shower or ice bath. That’s a myth. Cold can trigger dangerous heart rhythms, especially with stimulants like cocaine or MDMA.

If they’re having a stimulant overdose - think cocaine, meth, or ecstasy - they might be overheating. Their body temperature could spike above 40°C (104°F). In that case, cool them down gently: remove heavy clothing, fan them, apply damp cloths to their neck, armpits, and groin. Don’t use ice. Don’t give them water unless they’re fully awake and alert. Too much fluid too fast can cause dangerous electrolyte imbalances.

For alcohol overdose, the biggest danger is choking. Keep them on their side. Never let them lie flat. If they vomit, turn them quickly to the side. Clear their mouth. Stay calm. Vomiting is common. It doesn’t mean they’re fine. It means their body is trying to protect itself.

What Not to Do

Don’t shake them. Don’t slap them. Don’t try to make them walk. Don’t put them in a bath. Don’t give them coffee or food. Don’t assume they’re just sleeping. Many overdose deaths happen because someone mistakes unconsciousness for deep sleep. In fact, 28% of overdose deaths occur this way.

Don’t wait to see if they recover on their own. You’re not a doctor. You’re a lifeline. Your job is to keep them alive until professionals arrive. And that means staying with them, no matter how long it takes.

Why This Works

Communities that train people in full overdose response protocols have reversed over 12,000 overdoses with a 98.7% survival rate. That’s not luck. That’s science. The key isn’t naloxone alone. It’s the full sequence: call, breathe, monitor, stay. When you combine all four steps, survival jumps from 50% to nearly 99%.

The most common mistake? People forget to call 999 because they think naloxone is enough. One Reddit user wrote: “I gave naloxone, but I didn’t call. I thought they’d wake up. They didn’t.” He later learned the person died. That’s why calling first - and staying until help arrives - is non-negotiable.

What to Expect When Help Arrives

Paramedics will check vital signs: breathing rate, pulse, oxygen levels. They’ll give oxygen, start IV fluids, and may give more naloxone. They’ll transport them to the hospital even if they seem okay. Overdose can cause delayed complications - heart rhythm problems, lung damage, brain swelling. You’ll be asked what they took. Be honest. It helps them treat faster. Don’t worry about legal consequences. In the UK and most U.S. states, Good Samaritan laws protect you if you call for help.