How to Respond to a Suspected Overdose While Waiting for Help

When someone overdoses, every second counts. You might be the only person between them and death. Whether it’s a friend, a stranger, or someone you barely know, your actions in the next few minutes can make the difference between life and death. You don’t need to be a doctor. You don’t need special equipment. You just need to know what to do - and do it fast.

Step 1: Check Responsiveness and Breathing

The first thing to do is check if the person is responsive. Don’t shake them or shout in their face. That delays help. Instead, tap their shoulder firmly and say, “Are you okay?” loudly. If they don’t respond, check their breathing immediately.

Look for chest movement. Listen for breath sounds. Feel for air on your cheek. Normal breathing is steady and quiet. If they’re gasping, snoring, or making irregular, shallow breaths - that’s not normal. That’s respiratory failure. In opioid overdoses, breathing slows down or stops entirely. In stimulant overdoses, they might be breathing too fast or too shallow. Either way, it’s dangerous.

You have 10 seconds to decide. If they’re not breathing normally, move to the next step right away.

Step 2: Call for Emergency Help

Call 999 or your local emergency number. Don’t wait. Don’t think, “Maybe they’ll wake up.” Don’t worry about getting someone in trouble. Emergency services are trained to handle this. In Ireland, the Gardaí and ambulance crews respond to overdose calls every day. They won’t arrest someone for possession if they’re having an overdose - their priority is saving a life.

If you’re with someone else, send them to call while you start helping. If you’re alone, call on speakerphone so you can keep helping while you talk. Tell the operator: “Someone has overdosed. They’re not breathing normally.” Give your location clearly. Stay on the line. They’ll guide you through what to do next.

Step 3: Give Rescue Breathing

If the person isn’t breathing or is breathing very poorly, start rescue breathing. This keeps oxygen flowing to their brain until help arrives. Brain damage can start after just four minutes without oxygen.

Place them on their back. Tilt their head back gently by lifting their chin. This opens the airway. Pinch their nose shut. Seal your mouth over theirs. Give one slow breath - about one second long - until you see their chest rise. Don’t blow hard. Don’t overinflate. If their stomach swells, you’re blowing too much air. That can cause vomiting and choking.

Give one breath every 5 to 6 seconds. That’s about 10 to 12 breaths per minute. Keep going. Even if you’re tired. Even if you’re scared. Don’t stop unless they start breathing on their own or help arrives.

Step 4: Put Them in the Recovery Position

If they’re breathing but unconscious, don’t leave them on their back. That’s dangerous. Their tongue can block their airway. They could vomit and choke.

Roll them onto their left side. This is called the recovery position. Here’s how:

• Kneel beside them.
• Extend their arm closest to you straight out.
• Place their other arm across their chest, hand near their shoulder.
• Bend their far leg at the knee, foot flat on the ground.
• Hold their shoulder and hip, and roll them gently toward you.
• Once on their side, tilt their head back slightly to keep the airway open.
• Adjust their bent leg so it’s at a 90-degree angle - it helps keep them stable.

Check their breathing every few minutes. If they stop breathing, go back to rescue breathing.

Step 5: Administer Naloxone If You Have It

Naloxone reverses opioid overdoses. It doesn’t work on alcohol, cocaine, benzodiazepines, or other non-opioid drugs. But if you suspect opioids - and you should, because 75% of overdose deaths in the U.S. involve them - give naloxone.

In Ireland, naloxone nasal spray is now available without a prescription at pharmacies. It’s easy to use. Remove the cap. Insert the nozzle into one nostril. Press the plunger firmly for 2-3 seconds. You’ll hear a click. That’s it.

Wait 2-3 minutes. If they don’t wake up or start breathing normally, give a second dose in the other nostril. Keep giving rescue breathing while you wait. Naloxone wears off in 30 to 90 minutes. The drug they took might still be in their system. They could stop breathing again. That’s why you need to keep monitoring them until EMS arrives.

What Not to Do

There are a lot of myths out there. Don’t fall for them.

• Don’t put them in a cold shower or ice bath. This can cause dangerous heart rhythms, especially with stimulants like cocaine or MDMA.
• Don’t try to make them walk. They might fall, hurt themselves, or stop breathing.
• Don’t inject anything. Salt water, milk, caffeine - none of it helps. It can make things worse.
• Don’t assume they’re just sleeping. One in four overdose deaths happen because someone thought the person was just passed out.

Recognizing Different Types of Overdose

Not all overdoses look the same.

• Opioids (heroin, fentanyl, oxycodone): Slow or stopped breathing, blue lips or fingernails, pinpoint pupils (though fentanyl can cause normal-sized pupils), limp body, unresponsive.
• Stimulants (cocaine, meth, MDMA): Fast heartbeat, high body temperature (over 40°C), confusion, seizures, agitation, sweating. Their skin may feel hot and dry. Cooling them down gently with wet cloths helps - but don’t use ice.
• Alcohol: Slow breathing, cold and clammy skin, vomiting, unconsciousness. They’re at high risk of choking on vomit. Keep them on their side.

If you’re unsure, treat it like an opioid overdose. Give naloxone if you have it. Start rescue breathing. Call for help. It’s safer to give naloxone when it’s not needed than to wait when it is.

Why This Works

Studies show that bystanders who act quickly can cut overdose deaths in half. In communities where people are trained in these steps, over 98% of people who receive help survive to get to the hospital. That’s not luck. That’s knowing what to do.

The most common mistake? Not calling for help fast enough. People think, “I’ve got naloxone, I’ve got this.” But naloxone isn’t a cure. It’s a bridge. Emergency crews bring advanced care - oxygen, IV fluids, monitoring, hospital treatment. Without them, the person can crash again.

What to Do After Help Arrives

When paramedics show up, tell them everything: what you think they took, when you found them, what you did, how much naloxone you gave. Don’t guess. Be clear. That helps them treat the person better.

Don’t leave. Stay with them until they’re in the ambulance. You know their story. You know what happened. That information matters.

Be Prepared

If you live in an area where drug use is common - or if you know someone who uses drugs - keep naloxone on hand. It’s free or low-cost at many pharmacies and community health centers in Ireland. Practice using a training kit. Watch a 5-minute video on the recovery position. Learn the signs.

You don’t need to be brave. You just need to be ready.