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The opioid epidemic continues to pose a significant public health crisis, claiming thousands of lives each year. Recognizing the signs of opioid overdose and knowing how to respond promptly can be crucial in saving lives. In partnership with California Prime Recovery, an addiction treatment center in Orange County, CA, this blog aims to shed light on the signs of opioid overdose, provide guidance on administering naloxone—an opioid overdose reversal medication—and outline steps to assist someone experiencing an overdose. The misuse of prescription opioids and other controlled substances has led to a significant rise in opioid use disorder and opioid overdoses. People who misuse opioids, including prescription pain medicines and heroin, interact with opioid receptors in the brain to provide pain relief but also carry a high risk of addiction and drug dependence. Health care providers and emergency medical responders frequently encounter cases of suspected opioid overdose, characterized by very small pupils and stopped breathing. To combat this epidemic, naloxone, a medication that can reverse opioid overdose, has become widely accepted and is distributed through community-based programs and prescribed by healthcare professionals. Understanding the risk factors and signs of opioid overdose is crucial in preventing overdose deaths and ensuring timely intervention.

What are Opioids?

Opioids are a class of drugs that include both prescription medications and illegal substances. They are primarily used for their pain-relieving properties but can also produce feelings of euphoria and relaxation, making them susceptible to misuse and addiction. Opioids work by binding to specific receptors in the brain, spinal cord, and other areas of the body known as opioid receptors. When these receptors are activated, they block pain signals and release dopamine, a neurotransmitter associated with pleasure and reward. The prevalence of opioid misuse has led to significant drug abuse, resulting in complications such as addiction, overdose, and the need for treatments like naloxone.

Types of Opioids, Including Prescription Opioids

There are several types of opioids, including:

  1. Prescription Painkillers: These opioids are commonly prescribed by healthcare providers to manage moderate to severe pain. Examples include oxycodone (OxyContin), hydrocodone (Vicodin), morphine, and codeine.

  2. Heroin: Heroin is an illegal opioid drug synthesized from morphine. It is typically sold as a white or brown powder or as a black, sticky substance known as black tar heroin. Heroin is highly addictive and produces intense feelings of euphoria and relaxation.

  3. Synthetic Opioids: Synthetic opioids are manufactured drugs that are chemically similar to natural opioids but are made in a laboratory. Examples include fentanyl, tramadol, and methadone. Fentanyl, in particular, is much stronger than other opioids and is associated with a high risk of overdose.

How do Opioids Work in the Brain and Body?

Opioids work in the brain and body by binding to specific receptors called opioid receptors. These receptors are found in various regions of the brain, spinal cord, and other parts of the body. When opioids bind to these receptors, they modulate the transmission of pain signals and produce feelings of pleasure and euphoria.

In the brain, opioids primarily act on mu-opioid receptors, although they can also interact with delta and kappa opioid receptors to a lesser extent. Activation of mu-opioid receptors inhibits the release of neurotransmitters involved in the perception of pain, such as substance P and glutamate. This inhibition results in a reduction in the transmission of pain signals, leading to pain relief.

Additionally, opioids activate the brain’s reward system by increasing the release of dopamine, a neurotransmitter associated with pleasure and reinforcement. This surge in dopamine activity contributes to the feelings of euphoria and well-being commonly experienced with opioid use.

Side Effects of Opioids

Short-term side effects of opioids can include:

  1. Drowsiness: Opioids can cause feelings of drowsiness or sedation, making it difficult to stay awake or concentrate.
  2. Constipation: Opioids slow down bowel movements, leading to constipation, bloating, and discomfort.
  3. Nausea and Vomiting: Opioids can stimulate the part of the brain responsible for nausea, leading to feelings of queasiness and vomiting.
  4. Confusion: Opioids may cause confusion, disorientation, or cognitive impairment, particularly in higher doses.
  5. Itching: Opioids can cause itching or hives, known as pruritus, as a result of histamine release.
  6. Respiratory Depression: Opioids depress the respiratory system, leading to slowed or shallow breathing, which can be dangerous, especially in high doses or when combined with other depressants like alcohol or benzodiazepines.

Long-term side effects of opioids can include:

  1. Dependency and Addiction: Prolonged use of opioids can lead to physical dependence and addiction, characterized by cravings, compulsive drug-seeking behavior, and inability to control use despite negative consequences.
  2. Tolerance: With continued use, individuals may develop tolerance to opioids, requiring higher doses to achieve the desired effects. This can increase the risk of overdose and other adverse effects.
  3. Withdrawal Symptoms: Abruptly stopping or reducing opioid use can lead to withdrawal symptoms, including anxiety, restlessness, nausea, vomiting, diarrhea, muscle aches, and insomnia.
  4. Hormonal Imbalances: Chronic opioid use can disrupt hormonal balance, leading to changes in libido, menstrual irregularities, and decreased testosterone levels in men.
  5. Cognitive Impairment: Long-term opioid use has been associated with cognitive impairment, including difficulties with memory, attention, and executive function.
  6. Increased Pain Sensitivity: Prolonged use of opioids can lead to a phenomenon known as opioid-induced hyperalgesia, where individuals experience increased sensitivity to pain.
  7. Social and Occupational Impairment: Opioid addiction can have significant impacts on social relationships, employment, and overall quality of life, leading to financial strain, legal problems, and social isolation.

What is an Opioid Overdose?

A drug overdose occurs when someone has taken an excessive amount of opioids, leading to a dangerous level of opioid intoxication that can result in severe and potentially life-threatening symptoms. Opioids depress the central nervous system, including the respiratory system, and high doses can cause respiratory depression, which can lead to breathing difficulties, unconsciousness, and, in severe cases, death. Identifying signs of substance abuse, such as fresh needle marks and other drug paraphernalia, can be crucial in diagnosing an overdose.

During an opioid overdose, the body’s natural drive to breathe is suppressed, resulting in slowed or shallow breathing, or even a complete cessation of breathing. Without adequate oxygen supply to the brain and other vital organs

What Causes an Opioid Overdose?

An opioid overdose occurs when the amount of opioid analgesics in the body surpasses what the body can tolerate, leading to respiratory depression, loss of consciousness, and potentially fatal consequences. Opioids, whether prescription painkillers like oxycodone and morphine or illicit drugs like heroin, can cause respiratory depression, which is a slowing or stopping of breathing. Here are common ways in which someone can overdose on opioids:

  1. High Dose:

  • Taking a higher dose of opioids than the body can tolerate increases the risk of overdose. This can happen when individuals take more than the prescribed dose of a medication or when using illicit opioids.

  1. Tolerance:

  • Over time, individuals may develop tolerance to the effects of opioids, meaning that they need higher doses to achieve the same pain relief or euphoria. If someone takes a dose that their body is not accustomed to, it can lead to overdose.

  1. Combination with Other Substances:

  • Combining opioids with other substances that depress the central nervous system, such as alcohol, benzodiazepines, or other sedatives, can significantly increase the risk of overdose. The combined effect on respiratory function can be particularly dangerous.

  1. Illicitly Manufactured Fentanyl:

  • Illicitly manufactured fentanyl, a synthetic opioid that is much more potent than other opioids, has been a major contributor to opioid overdoses. Its high potency increases the risk of overdose, especially when people unknowingly consume fentanyl-laced substances.

  1. Unintentional Overdose:

  • Accidental overdose can occur when individuals miscalculate the dosage, take multiple doses too closely together, or mistakenly use a more potent opioid than intended. This can happen in situations of drug misuse or when opioids are obtained from illicit sources.

  1. Reduced Opioid Tolerance:

  • Individuals who have undergone periods of abstinence, such as during addiction treatment or incarceration, may experience a reduced tolerance to opioids. If they resume use at previous levels, the risk of overdose is significantly increased.

  1. Lack of Access to Naloxone:

  • Naloxone, an opioid antagonist, can reverse the effects of an opioid overdose if administered promptly. Lack of access to naloxone or delayed administration can contribute to fatal outcomes.

It’s important to note that opioid overdoses can happen to individuals who are using opioids for legitimate medical purposes, those who misuse prescription opioids, and individuals who use illicit opioids. Understanding the risks, promoting responsible prescribing practices, and providing education on overdose prevention and intervention are crucial

Signs and Symptoms of an Opioid Overdose

Signs and symptoms of an opioid overdose can vary depending on factors such as the type and amount of opioid consumed, as well as individual tolerance and metabolism. However, common signs and symptoms of an opioid overdose may include:

  1. Unresponsiveness: The person may be unconscious and unable to be awakened, or they may be extremely difficult to rouse.

  2. Shallow or Slow Breathing: Breathing may become slow, irregular, or shallow. In severe cases, the person may stop breathing altogether.

  3. Pinpoint Pupils: The person’s pupils may appear very small (pinpoint), even in dim lighting. This is a classic sign of opioid intoxication.

  4. Blue Lips or Fingernails: A bluish or grayish tint to the lips, fingertips, or nails (cyanosis) may indicate oxygen deprivation.

  5. Cold or Clammy Skin: Skin may feel cold or clammy to the touch, indicating poor circulation.

  6. Limp Body: The person’s body may feel limp or floppy, and their muscles may be relaxed.

  7. Vomiting: Some individuals may vomit during an opioid overdose, particularly if they have taken a high dose or have combined opioids with other substances.

Commonly Abused Opiates

Opioids are commonly prescribed for Acute use, typically a short term prescription, for example after a major surgery; and for Chronic use, which may be longer term prescriptions, for example to advanced cancer patients. However, the highly addictive nature of opioids make them easy for people to abuse. Many individuals start out with prescriptions for pain relief, but extended use of even prescription drugs affects the body’s dependence on drug induced dopamine and endorphin secretions.

Some commonly abused opioid drugs are:

  • Vicodin (Hydrocodone and Acetaminophen)
  • Morphine
  • Codeine
  • Fentanyl
  • Hydrocodone
  • Hydromorphone
  • Heroin (an illegal opioid)

Fentanyl and Heroin are responsible for the most number of overdose emergencies and deaths in the U.S.

How to Help in an Opioid Overdose Situation

If you suspect that someone around you is experiencing a drug overdosing, here are some initial steps to take.

Call 911

An opioid overdose incident requires immediate medical intervention. Call 911 or your local emergency medical number immediately. Gather any information you can provide, such as name of patient, location of the incident, name of the opioid that you find on the patient, and if you are aware of any other substances involved.

Check for Response

If you notice a person displaying any of the signs above, try to induce some kind of response from them by calling their name, tapping them on the shoulder, or administering a sternal rub. A sternal rub is performed by making a fist and rubbing the knuckles along their sternum (at the center of their chest, below the breastbone). If they respond to any of these, verify whether they can remain alert.

Administer Narcan (Naloxone) to Reverse Opioid Overdose

Although Narcan is a prescription drug, it is usually available at pharmacies in cases of emergency situations. The co-prescription of naloxone with prescription opioids is recommended by the U.S. Centers for Disease Control and Prevention to reduce the risk of opioid-related emergency room visits and overdose deaths. If you are a medical professional or have access to Narcan, immediately administer the drug while you wait for emergency medical professionals to arrive. Even if you are unsure whether the patient’s condition is due to opioid overdose, it is safe to give them Naloxone as a first step.

Perform CPR and/or Rescue Breathing

If you have had training in rescue breathing and CPR, you may administer rescue breathing if you notice the person is not breathing. If you are not trained in rescue breathing, you may administer CPR by giving them quick, uninterrupted chest compressions.

Stay Until Help Arrives

Try to keep the patient in a comfortable position while you wait for help to arrive. When medical help arrives, stay and provide any information necessary for you to hand them off.

Preventative Measures for Opioid Overdose

Preventing opioid overdose is crucial and involves specific measures and tips, such as recognizing the signs of an overdose, accessing effective treatment options, administering life-saving services, and obtaining naloxone to prevent opioid overdose.

Not all overdose cases are due to abusing opioids. In many cases, it can be caused due to lack of knowledge, easy accessibility, and existing preconditions. Here are some suggestions of how to prevent opioid overdoses.

  • Only use opioids under prescription, exactly as prescribed

  • If you are using other medications be sure to ask your doctor about combining them

  • Do not combine prescription medications with other substances such as alcohol or unprescribed drugs

  • Have Naloxone handy and learn how to administer it

  • Keep all medications out of reach of children and pets

How to Have a Successful Recovery from Opioid Overdose

After completing the emergency medical intervention, patients often go through the detoxification process which is usually a medically assisted treatment (MAT) in the case of opioids. However, it is not a secret that individuals walking out of a detox will most likely go back to using the drugs.

Is it possible to have a successful recovery? The answer is YES, and it lies in long term treatment. We offer several variations of long term recovery treatment plans to accommodate all kinds of patients with different kinds of lifestyles and obligations.

Opioid Addiction Treatment Options

Opiate addiction is a complex condition that requires a multifaceted approach to address its physical, psychological, and social aspects. Here is a detailed overview of various treatment options available for individuals struggling with opiate addiction:

  1. Detoxification (Detox):

    • Description: Detoxification is the initial phase of treatment aimed at safely and gradually removing opiates from the body.
    • Key Points:
      • Medically supervised detox helps manage withdrawal symptoms.
      • Tapering off opiates may be utilized to reduce the intensity of withdrawal.
      • Detox alone is not sufficient for long-term recovery.
  2. Medication-Assisted Treatment (MAT):

    • Description: MAT combines medications with counseling and behavioral therapies to address opiate addiction.
    • Key Medications:
      • Methadone: Reduces cravings and withdrawal symptoms.
      • Buprenorphine: Eases withdrawal and cravings, with lower risk of misuse.
      • Naltrexone: Blocks opiate effects, reducing cravings.
    • Benefits:
      • Helps prevent relapse.
      • Supports long-term recovery.
      • Reduces withdrawal discomfort.
  3. Inpatient Rehabilitation (Residential Treatment):

    • Description: Inpatient rehab involves staying in a residential facility for a specified duration.
    • Key Features:
      • 24/7 medical supervision and support.
      • Intensive therapy and counseling.
      • Structured environment conducive to recovery.
    • Duration: Typically 30 to 90 days, depending on individual needs.
  4. Outpatient Rehabilitation:

    • Description: Outpatient programs provide treatment without requiring residential stays.
    • Key Features:
      • Allows individuals to maintain daily routines.
      • Regular counseling sessions.
      • Flexibility in scheduling.
    • Intensity: Varies from several hours a week to daily sessions.
  5. Cognitive-Behavioral Therapy (CBT):

    • Description: CBT is a widely used therapeutic approach that addresses thoughts, behaviors, and emotions associated with addiction.
    • Key Components:
      • Identifying and challenging negative thought patterns.
      • Developing coping strategies.
      • Enhancing problem-solving skills.
    • Benefits:
      • Helps change addictive behaviors.
      • Addresses underlying issues contributing to addiction.
  6. Support Groups:

    • Description: Peer support groups provide a sense of community and understanding among individuals in recovery.
    • Examples:
      • Narcotics Anonymous (NA).
      • SMART Recovery.
      • Alcoholics Anonymous (AA) for those with dual diagnoses.
    • Benefits:
      • Shared experiences and insights.
      • Accountability and encouragement.
      • Building a sober network.
  7. Family Therapy:

    • Description: Involves the family in the recovery process to improve communication and support.
    • Objectives:
      • Resolving conflicts.
      • Rebuilding trust.
      • Enhancing family dynamics.
    • Benefits:
      • Addresses family-related stressors.
      • Establishes a supportive environment.
  8. Holistic Therapies:

    • Description: Integrates complementary therapies to support overall well-being.
    • Examples:
      • Yoga and meditation.
      • Art or music therapy.
      • Acupuncture and massage.
    • Benefits:
      • Stress reduction.
      • Improved emotional regulation.
      • Enhanced physical and mental health.
  9. Aftercare and Continuing Support:

    • Description: Ongoing support and resources post-treatment to maintain recovery.
    • Components:
      • Follow-up counseling.
      • Support group participation.
      • Alumni programs.
    • Importance:
      • Reduces the risk of relapse.
      • Sustains motivation for long-term recovery.

Does Insurance Cover Opiate Addiction Treatment?

Yes, many insurance plans cover opiate addiction treatment as part of their behavioral health services. However, the extent of coverage can vary based on factors such as the specific insurance plan, in-network or out-of-network providers, and the level of care needed.

It is advisable for individuals seeking opiate addiction treatment to work closely with their insurance provider and the treatment facility’s admissions team to understand the specific terms of coverage. This collaboration helps individuals make informed decisions about treatment options and navigate the financial aspects of addiction care. Additionally, seeking assistance from the treatment facility’s insurance coordinator can provide valuable support in verifying benefits and understanding the insurance process.

Common Insurance Plans Used for Addiction and Mental Health Treatment

Common types of insurance plans used for addiction and mental health treatment include:

  1. Preferred Provider Organization (PPO):

    • PPO plans offer flexibility in choosing healthcare providers, allowing individuals to visit both in-network and out-of-network providers without a referral. PPO plans typically cover a portion of the cost for addiction and mental health rehab services, but out-of-pocket expenses may be higher when using out-of-network providers.
  2. Health Maintenance Organization (HMO):

    • HMO plans require individuals to choose a primary care physician (PCP) who coordinates their care and provides referrals to specialists, including addiction and mental health treatment providers. HMO plans often have lower out-of-pocket costs but may limit coverage to in-network providers, except in emergencies.
  3. Exclusive Provider Organization (EPO):

    • EPO plans combine aspects of both PPO and HMO plans, offering a network of preferred providers for individuals to choose from. While EPO plans do not require a PCP or referrals for specialists, coverage is typically limited to in-network providers, except in emergencies.
  4. Point of Service (POS):

    • POS plans offer individuals the option to receive care from both in-network and out-of-network providers. However, using out-of-network providers may result in higher out-of-pocket costs, and individuals may need a referral from their PCP to see specialists, including addiction and mental health treatment providers.

These insurance plans may vary in terms of coverage, network providers, cost-sharing requirements (e.g., copayments, coinsurance, deductibles), and authorization requirements for addiction and mental health rehab services. It’s essential for individuals to review their insurance plan documents, understand their coverage details, and verify network providers before seeking treatment. Additionally, individuals may need to obtain preauthorization or prior approval for certain rehab services to ensure coverage and minimize out-of-pocket expenses.


Opioid overdoses have become a leading cause of accidental death, driven by the misuse of prescription opioids and other substances. To address this crisis, healthcare providers and local health departments are implementing treatment programs and naloxone distribution initiatives. Administering naloxone promptly can prevent death by reversing the life-threatening effects of an overdose, such as stopped breathing. Awareness and education about the signs of an opioid overdose, combined with timely emergency medical help, are essential in reducing the risk of overdose and supporting those with opioid use disorder. By leveraging these strategies, we can work towards mitigating the devastating impact of opioid abuse on individuals and communities.

Seeking Treatment? We Can Help!

At California Prime Recovery, as an in-network provider we work with most insurance plans, such as:

If you or a loved one are struggling with mental health challenges or substance abuse, reach out to California Prime Recovery today. Our team of compassionate professionals is here to support your journey towards lasting well-being. Give us a call at 866-208-2390

FAQs on Opioid Overdose and Opioid Use Disorder

How can opioid overdoses be prevented?

Opioid overdoses can be prevented by using opioids only as prescribed by a healthcare provider, avoiding combining opioids with other substances like alcohol or sleeping pills, and having naloxone available to reverse an overdose.

What is naloxone, and how does it work?

Naloxone is a medication that can quickly reverse the effects of an opioid overdose. It works by binding to opioid receptors in the brain, displacing the opioids and restoring normal breathing. Naloxone can be administered as a nasal spray or injection.

Who can administer naloxone?

Naloxone can be administered by anyone who has been trained to use it, including family members, first responders, and healthcare providers. It is important to call 911 immediately after administering naloxone.

Where can I get naloxone?

Naloxone is available at pharmacies, through community-based distribution programs, and from healthcare providers. Some local health departments also provide naloxone and training on its use.

What should I do if I suspect someone is having an opioid overdose?

If you suspect someone is having an opioid overdose, call 911 immediately, administer naloxone if available, and try to keep the person awake and breathing. Stay with them until emergency medical help arrives.

What are the risk factors for opioid overdose?

Risk factors for opioid overdose include taking high doses of opioids, combining opioids with other substances like alcohol or sedatives, having a history of substance use disorder, and having certain health conditions that affect breathing.

What is opioid use disorder?

Opioid use disorder is a medical condition characterized by the inability to stop using opioids despite negative consequences. It includes symptoms such as strong cravings, withdrawal symptoms, and continued use despite harm to oneself or others.

What treatment options are available for opioid use disorder?

Treatment options for opioid use disorder include medication-assisted treatment (MAT) with medications like methadone, buprenorphine, and naltrexone, as well as behavioral therapies and support programs. Treatment plans should be individualized to meet each person’s needs.

Can prescription opioids lead to addiction?

Yes, prescription opioids can lead to addiction if they are misused. Taking opioids in higher doses or for longer periods than prescribed increases the risk of developing opioid use disorder.

How can healthcare providers help prevent opioid overdoses?

Healthcare providers can help prevent opioid overdoses by prescribing opioids cautiously, educating patients on the risks of opioid use, providing naloxone, and offering resources for addiction treatment and support.

What should I do if I have been prescribed opioids for pain management?

If you have been prescribed opioids for pain management, use them exactly as directed by your healthcare provider. Do not share your medication with others, store it securely, and dispose of any unused medication properly. Discuss any concerns with your provider.

What is the role of local health departments in addressing opioid overdoses?

Local health departments play a critical role in addressing opioid overdoses by providing education, distributing naloxone, supporting community-based prevention programs, and coordinating with healthcare providers and emergency responders.

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