Drug overdose
Drug overdose
An overdose is when you take a toxic (poisonous) amount of a drug or medicine.
Symptoms of an overdose can occur rapidly, but sometimes people can experience a delay in symptoms.
Not all overdoses are fatal or life threatening, however medical advice should always be sought if overdose is suspected or has occurred.
An overdose is a medical emergency that requires immediate medical attention. Always call triple zero (000) if you know or think that someone has had an overdose.
Substances that people can overdose on include:
alcohol
prescription medications
over-the-counter (non-prescription) medications
illicit drugs
some herbal remedies.
Symptoms of overdose
A wide range of signs and symptoms can occur when a person overdoses, and everyone responds differently. Signs and symptoms depend on a variety of factors including:
which substance (or substances) they took
how much they took
the strength of the drug
how they took it
their state of health
their age.
Symptoms of a drug overdose (including alcohol poisoning) may include:
nausea and vomiting
severe stomach pain and abdominal cramps
diarrhoea
chest pain
dizziness
loss of balance
loss of co-ordination
being unresponsive, but awake
limp body
seizures (fitting)
drowsiness and confusion
agitation
paranoia
slow or erratic pulse
difficulty breathing, shallow or erratic breathing or not breathing at all
hallucination
visual disturbances
choking or gurgling sounds
snoring deeply
blue fingernails or lips
pale or clammy face
loss of consciousness.
The
Alcohol and Drug
Foundation
External Link
has more information about different types of drugs, their effects and risk factors.
First aid for overdose
If you think someone has taken an overdose:
Try your best to stay calm.
Call triple zero (000) for an ambulance.
If the person is unconscious but breathing, place them gently on their side in the recovery position. Ensure their airway remains open by tilting the head back and lifting the chin. (This can help them to breathe and stop them from choking if they vomit.)
Check breathing and monitor their condition until help arrives.
Do not try to make the person vomit.
Do not give them anything to eat or drink.
Keep any pill containers to take to the hospital.
Overdose – what to do in an emergency
has detailed information about dialling triple zero (000) for a drug overdose, and what will happen in the emergency department.
If you think someone may have taken an overdose but they are not showing any symptoms and seem okay
, call the Poisons Information Centre on
13 11 26
(24 hours, 7 days) for advice on what to do.
An overdose can still be an emergency, even if the person seems okay at first.
Consider first aid and naloxone training for an overdose response
Some knowledge of basic first aid could mean the difference between life and death in an emergency. Consider:
Overdose first-aid and naloxone training
– Victoria has various health services that can teach you how to prevent, recognise and respond to a drug overdose. They will also organise free naloxone (a medication that can reverse opioid overdose) for you to carry if you’re at risk of experiencing or witnessing an opioid overdose. Many people carry naloxone and have used it to reverse thousands of overdoses. See the ’where to get help’ section of this fact sheet for service details.
A first-aid course
– so that you will be able to manage if someone is injured or becomes ill.
Paracetamol overdose
Paracetamol is a common form of pain management and is also used to reduce fever. It is usually bought over the counter without a prescription.
It is one of the most common medicines taken by young children in an accidental overdose.
Paracetamol is also commonly taken by
people who intend to harm themselves (suicide attempts)
.
Signs of paracetamol overdose include:
drowsiness
coma
seizures
abdominal pain
nausea
vomiting.
Another name for paracetamol is acetaminophen (often known by its brand name, Panadol®).
There is only a small difference between the maximum daily dose of paracetamol and an overdose, which can cause liver damage.
Large amounts of paracetamol are very dangerous, but the effects often don’t show until about 2 to 3 days after taking the tablets. Treatment must start early to be effective, before the effects begin.
Always seek treatment for paracetamol overdose immediately, even if the person seems well.
Treatment for drug overdose
Medical care for overdose depends on:
The drug (or drugs) taken.
The dose.
When and how the drug was taken.
What else it was taken with.
The effect on the person – including any medical complications resulting from the overdose.
If you go to hospital for a suspected drug overdose, the healthcare team will typically:
Perform a full assessment in the emergency department
– which may include blood tests, observation and psychological review.
Remove the drug from your body – for example, by giving activated charcoal, which binds the drug so the body can’t absorb it.
Administer an antidote, when possible – for example, naloxone hydrochloride (brand names Prenoxad®, Nyxoid®, Narcan®) is a drug that can reverse opioid overdose.
Admit you to hospital for further treatment.
A follow-up appointment with your doctor is important for everyone who has had an overdose. Your doctor can monitor your healing, advise on continued treatment (if required) or arrange for further help (referral).
Self-care after treatment with activated charcoal
If you were given charcoal in hospital, you will pass it with your next bowel motion in a day or two. Home care suggestions include:
Follow all instructions given by the doctor.
Drink plenty of water to avoid constipation.
Be aware that charcoal could interfere with the effectiveness of other medications you may be taking. For example, if you are taking the oral contraceptive pill, you will need to use another method of contraception until your next period. If you are unsure about how charcoal may affect your other medications and what to do about it, ask your doctor.
Why an overdose might happen?
Sometimes it’s unclear if an overdose was accidental or intentional. There may be elements of both.
Regardless of why the overdose happened, it’s important to treat people who have experienced an overdose with care and dignity.
Accidental
– if a person takes the wrong substance or combination of substances in the wrong amount or at the wrong time without knowing that it could cause them harm. This may include people who take a drug to get a certain desired effect (for example to get ‘high’ or reduce unpleasant emotions), but don’t realise the strength or ingredients of what they’re taking.
Intentional
– a person who takes an intentionally harmful dose of a substance or combination of substances. This can be sign of physical, emotional, or internal distress, and highlight the need for some additional care and support.
Overdose risk factors
People of any age may overdose. Your
risk factors for drug-related harm
is increased when:
More than one substance is taken at the same time.
The body is not used to taking a certain substance.
Preventing overdose
Some ways to help prevent an overdose include:
Practise medicine safety
. Always read medication labels carefully. Take prescription medications only as directed. Keep all medications in their original packaging.
Tell your doctor or other health professional if you have had an overdose before.
Do not keep medications you no longer need. Return them to the pharmacist.
Keep all medicines, alcohol, drugs and poisons locked away in a safe secure place and out of reach of children.
Be careful when taking different substances (including alcohol) at the same time. They can interact negatively and increase your risk of overdose. Ask your doctor or pharmacist if there are any interactions you should be aware of.
Safer use
There is no safe level of drug use, use of any drug carries some risk. If you do choose to use a substance, here are some ways to keep you safer from overdose.
Start low and go slow:
If you haven’t used a drug (such as
heroin
) for a while, your tolerance is likely to be a lot lower than it was before – take it slow and start with a smaller amount.
If using drugs from an unknown source or of unknown purity, have a smaller test amount at first.
If you have any unexpected or delayed reaction to a drug, do not take more.
Make sure you’re in a safe environment with people you trust.
Try to avoid using alone – let someone know where you are and what you are doing, or have a friend with you.
Keep naloxone on hand – if you’re using opioid drugs like heroin, morphine or oxycodone – it helps temporarily reverse the effects of opioids.
Victoria’s Take-Home Naloxone
Program
External Link
provides access to free naloxone to people who may experience or witness an opioid overdose from a range of community health providers across Victoria. Naloxone is also
available from
pharmacies
External Link
registered with the Australian Government’s Take-Home Naloxone Program.
Check any recent
drug alerts if you live in
Victoria
External Link
. Remember, other false or contaminated drug products may be circulating, even if no warning has been issued about them.
Where to get help
In an emergency, always call triple zero (000)
Emergency department of your nearest hospital
Victorian Poisons Information
Centre
External Link
Tel.
13 11 26
– for advice when poisoning or suspected poisoning occurs and for poisoning prevention information (24 hours, 7 days)
Your GP (doctor)
Suicide Call Back
Service
External Link
Tel.
1300 659 467
Lifeline
External Link
Tel.
13 11 14
DirectLine
External Link
Tel.
1800 888 236
– for 24-hour confidential drug and alcohol telephone counselling, information and referral. Free overdose training and naloxone from a health service is also available
Harm Reduction
Victoria
External Link
Tel.
(03) 9329 1500
or email:
– for overdose training and naloxone from peers (the DOPE program)
PAMS (Pharmacotherapy Advocacy Mediation
Support)
External Link
Tel.
1800 443 844
– free confidential telephone service run by Harm Reduction Victoria
Self Help Addiction Resource Centre
(SHARC)
External Link
Tel.
1300 660 068
– for information and support for people concerned about a relative or friend using drugs
St John Ambulance
Australia
External Link
(first aid courses) Tel.
1300 360 455