Taking too much of a medicine or substance intentionally or accidentally is known as an overdose
Drug abuse always carries the risk of serious side effects, including overdose and death.
Whether you abuse alcohol, an illegal drug such as cocaine, heroin or medications prescribed by a doctor—such as opioid painkillers, anti-psychotics, neuropathic painkillers, benzodiazepines or any other type of medication—addiction development will always be a real concern and possibility each and every time you use or drink.
In many cases, if substance abuse behavior persists, there remains a real possibility of a drug or alcohol overdose, death from combining multiple drugs or substances and ultimately, death from overdose or from the physical & mental damage you do to yourself when you use or drink!
Any overdose from a substance can be either accidental or intentional.
Accidental
The overdose is considered accidental if you take the medicine by mistake, you use the wrong medicine or you take too much of a medicine by mistake. Accidental overdoses can also happen during medical or surgical procedures.
Accidental overdoses tend to happen when people take more of a prescription medication or illicit substance than originally intended to, so that they could achieve certain desired results, or when they use too much of an illicit substance trying to get a better high.
Intentional
Intentional overdoses are a result of someone attempting to end their life through suicide or knowingly taking too much of a substance to “push” or achieve a bigger high than ever before, even though they know that what they are doing could realistically kill them. Regardless of the intent, any loss of life due to an overdose is tragic & could be prevented.
Any overdose can have severe and lasting repercussions if the individual were unsuccessful and could end up with lifelong and life-changing outcomes as a result of their actions. If substance abuse behavior persists, there remains a real possibility of intentional or unintentional overdose.
Statistics For The UK
- There were 4,359 deaths related to drug poisoning registered in the UK in 2018, the highest number and the highest annual increase (16%) since the time series began in 1993.
- The male drug poisoning rate has significantly increased from 89.6 per million males in 2017 to 105.4 in 2018; while the female rate increased for the ninth consecutive year to 47.5 per million females in 2018, the latest increase was not statistically significant compared to 2017.
- Two-thirds (or 2,917) of drug-related deaths were related to drug misuse, accounting for 50.9 deaths per million people in 2018.
- The North East had a significantly higher rate of deaths relating to drug misuse than all other English regions; London had the lowest rate.
- Between 2017 and 2018, there were increases in the number of deaths involving a wide range of substances, though opiates, such as heroin and morphine, continued to be the most frequently mentioned type of drug.
- Deaths involving cocaine doubled between 2015 and 2018 to their highest ever level, while the numbers involving new psychoactive substances (NPS) returned to their previous levels after halving in 2017.
- The alcohol-related mortality rate in England in 2018 was 46.5 per 100,000 people, equivalent to 24,720 deaths.
- In England alone, there were over 314,000 potential years of life lost related to alcohol consumption, the highest level since 2011
You can find downloadable information and media on our Downloads & Media page here.
Signs & Symptoms Of A Drug Overdose
The physical and psychological (mental/thinking) signs of a drug overdose can vary depending on the type of drug taken and whether the drug(s) were taken in combination with other substances such as cocaine.
Common signs (what you see) and symptoms (what the patient/individual reports) of a drug overdose can include the following and will differ depending on what the person has taken, how much, whether they took anything else including prescription medication, over the counter medication, illicit drugs or alcohol and how long ago since they took it/them:
- Dilated (big) or pin-point pupils
- Unsteady walking or standing
- Chest pain
- Severe difficulty breathing, shallow breathing or completely stop breathing
- Gurgling or wheezing sounds that may indicate the person’s airway is blocked
- Blue lips or fingers
- Nausea or vomiting
- Abnormally high or low body temperature and sweating
- Violent or aggressive behavior
- Disorientation, hallucination, delirium or confusion
- Abdominal pain
- Abnormal heart rhythm
- High or low blood pressure
- High or low pulse (heart beating rate)
- Headache
- Localised or general pain
- Shaking or tremors
- Paranoia
- Agitation
- Seizures (fits)
- Unresponsiveness
- Unconsciousness
- Coma
- Death
You may also notice drug paraphernalia or alcohol bottles, cans ect around the person or people.
A person may not exhibit all or even most of these signs, but even a few of these symptoms can indicate a person could be experiencing an overdose. Each drug, medicine has different effects when taken in larger amounts than supposed to and whether alcohol was also involved however, this gives you an overview of a broad range of signs & symptoms.
Overdose Risk Factors
If you abuse any substances including medication, illegal drugs or alcohol, there is always a real risk of overdosing. However, certain actions and conditions may further increase that risk, including:
- Significant physical/mental dependence on the drug(s) or alcohol
- Prior overdose(s) attempts recently
- Abusing multiple substances, including alcohol
- Taking a large amount of the substance at once
- Dropping out of substance abuse treatment
- Gradually increasing the dose of the substance over time (tolerance)
- A reluctance to seek emergency help when needed
- Intravenous (injecting) drug use
- Being recently released from prison
- Previous intentional suicide attempts
- Resuming drug use after a period of abstinence
- Low level of physical tolerance if you are new to the drug or alcohol
- Also on MAT (Medication Assisted Treatment) medicines such as Methadone or Acamprosate
Tolerance refers to the state that occurs when your body has become accustomed to the presence of a drug, both prescription, over the counter or illegal and alcohol so it requires higher and higher amounts or more frequent doses of the drug to achieve the same kind of “high” or feelings they previously got with a smaller dose. If you continue to increase your dose or take the drug in bigger amounts or more frequently, you may have a higher risk of overdosing.
Tolerance may also influence overdose risk in another way. For instance, people with a history of chronic or heavy substance abuse may develop considerable tolerance to the effects of a drug, allowing them to take more than someone who is “drug naive” or has less of a history with substances. Following attempts to quit the drug or any period of abstinence means that their tolerance will lower in the drug-free interim. Should that person suddenly return to using the drug, especially in doses that they may have once been accustomed to, overdose may be highly likely to occur.
Also the way they use the substance(s) also affects the speed at which the substance enters the body and how quickly you feel its full effects.
For example, If someone smoked heroin for the past three years then enters recovery and stays there, substance free for six months and then relapses, they begin using heroin again and decide on this occasion to inject it, rather than smoke it, they will not only have a lower tolerance to the heroin but by also injecting it, means that they will get nearly all of the drug in one go so with the combination of a lower tolerance and injecting it, would put them at an extremely high risk of overdose and/or death.
What To Do If You Or Someone Else Overdoses on Drugs?
If you or a loved one has potentially overdosed on drugs, seek immediate medical attention by calling 999 immediately to receive emergency help right away and tell them you suspect that the person has overdosed. If you know what they took, what strength of medication, how much you suspect they took and how they took it. For example, by mouth or injecting it. This information is vital for the person to get the most effective treatment to save their life. Keep any empty boxes or bottles for the Paramedics and Doctors.
You might also implement a few of the following lifesaving skills while waiting for an Ambulance to arrive. However, be sure to avoid putting your own safety at risk since certain drugs can prompt violent or unpredictable behavior in the person taking them.
Below you will find a quick, brief overview of the process that will more than likely occur when you suspect you or someone else has overdosed and the things that may then happen once you’ve called 999.
- If you come across someone you suspect of overdosing, if the area or scene they are in is unsafe, attempt to make it safe before you or anyone else approaches to help. One casualty is better than two dead ones! If you can do this safely, then attempt to do so. If you can’t, contact 999 immediately and wait at a safe distance until they arrive
- Check the person’s breathing and heart rate by looking for the chest to rise and fall or by placing your ear by their mouth to see if you can hear and/or feel them breathing
- If the person is unconscious, try to get a response by shaking them, calling their name or rubbing your knuckles against their breastbone or by pinching them. Ask the person questions to assess their level of alertness and to calmly keep them engaged, focused and distracted if possible
- If the person is not breathing, turn them onto their back and attempt to perform “mouth to mouth” breaths and chest compression’s (pressing against the chest, over the area of the heart). The Ambulance Service will guide you through performing these techniques if you panic, forget or don’t know how to do it. Another reason, to contact 999 immediately
- Follow any other instructions that the 999 operators may ask you to do or things to get such as a defibrillator if one is nearby.
- Do not allow the person to take any more of the substance, don’t let them drink water (unless told to by 999 operators) or alcohol under any circumstance
- Don’t let them eat or smoke as this may negatively impact the doctors attempts to save their life in the Ambulance or in hospital, should emergency medical procedures such as operations or certain medicines must be given
- Obtain as much information as possible, including the name of the medication or substance, the dose (the strength), how much was taken and the last time they took the substance(s)
- If prescription medications or otherwise labelled substances have been used, take the container with you to the A&E or give it to the Ambulance who arrives, even if they are empty.
- Make note of any identifying paraphernalia or bring along any containers of other drugs or substances the person may have taken. illegal or not
- If the overdose was intentional, they may have also attempted to commit suicide using a different method as well as overdosing such as cutting or stabbing themselves, make sure you check their body for any signs of bleeding or stab wounds. DON’T remove any impaled objects and simply apply, firm, direct pressure over the wounds or around any impaled objects.
- Do not try to reason with the person or give your opinions about the situation. Simply support them, reassure them & try to keep them and yourself as calm as possible
- Stay as calm as possible while waiting for medical personnel arrive.
- Assure the person that help is coming.
- Again, as mentioned earlier, If the person is in a dangerous location and would also put you at high risk of becoming injured or unwell, call 999 and wait at a safe distance until they arrive. One casualty is better than two dead ones! If you can remove the danger safely, then attempt to do so
- Consider administering Naloxone (Narcan) if a kit is available and you suspect the person has overdosed on opioids/opiates including codeine, morphine, fentanyl & heroin. Naloxone is an emergency medication that can reverse the effects of an overdose of opioid & opiates as mentioned above.
- If the person is conscious, either sit them up on the floor so that they do not fall or lay them down in recovery position. More information about this technique can be found below.
This article will tell you everything you need to know about naloxone, how it could help you to save someone’s life and how to get a free kit. Keep reading on.
Consider Taking A First Aid Training Course
Consider taking a one day or three day first aid course. You will learn these life saving techniques as well as many other useful skills, not only for overdosing but other medical emergencies too. Some organisations offer free workshops to learn CPR skills for free if you cannot afford to pay for one yourself. Contact your GP Surgery or nearest drug and alcohol service to find out more. You can find your nearest services on our help & support page here.
Locating You/The Person Who Has Overdosed Using “What3Words”
The organisation “what3words” has given every 3M square a unique combination of three words. People are using the free app to help 999 know exactly where to find incidents.
Watch and share real stories to raise awareness of how what3words can help in emergencies, outdoor activities and deliveries.
Find you location or more information here: http://www.what3words.com
Naloxone
What is naloxone?
Naloxone is a drug that can reverse the effects of opioids and opiates, such as heroin, methadone, opium, codeine, morphine, fentanyl and buprenorphine. Naloxone can even save someone’s life if it’s used quickly after they’ve overdosed on opioids or opiates.
Medical professionals have been introducing naloxone into the public spotlight for some time now, with negligible results & using naloxone in emergencies for many years. We want to make sure that anyone who needs it, has it to hand and knows how to use it.
Naloxone kits come in a couple of different varieties, intranasal (up the nostril) and Intramuscular (injected into the muscle) so its important you know how to use both types as they will vary from area to area and country to country. Contact your nearest drug and alcohol service to find out what types of kit are available in your area.
Get A Free Naloxone Kit & Training
If you’d like a naloxone kit, just visit your local drug or alcohol service. A trained member of staff will give you a kit and teach you how to prevent and manage opioid overdoses as well as recognising an overdose and how to use your kit or kits available. Naloxone training can take as little as 10-15 minutes.
In UK law, anyone can carry and use naloxone in an emergency. You don’t need to be a doctor or medical professional. We give kits to anyone who could use it to save a life, for example if you use opiate drugs, if someone you know does or you encounter or work with addicts regularly. Just check your company or organisations policy on carrying your own Naloxone kit whilst at work or in a work capacity first.
Remember to regularly check the date of expiry on your kit and ensure yours is always in date. We suggest you set a reminder in your phone or write it down somewhere you will see it regularly to ensure your kit is always in date and usable.
If you use your kit, if it lost, damaged or becomes out of date before you’ve used your kit, they’ll be happy to give you a new one by exchanging them at the drug and alcohol service or organisation who have you the one you currently have for free.
How To Use Naloxone To Save Someone’s Life
If someone has had an opioid or opiate overdose, naloxone will only reverse the effects for a short while. After approximately 20-40 minutes, the effects will wear off and the person will go back into overdose, so ensure that you or the person who has overdosed hasn’t slipped back into their overdose if the Ambulance Service hasn’t arrived yet as you may need to give another dose of Naloxone.
Always dial 999 and ask for an ambulance straight away after giving someone naloxone. Using your kit is only useful if the person will receive advanced care from Paramedics and Doctors in hospital so ensuring that 999 has been called as early in the process as possible is vital!
Naloxone kits come in two types:
- Prenoxad -A kit you inject into the person’s muscle
2. Nyxoid – which comes as a nasal spray that you administer up the person’s nostril
What To Do If Someone Is Having An Overdose
Keep calm and follow these steps:
- Make sure that you’re not in any danger first. Keeping yourself safe is important as it is better to have one casualty than two dead ones!
- Call 999 immediately and ask for an ambulance
- Check to see if there is anything obstructing their airways by looking into their mouth
- If there is anything obstructing their airway such as chewing gum, attempt to sweep it out of their mouth with your finger, NO FURTHER THAN YOU CAN SEE
- Place the person in the recovery position. You can download our guide to print off and keep handy here and you can find out how to do this here by watching this video
- If you have Prenoxad, inject it into their thigh or upper arm muscle
- If you have Nyxoid, place the spray in their nose and press the plunger
- Wait with the person until the ambulance arrives and give the used naloxone kit to the paramedics. You may need to give more than one dose of naloxone if the Ambulance services becomes delayed & takes a while to turn up
When you use naloxone, you should see it start to work in 2-5 minutes. The effects will last for between 20-40 minutes, but after that they will wear off and the person will begin overdosing again. It’s important that the person still gets medical help during this time, ideally before this happens as you may need to give more than one dose of naloxone.
Naloxone is only effective for opioid overdoses and won’t work with any other non-opioid drugs. You should never use it as a safety net to take extra risks.
If I didn’t do it, I knew he would die so I gave him two doses
Owen – Carrier of naloxone
How To Tell If Someone Has Overdosed
Keep an eye out for these signs that someone is having an overdose:
- Deep snoring/gurgling noises
- You can’t wake the person up and they don’t respond if you shake their shoulders or call their name or respond to mild pain stimulus such as rubbing your knuckles on their sternum (breast bone)
- A blue tinge to the lips, nail beds or other extremities
- They have stopped breathing
You should always call 999 if you think someone is having an overdose.
Don’t be scared that you’ll get in trouble. The ambulance will not bring the police with them except in very particular cases such as violence or threat of harm to them or others.
Alcohol Poisoning
Being poisoned by alcohol can damage your health or even put your life in danger.
Alcohol poisoning is a leading cause of poisoning in England, especially among young people.
It’s important to avoid misusing alcohol and to be aware of how much you’re drinking and the effect this could have on your body.
Signs & Symptoms Of Alcohol Poisoning
The signs and symptoms of alcohol poisoning can include:
- Confusion
- Severely slurred speech
- Loss of co-ordination
- Vomiting
- Irregular or slow breathing
- Pale or blue-tinged skin caused by low body temperature (hypothermia)
- Being conscious but unresponsive (stupor)
- Passing out and being unconscious
In the most severe cases, alcohol poisoning can lead to coma, brain damage and death.
When To Seek Medical Help
If you suspect alcohol poisoning, dial 999 immediately to request an ambulance.
While you’re waiting:
- Try to keep them sitting up, conscious and awake
- Don’t allow them to eat, drink or smoke until the Ambulance has arrived as they may need medication from the Paramedics or Doctors that could cause problems if they have already ate, drank or smoked. This includes coffee or tea to try and “sober them up” or even cold showers
- If they have passed out, lie them on their side in the recovery position and check they’re breathing properly, you can also download our free recovery position guide to print off and keep in an easy, visible spot so that everyone can see it in an emergency. You can download it here.
- Keep them warm & dry
- Stay with them at all times, unless you must leave them to call 999. Return to them immediately once you have called for the Ambulance unless the scene or environment becomes unsafe. If it does, stand at a safe distance and make sure you keep yourself and other bystanders safe until the Ambulance arrives
Never leave a person alone to “sleep it off”.
The level of alcohol in a person’s blood can continue to rise for up to 30 to 40 minutes after their last drink, so symptoms may worsen before they improve and can cause their symptoms to suddenly become much more severe very quickly. Make sure you monitor them constantly.
Do not give them coffee or tea in an attempt to “sober them up” as the caffeine may worsen their symptoms and cause more problems further down the line when they are being treated in the Ambulance or at the Hospital. This also includes cold showers or any other method in an attempt to quickly reduce their alcohol level.
These methods will not help and may even be dangerous or fatal.
How Alcohol Poisoning Is Treated In Hospital
In hospital, the person will be carefully monitored until the alcohol and/or other substances have left their system.
If treatment is required, these may include:
- Inserting a tube into their mouth and windpipe (intubation) to open the airway, remove any blockages and help with breathing via a machine (a ventilator)
- Use an intravenous drip, which goes directly into a vein to top up their water, blood sugar levels, vitamin levels and also allows Doctors & Nurses to give a range of medicines into their cannula to treat symptoms that may develop or worsen
- Fitting a catheter to their bladder to drain urine straight into a bag so they do not wet themselves if their level of consciousness is very low
- Putting them to sleep so that Doctors & Nurses can manage the persons body using machines more accurately. They may become aggressive, combative, at risk of injuring themselves or to perform certain procedures more comfortably for the person if they also suffer with mental health conditions which may be worsened by receiving treatment. This process also eliminates this possibility.
Dangers Of Alcohol Poisoning
If a person is poisoned by alcohol, they could:
- Stop breathing
- Have a heart attack
- Die by choking on their own vomit or relaxed tongue muscle
- Become severely dehydrated, which can cause permanent brain and organ damage in severe cases
- Develop severe hypothermia
- Have fits (seizures) as a result of lowered blood sugar levels or damage to their organs including kidneys, liver, heart and brain
- At risk of hurting themselves or others as a result of undertaking risky or dangerous behaviours as a result of lowered inhibitions when they are/were drunk
Repeated vomiting and retching can lead to vomiting blood, caused by a torn blood vessel at the junction of the stomach and gullet.
Various other medical conditions can arise as a complication from being poisoned by the alcohol. Especially if they have a physical and psychological dependence to alcohol or have organs that are already compromised from sustained excess alcohol
Other Related Risks
Drinking too much alcohol can affect a person’s judgement and put them in situations where their health and safety are at risk.
For example, they may:
- Have an accident or get injured
- Become involved in violent or antisocial behaviour
- Have unsafe sex, which can lead to an unplanned pregnancy or a sexually transmitted infection (STI)
- Lose personal possessions
How Does Alcohol Poisoning Happen?
Every time you drink alcohol, your liver has to filter it out of your blood.
Alcohol is absorbed quickly into your body (much quicker than food), but the body can only process around 1 unit of alcohol an hour.
If you drink a lot of alcohol over a short space of time, such as on a night out, your body will not have time to process it all.
Alcohol poisoning can also occur if a person drinks household products that contain alcohol. Children sometimes drink these by accident.
The amount of alcohol in your bloodstream, known as your blood alcohol concentration (BAC) will rise.
The Effects Of Alcohol
Around 1 to 2 units
- Your heart rate will speed up and your blood vessels will expand
- You get the warm, sociable feeling associated with moderate drinking
Around 4 to 6 units
- Your decision making and judgement will start to be affected, making you lose your inhibitions and become more reckless
- The cells in your nervous system will start to be affected, making you feel lightheaded
- Your co-ordination will be affected and your reaction time may be slower
Around 8 to 9 units
- Your reaction times will be much slower
- Your speech will be slurred
- Your vision will begin to lose focus
- Your liver will not be able to remove all of the alcohol overnight, so it’s likely you’ll wake up with a hangover
At this stage you should seriously consider not drinking any more alcohol.
If you do continue:
Around 10 to 12 units
- Your co-ordination will be seriously impaired, placing you at high risk of having an accident
- You may stagger around or feel unstable on your feet
- You’ll feel drowsy or dizzy
- The amount of alcohol in your body will begin to reach toxic levels
- You may need to go to the toilet more often as your body attempts to quickly pass the alcohol out of your body in your urine
- You’ll be dehydrated in the morning, and probably have a severe headache
- The excess alcohol in your system may upset your digestive system, leading to nausea, vomiting, diarrhoea or indigestion
More than 12 units
- You’re at high risk of developing alcohol poisoning, particularly if you’re drinking lots of units in a short space of time
- The alcohol can begin to interfere with the automatic functions of your body, such as your breathing, heart rate and gag reflex
- You’re at risk of losing consciousness
Recommended Alcohol Limits
If you drink most weeks, to reduce your risk of harming your health:
- Men and women are advised not to regularly drink more than 14 units a week
- Spread your drinking over 3 days or more if you drink as much as 14 units a week
A unit of alcohol is equivalent to:
- half a pint of lower strength lager, beer or cider (ABV 3.6%)
- a single small shot of spirits (25ml, ABV 40%)
Find out more about alcohol units
You should also avoid binge drinking as it’s dangerous and puts you at risk of alcohol poisoning.
Read more about drinking and alcohol, including tips on cutting down on your drinking. You can also download our own media & downloads on this topic and others on our Downloads & Media Page here.
| Organisation | Website |
| drugwise | https://www.drugwise.org.uk/ |
| What3words | https://what3words.com |
| International Overdose Awareness Day | https://www.overdoseday.com/ |
| NHS | https://www.nhs.uk/live-well/healthy-body/drug-addiction-getting-help/ |
| Alcohol Change UK | https://alcoholchange.org.uk/ |
| Naloxone UK | https://naloxone.org.uk/ |
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