Is This an Emergency? What to Do if Someone Overdoses

Call 911 if your loved one won’t wake up, is breathing very slowly or not at all, has blue or purple lips, is having a seizure, is severely confused, or has just tried to take their own life. Everything below is what to do while help is on the way, and where to turn once the danger has passed.

What do I do for a suspected opioid overdose?

Signs include not waking up, slow or shallow breathing, choking or gurgling sounds, tiny pupils, a pale or clammy face, and blue or purple lips or fingernails.¹⁷¹⁴ Assume any street pill or powder could contain fentanyl. Counterfeit pills can look just like oxycodone or Xanax.¹

Give naloxone (such as Narcan) as a spray into the nose. Don’t wait for the ambulance.²⁴
If breathing has stopped or is very weak, start CPR if you’re trained, or follow the dispatcher’s directions.¹⁴
No normal breathing after 2–3 minutes? Give another dose.⁴⁶
Lay them on their side so they don’t choke.²
Stay with them, even if they wake up. Naloxone can wear off before the opioid does, and they can slip back into an overdose.³

Narcan and some other naloxone nasal sprays are sold over the counter.³⁵ If fear of arrest is making anyone hesitate to call, most states have Good Samaritan laws that may protect the person who overdosed or the person who called; what they cover varies by state.⁴ There’s more detail in how to use naloxone and spot an opioid overdose.

Still very sleepy after naloxone?

In April 2026 the CDC warned that medetomidine, a veterinary sedative, is spreading in the illegal fentanyl supply. Naloxone doesn’t reverse it, so the person may stay sleepy. Give naloxone anyway and keep watching their breathing.⁶

How do I know if it’s alcohol poisoning?

Passing out doesn’t mean the danger is over. Watch for someone you can’t wake, vomiting while passed out, a seizure, fewer than 8 breaths a minute or gaps of 10 seconds or more between breaths, and clammy, pale or bluish skin.⁷ Keep them on their side and stay with them. Coffee, a cold shower or walking it off won’t sober anyone up.⁷

What if they have a seizure or severe withdrawal?

Stopping alcohol or benzodiazepines (Xanax, Klonopin, Valium) suddenly can cause seizures and delirium, and both can be fatal.⁸⁹ Hallucinations or extreme agitation after cutting back are as serious as a seizure.

During a seizure, gently turn them onto one side, move hard objects away, don’t hold them down, put nothing in their mouth, and time it.¹⁰ If they’re planning to quit cold turkey, read whether it’s safe to stop at home before they start.

What if they talk about suicide?

Ask directly: “Are you thinking about killing yourself?” Asking does not plant the idea.¹¹ Stay with them or make sure someone else does, and lock up or remove firearms and stockpiled medications.¹¹

Then call or text 988 together. It’s free, open 24/7, and handles substance use crises too.¹² Veterans can press 1 after dialing.¹³

Where can we get help if it’s not an emergency?

The SAMHSA National Helpline, 1-800-662-4357, gives free, confidential referrals around the clock in English and Spanish.¹⁶ FindTreatment.gov is the federal search tool for state-licensed treatment providers.¹⁵ The behavioral health number on their insurance card will point you to in-network providers.¹⁶ And if they’re about to stop drinking or taking benzodiazepines, their own doctor or an urgent care clinic can check them the same day.

When things are calmer, the family guide to helping a loved one walks through what comes next, including how to raise getting help without a fight.

Be ready before the next crisis

0 of 4 done

Keep naloxone at home, in the car and in their bag, and show everyone where it is.
Save Poison Control (1-800-222-1222) in your phone for swallowed unknown pills or a child who got into medication.
Lock up medications and drop unused ones at a pharmacy take-back.
Ask them never to use alone or mix opioids with alcohol or sedatives.

Which page should I read next?

Get Help Now: pages in this section

1When withdrawal is dangerousIs it safe to stop at home?2Opioid overdose and naloxoneSigns and how to keep them alive 3Alcohol withdrawalTimeline, DTs and when to go to the ER 4Benzodiazepine withdrawalWhy stopping Xanax suddenly is risky 5Fentanyl and overdose riskCounterfeit pills, xylazine and mixing 6Family Emergency Action GuideA printable for the next 10 minutes 7Trusted resources and crisis numbersFree helplines, no sales pitch

Frequently asked questions

Can naloxone hurt someone who didn't take opioids?

No. It won’t harm someone who hasn’t taken opioids, so when in doubt, give it.³⁴

Can I drive them to the ER myself?

Only if they’re awake and breathing normally. Someone who is unresponsive, breathing poorly or seizing needs an ambulance, so care can start on the way.

Your next step

Print the Emergency Action Guide

How to use naloxone, step by step →Crisis numbers that aren't selling anything →

Sources

CDC — Fentanyl (June 2025). cdc.gov/overdose-prevention/about/fentanyl.html — accessed Oct 2026
CDC — Fact Sheet: Family and Caregivers, How and When to Use Naloxone for an Opioid Overdose (April 2024). cdc.gov/overdose-prevention/media/pdfs/2024/04/Naloxone-Fact-Sheet_Fam… — accessed Oct 2026
FDA — Access to Naloxone Can Save a Life During an Opioid Overdose (Consumer Update, content current as of June 2026). fda.gov/consumers/consumer-updates/access-naloxone-can-save-life-durin… — accessed Oct 2026
CDC — 5 Things to Know About Naloxone (May 2, 2024). cdc.gov/overdose-prevention/reversing-overdose/about-naloxone.html — accessed Oct 2026
FDA — FDA Approves First Over-the-Counter Naloxone Nasal Spray (March 2023). fda.gov/news-events/press-announcements/fda-approves-first-over-counte… — accessed Oct 2026
CDC Health Alert Network — Medetomidine in the U.S. Illegal Fentanyl Supply Increasing Risk for Overdose and Severe Withdrawal Syndrome, HAN-00527 (April 2, 2026). cdc.gov/han/php/notices/han00527.html — accessed Oct 2026
NIAAA — Understanding the Dangers of Alcohol Overdose. niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-dan… — accessed Oct 2026
American Society of Addiction Medicine — The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management (2020). asam.org/docs/default-source/quality-science/the_asam_clinical_practic… — accessed Oct 2026
FDA — FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class, Drug Safety Communication (September 23, 2020). fda.gov/drugs/drug-safety-and-availability/fda-requiring-boxed-warning… — accessed Oct 2026
CDC — First Aid for Seizures (May 2024). cdc.gov/epilepsy/first-aid-for-seizures/index.html — accessed Oct 2026
SAMHSA — Suicide Prevention (updated September 2026). samhsa.gov/mental-health/suicidal-behavior/prevention — accessed Oct 2026
SAMHSA — 988 Suicide & Crisis Lifeline. samhsa.gov/mental-health/988 — accessed Oct 2026
U.S. Department of Veterans Affairs — Veteran suicide prevention (Veterans Crisis Line). va.gov/health-care/health-needs-conditions/mental-health/suicide-preve… — accessed Oct 2026
SAMHSA — Opioid Overdose Prevention and Reversal (updated December 2025). samhsa.gov/substance-use/treatment/overdose-prevention — accessed Oct 2026
SAMHSA — Find Substance Use Disorder Treatment. samhsa.gov/substance-use/treatment/find-treatment — accessed Oct 2026
SAMHSA — National Helpline. samhsa.gov/find-help/helplines/national-helpline — accessed Oct 2026
CDC — Signs of Opioid Misuse, Opioid Use Disorder, and Overdose. cdc.gov/overdose-resources/pdf/Signs-of-Opioid-Misuse-Opioid-Use-Order… — accessed Oct 2026