Every year, more than 100,000 people in the U.S. die from drug overdoses-and most of those happen at home. If someone in your family uses drugs, whether legally prescribed or not, knowing how to spot an overdose could save their life. You don’t need to be a doctor. You just need to know what to look for and what to do next.

What an Overdose Really Looks Like

People often confuse being high with an overdose. That’s dangerous. Someone who’s high might be dizzy, giggly, or sleepy-but they’ll still respond if you shake them or call their name. Someone overdosing won’t. Not at all.

For opioid overdoses-which include heroin, fentanyl, oxycodone, and even some prescription painkillers-the signs are clear and urgent:

• Unresponsive: Shout their name. Rub your knuckles hard on their sternum (center of the chest). If they don’t move, react, or open their eyes, it’s an overdose.
• Slow or stopped breathing: Watch their chest. If they take fewer than one breath every five seconds, or if their breathing sounds like gasping or gurgling, they’re not getting enough oxygen.
• Blue or gray lips and fingernails: This is a sign of low oxygen. On lighter skin, it looks blue or purple. On darker skin, it looks grayish, ashen, or dull. Don’t wait for blue-gray is just as bad.
• Clammy, cold skin: Their face and body may feel wet and cool, even if the room is warm.
• Limp body: They’ll slump like a ragdoll. No muscle control.

Stimulant overdoses-like from cocaine, meth, or Adderall-look different. Watch for:

• Extreme high body temperature (over 104°F)
• Seizures or shaking
• Chest pain or racing heartbeat
• Confusion, aggression, or hallucinations

And here’s the truth: if you’re unsure, treat it like an overdose. Waiting to be sure can cost a life.

Why Family Members Are the First Responders

About 78% of overdose deaths happen in private homes. That means the person who finds them isn’t a paramedic-it’s you. A parent. A sibling. A partner.

Research shows that when family members act fast, overdose deaths drop by up to 40%. Why? Because emergency services take time to arrive. In the critical minutes after breathing stops, brain damage starts. But if someone with naloxone (Narcan) is there, they can reverse it.

Naloxone works in under two minutes. It’s safe. It doesn’t work on non-opioid overdoses, but it won’t hurt someone who isn’t overdosing. If you’re not sure, give it anyway.

How to Teach It-Without Scaring Them

Teaching family members isn’t about giving a lecture. It’s about practice. Studies show that people remember 73% more when they practice what to do, not just hear about it.

Here’s how to do it right:

1. Start with a calm conversation: Say, “I care about you, and I want to make sure we’re ready if something happens.” Avoid blame. Focus on safety.
2. Use real examples: Show them videos or stories from real families who reversed overdoses. The Overdose Lifeline YouTube channel has short, powerful clips that show exactly what to look for.
3. Practice with a training kit: Buy a naloxone training kit (they’re $35 and don’t contain real medicine). Use it on a mannequin or even a pillow. Practice giving the shot or nasal spray. Do it three times. Muscle memory saves lives.
4. Use skin tone guides: Many people miss overdose signs on darker skin because they’re taught to look for blue. Show them how gray, ashen, or pale skin can mean the same thing. The CDC and California Health Department have free printable guides.
5. Role-play the call to 911: Teach them to say: “My family member isn’t responding, isn’t breathing, and I’ve given Narcan.” That gets help there faster.

One dad on Reddit said: “After practicing with the training kit three times, I recognized my son’s overdose immediately. I gave Narcan before EMS got there. He’s alive because we practiced.”

What to Do When You See an Overdose

When you spot the signs, follow this simple sequence: Recognize, Respond, Revive.

• Recognize: Check for unresponsiveness, slow breathing, and skin color changes.
• Respond: Call 911 right away. Even if you give Narcan, they still need medical help. Overdose can come back.
• Revive: Give one dose of naloxone (nasal spray or injection). If they don’t wake up in 2-3 minutes, give a second dose. Start rescue breathing if they’re not breathing. Push hard and fast on their chest-30 compressions, then two breaths. Keep going until help arrives.

Don’t wait for signs to get worse. Don’t try to wake them with cold showers or coffee. Don’t leave them alone. And don’t be afraid to use Narcan. It’s not a last resort-it’s the first step.

Getting Naloxone Is Easier Than You Think

In 31 states, you can walk into a pharmacy and get naloxone without a prescription. In 19 others, you need to complete a short training first-but that training is often free at community centers, clinics, or online.

The Harm Reduction Coalition and SAMHSA offer free training materials and sometimes free naloxone kits. Local health departments in Halifax and across Canada also distribute them at no cost. Ask your pharmacist. Call your city’s public health line. It’s not hard to get.

Keep one in your car. One in your purse. One in your kid’s backpack. You never know when it’ll be needed.

What to Do After

After you’ve reversed an overdose, the person will likely be confused, scared, or angry. That’s normal. Don’t lecture them. Don’t say “I told you so.” Just say: “You’re safe. We’re here.”

Then, plan the next step. Talk to a counselor. Look into harm reduction programs. Ask about medication-assisted treatment (like methadone or buprenorphine). Recovery isn’t a single event-it’s a process. And your support matters more than you know.

Common Mistakes to Avoid

• Waiting to see if it gets worse: The longer you wait, the less chance they have.
• Thinking only opioids are dangerous: Fentanyl is in almost every street drug now-even pills that look like Xanax or Adderall.
• Assuming they’re just drunk or high: Overdose doesn’t always look like a passed-out person. Sometimes they’re just very still.
• Not practicing: Stress makes you forget. Practice makes it automatic.
• Feeling guilty for teaching: Some families think talking about overdose “jinxes” it. But research shows training reduces fear and increases survival.

Resources You Can Use Right Now

• NIDA’s Overdose Recognition Guide (updated September 2023) - Free downloadable PDF
• Overdose Lifeline App - Free app with step-by-step video instructions
• SAMHSA’s ‘Stop Overdose’ Curriculum - Used in all 50 U.S. states
• Canadian Overdose Prevention Society - Offers free naloxone and training across Canada
• Local pharmacies - Ask for naloxone and training. Most will give it to you.

You don’t need to fix everything. You just need to be ready. One trained family member can make the difference between life and death.