How to Respond to a Drug Overdose: Naloxone, Rescue Breathing & CPR

The opioid crisis continues to devastate communities across America. According to the CDC, over 107,000 people died from drug overdoses in 2023, with opioids — including fentanyl, heroin, and prescription painkillers — responsible for the vast majority. The American Heart Association has updated its guidelines to include opioid-associated emergencies, recognizing that bystander intervention saves lives.

Recognizing an opioid overdose is the critical first step. Key signs include: unresponsiveness or inability to wake the person, slow, shallow, or completely absent breathing, pinpoint (very small) pupils, blue or grayish lips and fingertips (cyanosis), gurgling or snoring sounds, and a limp body. If you suspect an overdose, do not wait to be certain — act immediately.

Step 1: Call 911 right away. Florida's 911 Good Samaritan Act provides legal protection for people who call for help during an overdose emergency. Do not let fear of legal consequences prevent you from making the call. Time is the most critical factor in overdose survival.

Step 2: Administer naloxone (Narcan) if available. Naloxone is a life-saving medication that rapidly reverses the effects of opioids. It is available as a nasal spray (Narcan) without a prescription at most pharmacies in Florida. To use the nasal spray: tilt the person's head back, insert the nozzle into one nostril, and press the plunger firmly. If there is no improvement after 2 to 3 minutes, administer a second dose in the other nostril.

Step 3: Open the airway and provide rescue breathing. The AHA recommends that for opioid overdose victims who have a pulse but are not breathing adequately, rescue breathing is the priority intervention. Tilt the head back, lift the chin, pinch the nose closed, and deliver one breath every 5 to 6 seconds. Each breath should last about one second and make the chest visibly rise. Continue rescue breathing until the person starts breathing on their own or EMS arrives.

Step 4: If there is no pulse, begin full CPR immediately. Perform 30 chest compressions followed by 2 rescue breaths. Push hard and fast — at least 2 inches deep at a rate of 100 to 120 compressions per minute. The AHA emphasizes that for overdose victims, ventilation (rescue breaths) is especially important because the primary problem is respiratory failure, not a cardiac rhythm issue.

Important considerations: Place the person in the recovery position (on their side) if they begin breathing on their own but remain unconscious. This prevents choking if they vomit. Naloxone wears off in 30 to 90 minutes, and the opioid effects may return — so never leave the person alone even after they appear to recover. Stay with them until paramedics arrive. Our BLS and First Aid courses in Tallahassee now include hands-on naloxone training so you are prepared to respond confidently in these emergencies.