Opioid Overdose Signs: What to Watch For and How to Act

When someone is experiencing an opioid overdose, a life-threatening reaction to too much opioid medication or illicit drug use. Also known as opioid poisoning, it happens when breathing slows or stops because the brain can’t signal the body to breathe. This isn’t rare—overdoses are climbing, and many people don’t know the signs until it’s too late. The key isn’t just knowing opioids are dangerous; it’s recognizing the exact moment something is wrong.

Look for three clear signs: slow or shallow breathing, unresponsiveness, when a person doesn’t wake up even when shaken or shouted at, and pinpoint pupils, extremely small pupils that look like pinpricks, even in low light. These aren’t vague symptoms—they’re red flags that mean the body is shutting down. Someone might also have blue or gray lips and fingernails, cold clammy skin, or gurgling sounds like they’re drowning in their own saliva. If you see even one of these, don’t wait. Don’t assume they’re just asleep. Don’t try to wake them with coffee or a cold shower. Time is the one thing you can’t get back.

Many people don’t realize that naloxone—a medication that reverses opioid overdoses—is available without a prescription in most places. It’s not a cure, but it buys you minutes. Keep it handy if you or someone you know uses opioids, even if it’s just for pain. And if you ever have to use it, call 911 anyway. Naloxone wears off faster than some opioids, and the person can slip back into overdose. This isn’t about fear—it’s about preparedness. You don’t need to be a medic. You just need to know what to look for and act fast.

Below, you’ll find real stories and facts from people who’ve been through this—whether they were the one overdosing, the one who found them, or the one trying to help. These aren’t abstract medical cases. They’re about moms, brothers, coworkers, neighbors. And they all started the same way: someone noticed something was off—and did something about it.