sofidexFor patientsAre you a clinician? Clinical site

Warning-sign checks

Heroin overdose: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Call your local emergency number now if someone:

    • Cannot be woken or is only briefly responsive
    • Is breathing slowly, irregularly, or not at all
    • Makes choking, gurgling, or unusual snoring sounds
    • Has blue, gray, or very pale lips, gums, or skin
    • Collapses after taking heroin or an unknown drug
    • Improves with naloxone, because breathing can slow again

    Give naloxone if available and follow emergency-dispatch instructions for rescue breathing or CPR.

    Stay until help arrives.

    Calling for help is appropriate even when you are unsure whether opioids were involved.

    And for anyone, someone who:

    • is unconscious, or cannot be woken
    • you believe has taken an overdose or swallowed something poisonous
    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
  2. 2

    Is any of this happening?

    Be seen today

    Seek prompt medical advice after discharge for worsening cough, fever, chest pain, shortness of breath, severe muscle pain, dark urine, confusion, weakness, or new problems with memory or movement.

  3. 3

    Does any of this apply?

    Book an appointment

    Arrange routine follow-up after any non-fatal overdose, even if you feel well.

    Follow-up can address lung or injury symptoms, replace naloxone, test for infections when relevant, and connect you with opioid use disorder treatment.

    And for anyone, someone who:

    • is having side effects from a medicine, or is struggling to take it as prescribed

Every sign above is quoted from the sofidex article on Heroin overdose. If you are not sure, err upward — it is always reasonable to be checked.