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Warning-sign checks

Opiate and opioid withdrawal: 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 emergency services if someone:

    • Cannot be woken or stay awake
    • Has slow, irregular, or stopped breathing
    • Has blue, grey, or unusually pale lips or skin
    • Makes choking, snoring, or gurgling sounds

    These are signs of opioid overdose, not ordinary withdrawal.

    Give naloxone if it is available, call emergency services, and provide rescue breathing or cardiopulmonary resuscitation if trained.

    Stay with the person because more than one naloxone dose may be needed.

    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 unconscious, or cannot be woken
    • 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
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Prompt assessment is particularly important if you are pregnant, have a serious heart or lung condition, use alcohol or sedatives regularly, or have had severe withdrawal before.

    Seek urgent medical care if you cannot keep fluids down, have persistent severe diarrhea, are passing very little urine, feel faint, become confused, or develop a fast or irregular heartbeat.

    Seizures, hallucinations, chest pain, severe abdominal pain, or thoughts of self-harm also require urgent assessment.

  3. 3

    Does any of this apply?

    Book an appointment

    Arrange medical advice before reducing or stopping an opioid that you use regularly.

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