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Overdose overview

Similar to rising trends across the nation, overdose deaths in Pennsylvania have been on the rise over the last two decades.  According to the Centers for Disease Control, heroin and opioid overdose are the leading cause of accidental death in Pennsylvania, killing more individuals than those involved in fatal motor vehicle accidents. 

What is an overdose?

An overdose means having too much of a drug or alcohol, or a mix of drugs and/or alcohol for your body to safely handle. It's possible to have too much of any drug and the signs of an overdose can look different depending on the drugs.

What to do

  • Call 911 immediately if you can't get a response from someone.
  • Stay with the person.  If you have to leave the person alone or if they throw up, lay the person in the rescue position - on their side, hand supporting the head, mouth facing downward, and a leg on the floor to keep the person from rolling.
  • If the person is not breathing, perform rescue breathing.
  • In the case of an opioid overdose, give the person Narcan (Naloxone), if it is available.

Signs of an overdose

Opioid or depressant overdose

  • Slow and shallow breathing
  • Very sleepy and unable to talk, or unconscious
  • Blue lips or fingertips
  • Snoring or gurgling sounds

Amphetamine or another stimulant overdose

  •  Amphetamine-induced psychosis (paranoia, hallucinations, delusions)
  • Overheating, dehydration, high blood pressure, and an increased risk of seizures

Alcohol poisoning/overdose

  • Confusion
  • Difficulty remaining conscious
  • Slow breathing or gaps in breathing
  • Clammy skin
  • Vomiting; seizures; slow heart rate; dulled responses, such as no gag reflex (which prevents choking); and extremely low body temperature

Avoiding an overdose

Be careful when taking prescription medications and over-the-counter medicines as you can overdose on these too. With all medications, read the instructions and speak to your doctor/pharmacist to make sure you take the correct dose.

  • Taking more than one drug can increase the effects and risk of overdose.
  • Taking a drug regularly can increase your tolerance to it.  This means your body may get used to the amount of a drug that you are taking and it may take more of it to feel the same effect.  Be careful not to exceed the recommended dosage.
  • If you haven’t used a substance for some time, you may not be able to “handle” the same amount as when you last used. 
  • Some drugs have a long half-life or amount of time it takes for the substance to leave your body.  While you may not feel its effect the next time you use it, it may still be in your system.  Keep this in mind when taking the next dose.
  • Take medicines only in the amount and as often as directed.
  • To avoid children accidentally overdosing on prescription drugs, all medications should be properly stored and disposed of at a local Prescription Drug Take-Back Program.


Tolerance is your body’s ability to process a certain amount of a drug.  Low tolerance means that your body can only process a small amount of a drug (i.e., it takes fewer drugs to feel the effects) and increased tolerance means your body has learned how to process increased amounts of the drug (i.e., it takes more drugs to feel the effects).  Tolerance develops over time, so the amount of a drug a long-time user needs to feel the drug’s effects is a lot greater than a new user.  Tolerance also wavers depending on several factors including, weight, size, illness, stress, compromised immune system, and age.

Most importantly, tolerance can decrease rapidly when someone has taken a break from using a drug whether intentionally – for example, while in drug treatment or on methadone detox – or unintentionally – for example, while in jail or the hospital.

Research has also shown that tolerance is affected when a person uses drugs in a new or unfamiliar environment, and therefore at a higher risk for overdose. Tolerance is a risk factor for an overdose in a couple of ways:

  • As a person’s tolerance increases, he needs to take more of the drug to get the same effect which can lead to using more than the body can safely handle.
  • If for any reason, a person has taken a break from using, he may assume that he can still use the same amount as before, when in fact, his body is no longer accustomed to it and overdose can occur.