There has been a lot of disagreement and confusion on what to do when someone overdoses. Here is the complete thread dealing with what to do when someone overdoses, how to protect yourself legally, and what can you expect.
I shall also address common misconceptions, FAQ, and the truth of what can happen.
What to do when someone overdoses
1. Call 911 or your local emergency hotline to get an ambulance over as soon as you notice
the person has overdosed. Do not attempt to drive them to the hospital yourself.
2. Report two things:
A) The person is unresponsive and is clearly dying.
B) A clear and obvious public location that is easy to locate, relatively safe, and nearby.
This can be your front porch if need be, but you need to make the victim easily recognizable from the
3. Take the person who overdosed and bring them to the reported location.
It is not necessary for you to stay with the person if you feel the location
is safe enough and you are paranoid. You may want to write "DRUGS", "COCAINE", "HEROIN", etc,
on their shirt, forehead, arm, or on like a piece of large paper you stick on them.
Plain and simple, that is all you do. Time is of the essence, and every second you waste can result in a death. You must do as above. These steps are not outlined to be callous, but the best possible way to get the person the medical attention they need as soon as possible. The only thing that matters is time.
These rules do not change in different country. You face no legal risk or consequence following these steps, and these are absolutely the best things you can do for the overdose victim. Remember, it is not about you, it is simply about getting the EMT there as quick as possible. They will know what is going on and what to do immediately, do not try to play doctor if you are not trained.
~~~~~~~~~~~~~~~~~~NEW POST ~~~~~~~~~~~~~~~~~~~~~
Why are we doing as outlined? It seems callous, mean, strange, etc...
We call 911 first thing. As soon as you know the person overdosed, you must call 911. Do not attempt to shoot them up with Narcan unless you have proper medical experience doing so and are personally qualified, and do not try to shoot them with naltrexone. While these methods may work, are you really going to bet the person's life that you can do this correctly, the first time you ever try to, under such pressure you are not familiar with? No, it would be stupid. Call 911.
Do not attempt CPR either unless you have taken official classes learning how to do so. Even when done correctly, CPR often results in broken ribs and permanent damage. I cannot stress enough that you should not attempt CPR at all unless you are a medical professional, you can kill someone if you do it wrong, such as by puncturing a lung or artery. Do not mess with the body at all, just get it out in the open for the EMT to pick up easily.
We all have problems, and there is no reason to be ashamed to admit that if someone overdoses on their own drug use and their own fault, that you would rather they die than ruin your life with possible drug charges. This is perfectly normal. However, saving a life and looking out for Numero Uno are not independent of each other. You can make sure you avoid legal repercussion, and save a life.
Knowing this, there is no excuse for why you didn't call 911 when someone overdoses. If you are in a house of junkies, explain clearly to them that you intend to take the individual somewhere else, and that they face no risk of legal trouble since you are going to report it as a heart attack and leaving them somewhere else. The last thing you need is a junky cutting the phone line to prevent you from calling help.
How do I know it's an overdose?
- Lips, tongue, nail beds, earlobes, or skin are blue or purple
- Breathing is less than once every five seconds or stopped altogether
- Pulse is slow or there is none at all
- They start to seize, and lose control of motor functions.
- A person who has O.D.'d may be able to breathe and to look at you but not talk
- They may be unconscious, and are unresponsive!
What to say on the phone
Why are we reporting it as an unresponsive person and not a drug overdose?
Simple - Unresponsive person and drug overdose both get the same priority - Number 1 (or "Code Blue"). So you are not going to cause someone else to die because the ambulance went to you first instead of another call (although nothing is more pressing than a drug overdose). Also, while as much as you may think America is overzealous in anti-drug law, we are not going to let someone die. EMT respond just as quickly.
If this is the case, so why are we calling it an unresponsive subject? Well, given that they are both treated exactly the same in terms of response, it is quite simply for legal protection. The person who overdosed may not be too happy to wake up with a court summons when he comes to.
It is in fact true, that in many areas police are actually required to appear if a drug overdose is called in, and distribute charges to any drugs or paraphernalia found, including those of the person who made the call and the victim. In some areas, you can even receive a possession charge simply by being under the influence, which is relatively new legislation reasoning that you must have at one point possessed the drug, proof of which is your dirty system. Even admission of drug use at one point can be enough evidence to warrant a possession charge in some states.
By calling in a heart attack, you effectively leave the police out of the situation, and get the medical attention all the same. Many people have received felony charges simply from being an overdose victim or the conscientious caller. Also, you do not risk any charges simply because you called in "unresponsive person" instead of drug overdose. The truth of the matter is that the person is indeed unresponsive.
Please, do not be a fucking retard and say "heroin overdose" simply because you love the person and want to do what's right. I understand the heat of the moment and you may say drug overdose, but unresponsive subject gets the same treatment, is technically true, and the EMT are trained to know what is going on immediately. When it is reported as such, the EMT are preparing for possible drug overdose on the way over.
This has been researched by contacting multiple EMT offices, by the way.
~~~~~~~~~~~~~~~~~~~~~~ NEW POST~~~~~~~~~~~
Why are we moving the victim?
So why are we reporting the location of somewhere else, and not just calling the ambulance to where I am now? Isn't this just being an asshole and trying to save my own ass at risk of the victim?
No. While the ambulance is fast, it still takes them at least a minute or two to get there. This is the time spent taking the victim to the location reported.
Where am I taking them somewhere else, and why?
You are taking them to a highly visible, well known location. Preferably, on the main road of transit to get to your place from the hospital, or at least, as close as you can get in reasonable time. A street corner, a gas station, a traffic light intersection, notable land marks, are all considerable places to take the victim.
Also remember that an unconscious body is extremely heavy! Call in a realistic location, and if you do not think you could get far, then call in close by. Even the front porch, the point is you need to get the body outside so the EMT can do their job quickly. A stretcher is a pain in the ass to get through a door or up stairs.
This is because many times, ambulances do get lost. You are trying to help the ambulance reach the victim quicker this way. If you report an address, this may cause the ambulance to take a wrong turn, have to delay their arrival by checking street signs, et cetera. You want to take the victim somewhere easy for the ambulance to locate. The idea is that the ambulance is driving down main street to you and can pick you up without stopping.
Remember, the main cause of traffic delay (not with ambulances, just in general and commuting) is having to stop and make turns. You are trying to help the ambulance effectively make a straight line from the hospital to the victim. Many neighborhoods are just plain confusing as well, and even GPS can't change the fact that it is impossible to see street addresses at night even when they are lit up and the fact so many neighborhoods are not conventional in how they are addressed.
This is not done to protect you or save your ass. This it to make sure the ambulance gets to the victim as soon as possible. It is well known that ambulances have been lost in transit. Just think of how many times you've gotten lost driving.
If you cannot, for whatever reason, take them all the way to the street corner or on the main road, you can leave them on the front porch, on the sidewalk, et cetera. The main point is so the EMT will see the victim from the street immediately, and to be able to spend less time making many turns navigating around the area. We want the EMT to the victim as soon as possible, this has nothing to do with saving your ass.
Why am I dumping the body? You stated I didn't have to stay there, isn't this an asshole thing to do?
Preferably you took the body somewhere safe and well lit. If there is no such place, and you think that you couldn't even leave the body for a minute without fear of him being molested, perhaps calling in your immediate location is better.
You do not have to stay with the individual, the EMT will take care of them and realize what is going on as soon as possible. You can scribble "HEROIN" or "DRUG OVERDOSE" or "COCAINE", et cetera, with pen on their shirt or easily on their body, so EMT can get an idea of what is going on. If you choose to stay with the body, it may be a good idea to mention you suspect drug use.
However, if you are paranoid, you can leave the scene, or watch from afar. This guide is not here to make moral arguments. This article is purely for harm reduction. The main focus is to make sure someone gets the medical attention they need as soon as possible, not our own shortcomings as humans in life.
Obviously, the most caring thing you can do is stay with the individual, and there is absolutely nothing wrong with that. This guide is posted with the notion in mind that many of those involved are doing something illegal, and may be paranoid. The point of this guide is to get those who would normally not call 911 for fear of legal trouble, to calling 911 and realizing you can protect yourself. If you wish to stay with the person who overdosed, that is great. It still is important, however, that you move the body to an easy, well known location so the EMT can get there quicker without the possibility of them getting lost.
~~~~~~~~~~~~~~~~~~~~~NEW POST ~~~~~~~~~~~~~~
Common Myths, Misconceptions, and FAQ
I really care about this person, I could not do this I would go crazy!
If you really care for the person, you can stay with them the whole time. It is still important that you move the body to a location the EMT can get to easily, like an intersection on the main road or by a gas station. You still do everything as outlined above. It is a harrowing experience, but you just need to sit tight, remain calm, and focus on getting the EMT there as soon as possible. Don't try to fix them yourself!
This guide was written with the person who would normally run away and not call for help because of fear of trouble, in mind, however, you still do the same things as you would if you were a conscientious person. You do not need to bring legal trouble around and can still get the same medical attention.
I'm a fast driver! I'm going to drive to the hospital
Do not do this! Even if you are an overly concerned person, do not make this fatal mistake! The time it takes for you to load the body and drive to the hospital is much longer than it would take for the EMT to get to you! The steps outlined above are not a guide to "how to protect you ass" but "how to get the EMT there as quick as possible". By driving to the hospital you are simply being egotistical and conceited - do not do this, this is not the time to feed your ego. You may also kill someone by driving recklessly. The amount of pressure given the situation, I seriously doubt anyone in the world could drive safely.
What if I have Narcan, Suboxone, Naltrexone, etc?
Unless you are qualified and experienced, you should not rely on these. This is someone's life we are talking about, and if you fail you will be responsible for their death. Are you willing to bet you know exactly what you are doing and can handle the pressure? Are you willing to bet their life and the possibility of knowing you killed someone?
I hope not. Call 911 immediately. If you feel you know what you are doing, you can do this while you wait for the ambulance. If successful, you may be able to leave the scene before they arrive and call saying false alarm. If not, well, the EMT can make sure it's done right.
Narcan is usually administered intravenously (intramuscularly if IV is unavailable, in the thigh or shoulder) with a dose of around .4-2mg, and re-administered every 30 minutes. Narcan is an opiate antagonist, meaning it pulls the opiate off the receptors. It does not metabolize the opiate, meaning that the drug is still in their system at dangerous levels. It is quite possible that the victim can be injected with narcan, snap out of an overdose, only to die 30 minutes later when it wears off. The victim needs supervision.
If all you have is Naltrexone pills, you need to use only a minute amount. Remember, Naltrexone is usually given in 50mg pills, so know what the strength is first. You can attempt to make 1/25th of this, which is less than a quarter of the pill, mix it with water, and filter it with a cotton or micron filter, preferably at least twice or three times. You can shoot this as you would Narcan - an opiate overdose is more pressing than the possibility of an abscess. To divy it into a 25th, cut the pill in half, mix it with 2 ml (or CC) of water, then inject 20 units of the solution. Given the complication of this process and the essence of time, you must call 911 first and then can do this as you wait.
Do not use Suboxone, or administer Suboxone in any way! While there is Naloxone in it, the main ingredient in Narcan and Naltrexone, the binding affinity of buprenorphine, the main opioid in it, is extremely high, so high that it rivals the Naloxone. By administering Suboxone to an overdose victim you may very possibly be effectively increasing the amount of opiates in their system. In plain English, don't use Suboxone, it won't work, and will make the EMT's job harder.
Also note that while the common dosage is around 2mg for Naltrexone HCl, it can vary greatly depending on how strongly the opiate in question binds to receptors, therefore varying the effectiveness of Narcan and Naltrexone HCl, and quite simply that certain individuals have differing chemistry and under different doses; it is not uncommon that doses higher than 10 mg are needed. Always call 911 first, than you can attempt to help them yourself. Do not gamble that you will do it correctly, because if you fail then the death is your fault.
Won't a cold shower/cold ice/ice in the groin/etc... work?
No, they will not. Often a major problem with stimulant and cocaine overdose is that the person suffers life threatening hyperthermia, or that their body overheats. If someone is sick, and not overdosing, ice/cold water may help. But if they are in a life threatening situation, or even seizing or unconscious, ice/cold will not do enough to save the person.
You can put ice or water on them while you wait for 911, but they won't save the individual. All this may do is lessen the extent of brain damage once they come to. Call 911 first, then you can try out the water.
Also, you may end up drowning the individual or putting them into shock.
What about shocking the individual to wake up, like punching them, sticking my finger down their throat, kicking them, ice water in the groin, or hot water?
Do not do this, you may cause physical damage to their body, and it won't help to bring them back.
Many people try to "slap" or use cold/hot water to bring a person back. If they have effectively overdosed, this will not help as their central nervous system is unresponsive and essentially turned off. They will feel nothing.
What if I give them some Xanax/Pills or coffee or water etc...
Do not put stuff in their mouth or nose, they may drown on it or choke. It won't do anything to help them either.
Can I shoot them up with Milk/Orange Juice/Salt Water, etc...?
No, this is an old junky's tale.
Shooting up an individual with anything organic or organic based is extremely dangerous, and very likely can result is anaphylactic shock - an extreme allergic reaction where antibodies will attack in a self-damaging manner, and can result in death. This is an attack on foreign proteins, which are comparable to bacteria and the like, which your immune system will attack viciously.
Can I balance out their system, by shooting a heroin victim with coke, or a coke victim with heroin?
No, it doesn't work like that. The flood of cocaine/stimulants can actually paralyze your heart tissue which may cause an overdose, which won't change if you inject heroin. If you inject coke, this will do nothing to remove the heroin from their receptors and cause your CNS to start working.
The human body isn't some sort of balance scale. This does not work at all, and only further serves to complicate things and lead to death. In many cases, the mix of heroin and cocaine can actually complement each other to make death more likely. This is very stupid, elementary logic, don't do it...
Too many times people refuse to call 911 to avoid legal repercussion - there's nothing wrong with wanting to avoid the law. However, little do people know that you can address an overdose victim without the possibility of getting yourself in trouble.
Also, too many times people are the opposite - they feel they must do everything they can to save the person, and by doing so actually cause their death. Do not attempt to drive the person to the hospital! The ambulance can get their and back 5 times before you can get there because they can speed through traffic and in some places, have all lights turned green for them. This can also prevent you from facing legal trouble or putting lives in risk due to wreckless driving.
Don't kill someone driving someone to the hospital. Don't have the overdose victim die while you fumble around driving to the hospital yourself or doing something stupid. Do not be so egotistical and conceited.
Call 911 first thing. Move the body somewhere easy for the ambulance to pick them up. Report it as a heart attack to avoid the law and get the same attention.
Do not attempt to cure them without help on their way, do not attempt to drive the victim to the hospital yourself!
These steps are designed to get the help there as fast as possible. It is only by consequence they keep you safe from legal trouble. Given this, there should be no reason a house full of junkies will refuse to serve an overdose victim the right attention. If you are concerned, you can stay with the individual the whole time. Just do not attempt to drive them yourself, do not attempt to cure them without calling 911 first, and always make sure to move the individual somewhere the EMT can get to easily.
Take note that being in the situation, and reading it about it are completely different. I know when someone overdosed on me, it was the scariest moment in my life. Sometimes you may not remember all these steps, or you'll just freak out. That's normal, just make sure to get the help they need.
Thanks to so many in the Other Drugs Community for contributing, and I especially want to thank sixpartseven for so much help, especially in making this guide come true.