An overdose can happen to anyone, and knowing how to recognize the warning signs can save a life. While many people are familiar with the term overdose, they may not know what one looks like or how to respond. Understanding the risks, recognizing the signs, and knowing when to seek emergency help can make a critical difference.
According to Centers for Disease Control & Preventions (CDC) data, an estimated 69,973 people died from drug overdoses in the United States in 2025. Behind every number is a person whose life mattered, along with families, friends, and communities affected by their loss.
At Rise Recovery, we believe education, prevention, compassion and access to support are essential to building healthier communities. Since 1977, we’ve served individuals and families in San Antonio, helping people navigate the challenges associated with substance use and recovery.
Whether you’re concerned about someone you care about or simply want to be prepared, understanding overdose response is the first step.
and our team includes peer recovery specialists with lived experience who understand substance use disorder from the inside. We created this guide to give you clear, practical information on what an overdose is, why it happens, how to spot one, and exactly what to do. If anything here raises questions about someone you love, don’t hesitate to reach out.
What Is an Overdose?
An overdose occurs when a substance, medication, or combination of substances overwhelms the body's ability to function safely. An overdose may be accidental and does not necessarily mean a person has a substance use disorder. It can occur with prescription medications, nonprescribed substances, or combinations of substances. The effects vary depending on the substance involved.
Opioids, including fentanyl and certain prescription pain medications, can dangerously slow or stop breathing. Without sufficient oxygen, a person can experience permanent injury or death.
Alcohol and other depressants, including benzodiazepines, can also suppress important bodily functions. Combining them with opioids significantly increases the risk of overdose.
Stimulants, such as cocaine and methamphetamine, may cause dangerously elevated body temperature, irregular heartbeat, seizures, heart attack, or stroke.
Regardless of the substance involved, a suspected overdose is a medical emergency that requires immediate attention.
Why Do Overdoses Happen?
Several factors can increase overdose risk, including circumstances a person may not recognize or anticipate.
1. Unexpected fentanyl exposure - Illicitly manufactured fentanyl may be present in counterfeit pills or other unregulated substances without a person's knowledge. It cannot be reliably identified by appearance, smell, or taste, and the amount may vary considerably.
2. Taking additional doses before the effects are fully felt - Some substances take longer to produce noticeable effects. Taking additional amounts before the initial dose has taken effect can increase overdose risk.
3. Combining substances - Mixing substances can produce unpredictable and dangerous effects. In particular, combining opioids with alcohol or benzodiazepines can severely suppress breathing.
4. Changes in tolerance - A person's tolerance can decrease after a period without opioid use, including following treatment, hospitalization, or incarceration. Returning to a previously used amount can significantly increase overdose risk.
5. Being alone during an overdose - When someone experiences an overdose without another person present, emergency assistance and lifesaving interventions may be delayed.
Understanding these risk factors can help individuals, families, and communities make informed decisions and prepare for emergencies.
How to Spot the Signs of an Overdose
Signs of an opioid overdose may include:
Very small, "pinpoint" pupils
Falling asleep, losing consciousness, or not responding when you shout or shake them
Slow, weak, or stopped breathing
Choking, gurgling, or snoring sounds
A limp body
Cold, clammy skin
Pale, blue, or gray lips and fingernails
Signs of a stimulant overdose may include:
Hot, flushed, or sweaty skin
Chest pain or a racing, irregular heartbeat
Severe agitation, panic, paranoia, or hallucinations
Confusion or disorientation
Rigid muscles, tremors, or seizures
Trouble breathing
If you suspect someone is experiencing an overdose, do not wait for every symptom to appear. Call 911 and seek emergency assistance.
What to Do If Someone Is Overdosing
Responding quickly can save a life. You do not need to know exactly which substance was involved to take action.
Check for a response. Make sure the area is safe before approaching before trying to wake them. Speak loudly to the person and gently tap their shoulders to see whether they respond.
If the person is unresponsive or not breathing normally, treat the situation as a medical emergency.
Call 911. Tell the dispatchers the person’s location, whether they are responsive and/or breathing normally. If someone else is with you, have them call while you do the next step. Follow the dispatchers instructions and do not delay seeking emergency help.
Administer naloxone (Narcan) if an opioid overdose is suspected. Naloxone is a medication that can temporarily reverse the effects of an opioid overdose. If naloxone nasal spray is available, administer it accordingly to the product instructions. If normal breathing does not return within two to three minutes, give another dose using a new device. Additional doses may be needed.
Naloxone will not reverse overdoses caused solely by alcohol, benzodiazepines or stimulates. However, it can be administered when opioid exposure is suspected, even if you are unsure which substances were involved.
Support them breathing. If the person is unresponsive and not breathing normally, begin normally, begin CPR. Otherwise, roll the person onto their side so they won't choke.
Stay until help arrives. Continue monitoring their breathing and responsiveness. Even when naloxone restores breathing, emergency medical evaluation remains important. Its effects may wear off before the opioids have left the person’s system, and overdose symptoms may return.
Naloxone only reverses opioids, but it is safe to give even if you aren’t sure what the person took. Because fentanyl is often mixed into stimulants and other drugs, give it to anyone who is unresponsive or struggling to breathe. For someone showing stimulant overdose signs, call 911, move them somewhere quiet and cool, and clear away anything they could hit if they have a seizure.
Fear of legal trouble keeps some people from calling for help. Texas law offers a limited legal defense to people who call 911 for a possible overdose, stay on the scene, and cooperate with responders. It has conditions and doesn't provide full immunity, but a person's life comes first. Always make the call.
How Rise Recovery Can Help
The best time to get naloxone is before you need it. Rise Recovery offers a free Narcan vending machine in the lobby of our campus. Keep a dose in your car, your bag, or your first aid kit. Naloxone nasal spray is also sold over the counter at pharmacies.
An overdose is often a sign that someone needs ongoing support. Rise Recovery serves young people, adults, and families across Bexar County through peer recovery support, family programs, telehealth, school-based services, and Rise Inspire Academy, our recovery high school. Our youth and family peer support services are available at no cost, regadless of ability to pay.
If you're worried about someone's substance use, or about your own, you don't need to have it all figured out before seeking help. Contact Rise Recovery today to talk to someone about recovery support.
If someone is overdosing right now, call 911.
