Overdose - what to do in an emergency

What is an overdose?

Alcohol, medications, illegal drugs and some herbal remedies can cause harm if you take too much. A drug overdose is when someone takes a toxic (poisonous) amount of alcohol, drugs or medicine.

Although not all overdoses are fatal or life threatening, always seek medical advice if you suspect an overdose has occurred.

If someone needs urgent medical attention, call triple zero (000) and ask for an ambulance immediately.

Learn more about what causes drug overdose and how to prevent it here.

Drug overdose symptoms

Symptoms of a drug overdose or alcohol poisoning may include:

• nausea and vomiting
• severe stomach pain and abdominal cramps
• diarrhoea
• chest pain
• dizziness
• loss of balance
• loss of co-ordination
• being unresponsive, but awake
• limp body
• seizures (fitting)
• drowsiness
• confusion
• agitation
• paranoia
• slow or erratic pulse
• difficulty breathing, shallow or erratic breathing or not breathing at all
• hallucination
• visual disturbances
• choking or gurgling sounds
• snoring deeply
• blue fingernails or lips
• pale or clammy face
• loss of consciousness.

The Alcohol and Drug Foundation has more information about different types of drugs, their effects and risk factors.

Who to call during an overdose

If a person is physically unwell or unconscious, they need urgent medical attention – call 000 and ask for an ambulance.

Emergency phone operators are trained to help you and can provide advice about what you need to do while you're waiting for emergency services to arrive.

Police do not routinely attend alcohol poisoning or drug overdose emergencies, but you should tell the emergency phone operator if you think someone might harm themselves or others.

What to expect during the call to triple zero (000) – ambulance

When you call triple zero (000), you will be asked which service you require. Tell the operator that you need an ambulance – you will be transferred to an ambulance operator and asked for the following information:

• The location you need the ambulance to respond to. If the address if known, provide this to the operator.
• If the address is not known, be sure to tell the operator any additional information that may assist. This may include street or road names, parks emergency marker details, or any other landmarks nearby.
• Details of the situation and what has happened.
• How many people require medical assistance.
• The injured person’s age and sex.
• Whether the person is conscious or breathing.
• What the person has taken (if known).

The operator will organise assistance for you while you continue talking on the phone, even though you may not hear them do this.

Answer any of the operator’s questions as this can help the paramedics prepare their response before they reach you.

The operator may give you first aid instructions over the phone.

Tell the operator if you have naloxone on-hand. Naloxone is a medication used to reverse the effects of opioid drugs like heroin and morphine.

Do not hang up until the phone operator tells you to.

Emergency markers for difficult to find locations

Emergency markers are in locations with no set address (such as beaches, parks and trails) or places that are difficult to find. They are designed to pinpoint your exact location during an emergency.

What happens in the hospital emergency department for overdose?

Treatment for a drug overdose or alcohol poisoning starts as soon as the person arrives at the emergency department.

On arrival, they see a specialist emergency nurse called the triage nurse who assesses how serious their condition is.

In Australia, the triage system is used to guide hospital staff to see patients according to how sick they are.

This system allows patients with life-threatening problems to be seen first.

In general, the triage system has five levels:

• Level 1 – immediate – life-threatening
• Level 2 – emergency – could become life-threatening
• Level 3 – urgent – not life-threatening
• Level 4 – semi-urgent – not life-threatening
• Level 5 – non-urgent – needs treatment when time permits.

What to tell the emergency department

If you are with someone who has overdosed and they are unable to speak for themselves, emergency staff will need your assistance.

They may ask you lots of questions to help them work out the best course of treatment. This may include details about:

• the overdose – any alcohol, drugs or medications taken
• health problems (existing or past)
• any medications or treatments they are currently receiving
• known allergies
• family health history
• recent trips overseas
• whether the person is pregnant or breastfeeding
• any other important information.

Assessment and treatment for overdose

Emergency healthcare team will assess the person who has overdosed based on their condition.

The emergency team will:

• Do a full assessment – which may include blood tests, observation and psychological review.
• Do a physical examination.
• Take a medical history and ask for information on any existing health issues or treatments.

Treatment for overdose depends on:

• the drug (or drugs) taken
• the dose
• when and how the drug was taken
• what it was taken with
• the effect on the person, including any medical complications resulting from the overdose.

Overdose treatment may include:

• Removal of drugs from your body – such as using activated charcoal.
• Administering an antidote (such as naloxone) to reverse opioid overdose.

If you can be treated in the emergency department, staff will monitor your condition. They may suggest:

• Treatment at home with a follow up appointment with your GP or another service.
• A short stay in a unit attached to the emergency department.
• Admission to hospital if your problem is serious or requires special care.

Naloxone for opioid overdose

Naloxone is a lifesaving medication that can reverse the effects of an opioid overdose.

Community members can access naloxone with a prescription or over-the-counter from a pharmacy. There are also organisations approved to supply naloxone under the Victorian Take-Home Naloxone program.

Many Victorians carry naloxone and have used it to reverse thousands of opioid overdoses.

Victoria's Take-Home Naloxone Program

The Australian Government oversees the Take-Home Naloxone Program and works closely with states and territories on the delivery of the program. The Australian Government supports community access to free naloxone at pharmacies registered with the program.

Victoria's Take-Home Naloxone Program helps people at risk of experiencing or witnessing opioid overdose to access free naloxone. Selected providers across Victoria supply free take-home naloxone to consumers or their families, carers and supporters. Find your nearest provider with Directline's Service Finder or by calling 1800 888 236.

Find an approved naloxone provider

Access the List of approved naloxone providers.

Education and training

Harm Reduction Victoria Opioid Overdose: Recognise and Respond with Naloxone

This workshop focuses on how to recognise the signs of opioid overdose and how to respond using naloxone.

Harm Reduction Victoria's naloxone training is delivered by someone with lived or living experience of injecting drug use. Participants are provided with naloxone.

See the Harm Reduction Victoria website for more information.

Community Overdose Prevention and Education (COPE)

The Victorian Department of Health has endorsed Penington Institute's Community Overdose, Prevention and Education (COPE) training as the approved free online naloxone administration training for Victorian frontline workers in organisations approved to supply naloxone through Victoria's Take Home Naloxone Program. The training covers:

• recognising and responding to an opioid overdose
• naloxone administration and aftercare
• information about naloxone ordering, storage and data collection.

Where to get help

There are many helplines dedicated to helping people in need. Whether you are in crisis or need some advice, there are services that can offer you information, support and in some cases, referral.

• In an emergency, always call triple zero (000)
• Emergency department of your nearest hospital
• Victorian Poisons Information Centre Tel. 13 11 26 – for 24-hour, 7 days a week advice when poisoning or suspected poisoning occurs and for poisoning prevention information
• Your GP (doctor)
• DirectLine Tel. 1800 888 236 – for 24-hour, 7 days a week confidential drug and alcohol telephone counselling, information and referral, and to get free overdose training and naloxone from a health service
• Family Drug and Gambling Helpline Tel. 1300 660 068 – for 24-hour, 7 days a week information and support for people concerned about a relative or friend using drugs
• Suicide Call Back Service Tel. 1300 659 467 – provides free 24-hour professional telephone and online counselling for anyone affected by suicide
• Lifeline Tel. 13 11 14 – provides free 24-hours a day, 7 days a week crisis support and suicide prevention services
• Family Drug Support Australia Tel. 1300 368 186 – provides up to date information on all aspects of alcohol and drug use relative to the families of people who use substances. Family Drug Support also operates a national 24-hours a day, 7 days a week telephone support service for families affected by alcohol and other drug issues
• Pharmacotherapy, Advocacy, Mediation & Support (PAMS) Tel: 1800 443 844 – a statewide confidential phone service for anyone in Victoria experiencing issues with their opioid dependence treatment program. The telephone service operates Monday-Friday and can provide information, support, advocacy, referral and mediation for consumers or their service providers on opioid dependence treatment issues
• Youth Drug and Alcohol Advice (YoDAA) Tel: 1800 458 685 (Monday to Friday) – provides information, advice and support to young people, their families, carers or supporters regarding alcohol or other drug related issues in Victoria
• Youth Support and Advocacy Service (YSAS) Tel: (03) 9415 8881 – offers practical support and evidence-based clinical services in Victoria for young people experiencing problems associated with substance use, mental health, and youth justice. Services include day programs, outreach support, withdrawal and rehabilitation services, koori-specific services, and supported accommodation.