Author: Susanne Reed, PhD

Narcotics refer to opium, opium derivatives, and any synthetic version used to substitute for opium. Commonly called opioids today are prescription drugs such as morphine, methadone, codeine, fentanyl, OxyContin, Vicodin, and heroin.¹ According to the National Institute on Drug Abuse, there were 56,516 synthetic opioid overdose deaths in 2020. In addition, prescription opioid overdose deaths equaled 16,416 that same year, and there were 13,165 heroin overdose deaths. Many others experience a narcotics overdose involving opioids combined with another substance.² It’s important to know what happens during a narcotics overdose so you can seek emergency care for yourself or someone else.

In this article:

• How Do Narcotics Affect the Brain and Body?
• What Happens During a Narcotics Overdose?
• Signs of a Narcotics Overdose
• Symptoms of a Narcotics Overdose
• How a Narcotics Overdose Can Be Reversed
• Who is at Risk of a Narcotics Overdose?
• How to Avoid a Narcotics Overdose
• The Dangers of Synthetic Opioids and Fentanyl

How Do Narcotics Affect the Brain and Body?

When you take an opioid, it travels through the bloodstream to the brain. Opioids attach to opioid receptors that set off chemical reactions upon entering the brain, such as flooding the reward center with dopamine. The chemical reactions reduce or mitigate pain and make you feel a rush of pleasure, also known as euphoria.³

As opioids leave your system, the brain “remembers” this pleasurable feeling, which may lead to a desire to use opioids again, known as cravings. Eventually, you may begin to misuse opioids by taking more than prescribed or using them in a way that does not match prescription instructions. Continued misuse of opioids can lead to addiction and create lasting structural and functional changes in the brain.³

Natural Opioid Production Stops

Your brain naturally produces opioids but at a lower amount than what is produced by prescription or illicit opioids. Over time, your brain begins to depend on the drugs to produce dopamine and stops trying to make them on its own. Negative symptoms such as depression and anxiety appear when this occurs. When you go without opioids, the negative symptoms become extreme.

The Extended Amygdala Becomes Sensitive

The amygdala regulates stressful emotions such as anxiety, agitation, irritability, and uneasiness. Misusing narcotics makes the amygdala more sensitive, increasing these emotions that can make you so uncomfortable you feel like you must use more opioids to feel better.

The Brain Stem Struggles to Keep You Alive

The brain stem is responsible for heart rate and breathing functions in the body. It also controls sleep, which is crucial for good health. Opioids are central nervous system (CNS) depressants. They sedate the brain stem, slowing down all the functions for which it is responsible. This means your heart rate and breathing rate become slower. Consuming too many opioids will depress heart rate and breathing, but it can also stop them, leading to a narcotics overdose.

What Happens During a Narcotics Overdose?

When you take too much of an opioid or an opioid mixed with alcohol or some other depressant, the brain and body become overwhelmed and cannot handle the drug.

How you ingest the opioid will determine how quickly you flood the bloodstream with the substance. If you take it orally, it can take 30 minutes to an hour to take effect. If you inject opioids, the effect is immediate. Taking too much of an opioid causes a chain reaction within the body that leads to a narcotics overdose:⁴

• Slower blood flow to the brain due to collapsed veins
• Slower oxygen flow to the brain, causing potential seizures and brain damage
• Sedation of the lobes of the brain, preventing the body from functioning properly
• Dry mouth
• Slower heart rate
• Shallow breathing further prevents oxygen flow and can eventually stop altogether
• Slower oxygen flow continues, causing extremities to be void of oxygen
• Painful spasms of the stomach or intestines
• Pulmonary edemas
• Loss of consciousness and coma
• Heart arrhythmia and cardiac arrest

Signs of a Narcotics Overdose

Signs are the behaviors and reactions anyone can see when a person has a narcotics overdose. If you think someone may be overdosing, look for the following:⁵

• Extreme drowsiness
• Mental status changes
• Constricting pupils
• Discoloring of the tongue
• Involuntary movements or tics
• Foaming at the mouth
• Wheezing
• Choking sounds that may signal they are vomiting
• Choking on the vomit due to suppressed gag reflexes
• Limp arms, legs, and body
• Unresponsiveness

Symptoms of a Narcotics Overdose

Narcotics overdose symptoms are the effects and reactions the person experiencing a narcotics overdose may feel. These may not be visible to everyone until symptoms worsen. During a narcotics overdose, it is possible to experience the following:⁶

• Disorientation
• Confusion or stupor
• Agitation
• Paranoia
• Clammy skin
• Change in body temperature
• Chest pains

How a Narcotics Overdose Can Be Reversed

The Federal Drug Administration (FDA) approved naloxone, also known as Narcan, for friends and family of a person with a narcotics addiction or someone who is at risk of a narcotics overdose. If you notice the signs of a narcotics overdose, administer Narcan to reverse the life-threatening effects, such as slowed or stopped breathing. Naloxone is an opioid antagonist, which means it binds to opioid receptors and blocks the effects of opioids.⁷

When someone has a narcotics overdose and is given Naloxone, it reverses or blocks the effects of the opioids. It can be given as an injection or a nasal spray. As it enters the body of the person overdosing, Naloxone restores normal breathing and heart rate.⁷

What happens in the minutes following the dose of Naloxone is crucial. Narcan is not a cure. It is only effective for 30-90 minutes, and after that time, another narcotics overdose may occur.⁷ Therefore, calling for emergency services as soon as possible is necessary for this life-saving process. If medical professionals cannot arrive within 90 minutes, be prepared to administer another dose of Narcan.

If you know someone with an opioid use disorder, don’t hesitate to contact your doctor to receive a prescription for multiple naloxone doses.

Who is at Risk of a Narcotics Overdose?

Risk factors are events, situations, or circumstances that make you more likely to experience a narcotics overdose. When you have more risk factors, you have a higher chance of a narcotics overdose. Below are common risk factors found among veterans and pain management patients:⁸

• Taking opioids prescribed by more than one doctor
• Taking larger doses than prescribed
• Crushing, snorting, smoking, or injecting opioids rather than taking them orally, as prescribed
• Mixing opioids with other prescription or illicit substances
• Mixing opioids with sedatives, including alcohol
• Misusing opioids after being sober for a week or longer
• Misusing opioids in isolation with no one to administer Narcan in case of a narcotics overdose
• Having a medical condition that affects the liver or kidneys
• Having respiratory conditions such as asthma or sleep apnea

Additional narcotics overdose risk factors exist for people between ages 12 and 30 with a non-medical narcotics addiction, including:⁹

• Having a history of a mental illness or psychological distress
• Having a history of hospitalization for opioid withdrawal and detox
• Being dissatisfied with a relationship
• Being homeless or lacking a stable home environment
• Being incarcerated and using soon after release
• Witnessing the narcotics overdose of a friend or family member

How to Avoid a Narcotics Overdose

Other than administering Naloxone at the time of a narcotics overdose, you can implement prevention strategies to avoid a narcotics overdose. If you have an opioid use disorder, consider these tips:¹⁰

• Take the medicine as it is prescribed.
• Tell all your doctors about every medication you are taking.
• Do not take anyone else’s medication.
• Do not mix prescribed opioids with alcohol or any other prescription or illicit drugs.
• Do not change how you ingest the medicine, such as injecting it or crushing and snorting it when you are told to take it orally.
• Learn the signs of a narcotics overdose and teach them to your friends and family.
• Develop a narcotics overdose prevention plan with your friends and family.
• Provide naloxone to each person who is around you when misusing opioids.
• Seek harm reduction treatment to wean off opioids.
• Seek inpatient detox that uses medication-assisted treatment to ease withdrawal symptoms and cravings.
• Seek a network of support that may include peers, friends, family members, spiritual advisors, coworkers, and counselors.

The Dangers of Synthetic Opioids and Fentanyl

If you purchase illicit opioids, you may be at higher risk for a narcotics overdose because you do not know the exact substances or dosage included. You are never buying pure opioids. Illicit opioid manufacturers cut their opioids with similar-looking products, increasing the amount they can sell and the amount of money they can make.¹¹

For example, the manufacturer creates a pound of synthetic opioids. They cut it with baking soda, doubling the amount of product and revenue. They sell it to a local dealer, who again cuts it with more baking soda. Only the local dealer adds a dash of fentanyl to make sure you get high. They sell it to you.

The problem is that fentanyl is 50 to 100 times more potent than morphine, making it extremely deadly. When you snort, smoke, or inject the final product, you have no idea what you are consuming. The fentanyl can be too much for your body to handle, and you may experience a narcotics overdose.¹²

Illicit manufacturing of fentanyl means it can be made to look exactly like other drugs in powder, liquid, or pill forms. It can be added to eye drops and nasal sprays. You cannot tell the difference between fentanyl and other opioids by observation alone. This makes it very dangerous and potentially life-threatening.¹²

If you want to reduce your risk of a narcotics overdose, many treatment options are available for harm reduction or medical detox. Whether you have never had a narcotics overdose or have had multiple overdoses, a treatment program can help you take back control of your life. All you have to do is make one call to find rehab.

When you call our helpline at 800-934-1582(Who Answers?) , one of our treatment specialists will direct you to a treatment facility specializing in opioid use disorders.

Resources

1. Department of Justice Drug Enforcement Agency. (2020). Drug Fact Sheet: Narcotics.
2. National Institute on Drug Abuse. (2022). Overdose Death Rates.
3. National Institute of Drug Abuse. (2022). Drugs and the Brain.
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6. Boyer E. W. (2012). Management of Opioid Analgesic Overdose. The New England Journal of Medicine, 367(2), 146-155.
7. National Institute on Drug Abuse. (2019). How Naloxone Saves Lives in Opioid Overdose.
8. Wilder, C. M., Miller, S. C., Tiffany, E., Winhusen, T., Winstanley, E. L., & Stein, M. D. (2016). Risk Factors for Opioid Overdose and Awareness of Overdose Risk Among Veterans Prescribed Chronic Opioids for Addiction or Pain. Journal of Addictive Diseases, 35(1), 42-51.
9. Lyons, R. M., Yule, A. M., Schiff, D., Bagley, S. M., & Wilens, T. E. (2019). Risk Factors for Drug Overdose in Young People: A Systematic Review of the Literature. Journal of Child and Adolescent Psychopharmacology, 29(7), 487-497.
10. Substance Abuse and Mental Health Services Administration. (2018). SAMHSA Opioid Overdose Prevention Toolkit. HHS Publication No. (SMA) 18-4742. Rockville, MD.
11. Phillips JK, Ford MA, Bonnie RJ, editors. (2017). 4, Trends in Opioid Use, Harms, and Treatment. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division. Board on Health Sciences Policy. Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse. Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use. Washington (D.C.): National Academies Press (U.S.).
12. National Institute on Drug Abuse. (2021). Fentanyl Drug Facts.