Signs of an overdose include small, pinpoint pupils, loss of consciousness, shallow breathing, choking sounds, limpness and pale, blue or cold skin, according to the Centers for Disease Control and Prevention.
If someone is showing the signs of a possible opioid overdose involving opioids and xylazine, the Substance Abuse and Mental Health Services Administration recommends taking these steps:
1. Call 911 and stay on the phone until first responds arrive.
Washington has a good Samaritan law to protect people trying to save someone from an overdose.
2. Give naloxone — a drug that can reverse the effects of an overdose.
Naloxone will not cause harm if opioids are not involved in an overdose, but be aware that the effects of an overdose may continue after naloxone is given if xylazine is involved.
3. Give rescue breaths and chest compressions.
Rescue breaths are important for overdoses possibly involving xylazine because the sedative slows down breathing. To give adults rescue breaths, make sure the airway is clear, place one hand on the chin, tilt the head back and pinch the nose closed. Seal your mouth over the person’s mouth and give two slow breaths, watching the person’s chest rise. Follow up with one breath every five seconds. For chest compressions on adults, place the person on their back, press hard and fast on the center of the chest and keep your arms extended.
4. Monitor the person.
If the first dose of naloxone hasn’t taken effect after two to three minutes, another dose may be necessary.
The Washington State Department of Health has a detailed guide with visuals on its website.
