- Powered by American Addiction Centers

Fentanyl Overdose: Signs and Symptoms

Can You Overdose on Fentanyl?

Fentanyl is a synthetic opioid with effects similar to but 50 to 100 times stronger than morphine.6 Fentanyl gained international attention when the pop musician Prince died from an overdose of the drug in April 2016.

If you or a loved one uses fentanyl, it’s important to be able to recognize the signs of overdose to prevent death or injury. Recovering from a fentanyl overdose may require substance abuse treatment interventions to deal with addiction.

Signs and Symptoms Fentanyl Addiction

Fentanyl is an extremely powerful painkiller, and it can quickly lead to overdose due to its extremely potent effects.

Signs and Symptoms of a Fentanyl Overdose

  • Small, pinpoint pupils.
  • Very pale face.
  • Difficulty thinking, talking, or walking.
  • Dizziness.
  • Confusion.
  • Choking sounds or gurgling/snoring noises.
  • Trouble breathing (respiratory rate very slow, irregular, or altogether stopped).
  • Slow heartbeat, erratic heartbeat, or no heartbeat.
  • Blue skin tinge (the lips and fingertips will show first).
  • Feeling extremely sleepy or tired, with frequent episodes of nodding off.
  • Unresponsive loss of consciousness.
  • Coma.

If you have overdosed on fentanyl, the biggest risk is lack of oxygen resulting from decreased respiration. When a person does not breathe enough to oxygenate properly, it can result in damage to his or her lungs and brain, and lead to death. First responders have a short window in which to treat people who have overdosed on fentanyl because respiratory depression can occur extremely quickly.

If you are with someone who has taken fentanyl, and they begin making unusual sounds while they are “sleeping,” it is very important that you try to wake them up. Although you might think that the person is just snoring, they may actually be overdosing and at risk for death.

This video from the American Academy of CPR and First Aid shows how to perform rescue breathing on someone who is unconscious.

American Academy of CPR and First Aid

Things to Avoid

  • Do not put the individual into a bath. He or she could drown.
  • Do not force the person to vomit. He or she could choke.
  • Do not give the individual a drink. He or she could choke or throw up.
  • Do not slap, kick, or burn the individual to try to revive him or her.
  • Do not inject the victim with anything except naloxone. This could cause infection and is not an effective strategy. 1

In 2015, the Centers for Disease Control and Prevention (CDC) and the Drug Enforcement Administration (DEA) published a report that called for increased access to naloxone. According to the report, out of 82% of fentanyl deaths that emergency medical personnel responded to, there was at least one bystander present for 72% of cases.3 With increased access to naloxone, these bystanders may be able to help reverse overdoses and save lives in the future.

Risk Factors for Overdose

When a person uses an opioid regularly, his or her body develops a tolerance. This means that a person will need more of the drug to get the same effect. However, after just a few days of not taking opioids, a person’s tolerance begins to decrease. This increases the odds of a person overdosing if he or she takes the same amount of the drug they were once used to taking.

The risk of overdose increases even more when a person does not take drugs for a significant period of time, such as when he or she has stopped using or has been:

  • Incarcerated (jail).
  • Hospitalized.
  • In drug treatment or detoxification. 1

Other factors that increase overdose risk include:4

  • Mixing fentanyl with other drugs such as benzodiazepines and/or sedating medications.
  • Mixing fentanyl with cocaine.
  • Mixing fentanyl with alcohol.
  • Mixing fentanyl with antidepressant medication.

Death in an overdose situation may be more likely in those individuals with:5

  • A history of smoking.
  • Chronic bronchitis.
  • Emphysema (lung disease that blocks airflow).
  • Kidney or liver disease or dysfunction.
  • Cardiac illness.

Fentanyl Overdose Treatment

When someone overdoses on fentanyl, a first responder such as a paramedic or police officer will administer naloxone to help the individual begin breathing on their own.

Naloxone has a short half-life, meaning that the fentanyl-induced respiratory depression may return even after an overdose has been initially reversed. Because of this, patients suspected of a fentanyl overdose need to be vigilantly monitored, and multiple doses may need to be administered.

Other forms of treatment for a fentanyl overdose include:

  • Monitoring of vital signs.
  • Breathing support, including oxygen through a tube that is connected to a ventilator.
  • IV fluids.
  • Other medications to treat other symptoms or complications. 11

Can You Die From a Fentanyl Overdose?

A fentanyl overdose can be fatal. After an overdose occurs, immediate action must be taken because fatal respiratory depression can occur quickly.

According to the Centers for Disease Control and Prevention (CDC), overdose deaths involving synthetic opioids, including fentanyl, increased by 80% from 2013 to 2014.6 Compared to other drugs, fentanyl is much more dangerous because even an extremely small dose (2 milligrams) can be deadly.7 According to a report by the Substance Abuse and Mental Health Services Administration (SAMHSA), data on the number of fentanyl-related overdoses is hard to gather because hospitals do not typically test for fentanyl. 3

Below are some statistics that highlight the growing problem of fentanyl overdose deaths: 8,9,10

  • In Ohio, there were 514 reported fentanyl-related overdoses in 2014, compared to just 92 in 2013.
  • In 2014, more than 14,000 people died from opioid overdoses, including fentanyl.
  • In the first half of 2015, 55% of people who died from a fentanyl overdose in Florida tested positive for cocaine or heroin.

Recovering From an Overdose

If you are abusing fentanyl or you have overdosed, it is extremely important that you consider getting treatment to help you recover. There are rehab programs available to help provide you with a safe and comfortable environment while you work through your addiction.

Each program is different, so before choosing one, you may want to meet with a clinician for an assessment. Your doctor can help direct you toward an appropriate program depending on your level of fentanyl use, how long you’ve been using fentanyl, whether you have other health issues you would like addressed in treatment, and many other factors.

Below are a few of the types of programs available:

  • Inpatient treatment: Inpatient or residential fentanyl rehab centers require that you live at the facility for the duration of your treatment. Programs typically last 30 to 90 days. Inpatient programs typically include detox, group and individual therapy, and assistance with aftercare. Some residential programs offer additional types of recovery activities including art and music therapy, meditation, and yoga.
  • Outpatient treatment: During outpatient treatment, you can live at home while attending your recovery program. Most programs offer individual or group counseling. This is a more flexible option, and if you have responsibilities such as childcare, work, or school this might be more appropriate for you.
  • 12-step recovery programs: Groups like Narcotics Anonymous are available to help prevent relapse and provide support during the recovery process. Twelve-step programs are usually group-focused and are similar to other programs, such as Alcoholics Anonymous.
  • Medication-assisted treatment: Treatment for addiction to opioids like fentanyl can include medication such as methadone and buprenorphine. These medications can help people gradually stop using fentanyl, prevent withdrawal, curb cravings, and help to reduce relapse.

Find a Recovery Center

If you have overdosed on fentanyl and are looking for drug treatment, give us a call today at . You can speak to one of our treatment support specialists about recovery options.

[1]. Massachusetts Department of Public Health. (2011). Opioid Overdose Education and Naloxone Distribution.

[2]. National Library of Medicine. (2016). Fentanyl Transdermal Patch.

[3]. Centers for Disease Control and Prevention. (2016). Increases in Fentanyl-Related Overdose Deaths – Florida and Ohio, 2013- 2015.

[4]. Massachusetts Department of Public Health. (2011). Opioid Overdose Education and Naloxone Distribution.

[5]. Massachusetts Department of Public Health. (2011). Opioid Overdose Education and Naloxone Distribution.

[6]. Centers for Disease Control and Prevention. (2016). Fentanyl.

[7]. Drug Enforcement Administration. (2016). Counterfeit Prescription Pills Containing Fentanyls: A Global Threat.

[8]. Centers for Disease Control and Prevention. (2016). Prescription Opioid Overdose Data.

[9]. Massachusetts Department of Public Health. (2016). Data Brief: Opioid-related Overdose Deaths Among Massachusetts Residents.

[10]. Centers for Disease Control and Prevention. (2016). Increases in Fentanyl-Related Overdose Deaths – Florida and Ohio, 2013- 2015.

[11]. U.S. National Library of Medicine. Medline Plus. (2015). Opioid intoxication.