Now, I really mean it this time: this is the last I’m going to say about overdoses for awhile. I thought I’d pretty much gotten it out of my system with the urban myths about overdoses and the tips on how to avoid an overdose and how to know one when you see it. But yesterday, someone I know quite well overdosed unintentionally. They have had a lifetime methadone maintenance slot for years now, and if ever there was a success story to support methadone maintenance, he was it: after a lifetime of being a street junkie addicted to heroin and doing crimes to pay for his habit, he’s managed to hold onto the same job (even move up in the company), married a great gal and had a baby with her. Then yesterday, he had a migraine, happened to run into an associate from the old days who offered him a pill to wipe out the headache. He went home, had a couple of beers and woke up this morning in the hospital having suffered an overdose.

It’s that quick, and it’s that unexpected. Don’t think that because you have two, three, 10 or 20 years invested in a methadone maintenance program that you are immune to overdose. Sometimes all it takes is a one too many alcoholic drinks or one pill that unexpectedly mixes with your daily methadone dose to create an overdose situation. Maybe he hadn’t eaten very much that day or maybe he’d just come up or down a few milligrams on his methadone dose through the clinic. Maybe neither. Your body’s chemistry changes as you grow older and if you don’t get to the doctor for your regular checkups, you may not know when you’re developing a chronic issue that will affect how your body processes your methadone dose.

If your methadone dose is 30 milligrams or lower, you can switch to a Suboxone detox. Avoid the daily trip to the clinic, the liver damage associated with long-term methadone use and the possibility of overdose as you work your way toward a drug-free life. In the meantime, be aware of your body and if you are suddenly overwhelmingly tired, having difficulty breathing, have cold and clammy skin or muscle spasms. Any of these or a combination can indicate an overdose and it’s imperative that you get medical assistance while you still can or make sure that there is someone in the house with you who can watch over you and make sure that you’re okay.

We’ve talked a lot about how to recognize an overdose when you see it, what not to do it if it happens to a friend of yours and certain risks you can avoid to keep yourself out of the emergency room, but in most cases, if you overdose, you aren’t going to know what hit you, much less what to do about it. So if the worst happens and you end up flat on your back on a gurney, here’s what the medical professionals will most likely do.

First, they will make stabilize your breathing and your heart rate. Next, get ready for a nasty shock: at least .4cc of naloxone into a muscle. The shot you won’t feel, but if it works like it’s supposed to, you’ll wake right up…and feel sicker than you’ve ever felt. The naloxone essentially knocks whatever opiates are in your system off your opiate receptors and stop them from repressing your breathing. If it doesn’t work within a few minutes, they may administer another dose.

At the emergency room, you’ll most likely have your stomach pumped. Even if the naloxone does its job, the drugs are still in your system. When the naloxone wears off, you could easily slip back into overdose as the opiates overwhelm your system again. To keep that from happening, you’ll undergo a gastric lavage (stomach pumping) and most likely receive a dose of activated charcoal and laxative to flush the rest of the drugs out of your body. After that, you’ll be hooked up to monitors to make sure that your heart rate and blood pressure are stabilized, given fluids intravenously and kept overnight for observation.

In the best scenario, the treatment will be effective and you’ll be able to go home within 24 hours. In the worst scenario, well, treatment won’t be effective or won’t arrive in time. Opiate overdose deaths are exceedingly common. You can guard against it by entering into a Suboxone detox and treatment and breaking your addiction to opioid-based prescription drugs.

You may know what to do when someone you are with overdoses and you may know what not to do as well, but if you don’t know what an overdose looks like, that knowledge isn’t going to help very much. An opiate overdose is often difficult to discern in its early stages as the effects of opioid-based drugs can be pretty overwhelming. But there are a few signs and symptoms that can tip you off before things get out of hand. These include:

- Constricted pupils
- Faint heartbeat
- Shallow breathing
- Labored breathing
- Weak, flaccid muscles
- Clammy skin
- Excessive sweating
- Cold flashes
- Dark urine
- Nausea
- Vomiting
- Fainting
- Mental dullness
- Confusion
- Yellowing skin or eyes
- Overwhelming fatigue
- Blue-tinted lips, fingernails or skin
- Unconscious state
- Coma
- No breathing

Overdose is deadly. It is rare to survive one and if you do, count yourself lucky. You’ve been given a second chance at life. Take advantage of it and get out while you still can. The risk of overdose does not decrease with the length of your addiction or the increase in your dosage. Your higher tolerance is not protection. It can shift depending upon a number of variables and turn your average dose into an overdose.
Instead, detox off of your prescription painkillers with Suboxone and eliminate the risk completely. Don’t wait.