Fentanyl Overdose Symptoms, Signs & Treatment
Symptoms of Fentanyl Overdose
A person that is overdosing on fentanyl may exhibit the following signs and symptoms:2,7
- Low blood pressure
- Nausea and vomiting
- Limp body
- Changes in pupillary size
- Cold and clammy skin
- Blue colored lips and fingernails (cyanosis)
- Slowed or stopped breathing
- Decreased heart rate
- Reduced or loss of consciousness
The presence of the “opioid overdose triad of symptoms,” which is comprised of pinpoint pupils, respiratory depression, and a decreased level of consciousness, is strongly suggestive of a fentanyl overdose.7
In an effort to better educate first responders and bystanders on how to identify people who have overdosed on fentanyl, the Centers for Disease Control and Prevention conducted a study to investigate the characteristics of a fentanyl overdose. During the study researchers interviewed more than 60 people with firsthand accounts of a fentanyl overdose; all of the respondents had illicitly used fentanyl during the past year and either witnessed an overdose or survived an overdose in the past six months.8
One of the most commonly described characteristics of a fentanyl overdose was the rapid speed of onset, with 75% of the respondents describing symptoms of an overdose occurring within seconds to minutes. One respondent stated, “I would say you notice it [a fentanyl overdose] as soon as they are done [injecting the fentanyl]. They don’t even have time to pull the needle out [of their body] and they’re on the ground.” When asked to describe what happens during a fentanyl overdose, the most common responses were:8
- A person’s lips immediately turning blue
- Gurgling sounds with breathing
- Stiffening of the body or seizure-like activity
- Foaming at the mouth
- Confusion or strange behavior before the person becomes unresponsive
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What is Fentanyl?
Fentanyl is a potent synthetic opioid drug used for treating severe pain, such as that which is encountered after surgery or during advanced cancer.1 Like other opioid drugs, fentanyl works by binding to specific opioid receptors in the body, many of which are found in areas of the brain that control pain and emotions.2 The effects produced by fentanyl can include:3
- Pain relief
- Urinary retention
- Slowed breathing
Many people who use fentanyl may become dependent on the drug due to its potency, and this dependence can often lead to addiction. Fentanyl abuse is a major contributor to the current opioid epidemic that is devastating the country. Results from the National Survey on Drug Use and Health show that there were 269,000 people who misused prescription fentanyl in 2018.4
Unfortunately, this staggering number may under represent the true nature of fentanyl abuse in the United States, as the survey asked respondents specifically about the use of prescription fentanyl and thus did not account for the use of fentanyl that was illicitly manufactured in clandestine laboratories.
According to mortality data from the National Vital Statistics System, synthetic opioids (primarily illegal fentanyl) are the most common drugs involved in overdose deaths in the United States.5 Fentanyl overdoses were responsible for over 20,000 deaths in 2017 alone.6
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Fentanyl Overdose Treatment
Please be aware of the signs of a fentanyl overdose. If you suspect someone is suffering from a fentanyl overdose it is crucial that you act quickly. The most important step is to call 911 so that the person can receive immediate medical attention. Upon arrival, medical personnel will likely administer naloxone if they suspect fentanyl is involved. When administered immediately, this drug can reverse the symptoms of a fentanyl overdose.9
Once someone has recovered from an overdose, it is crucial that they seek immediate help to address their issues with fentanyl dependency and abuse. The first step is to undergo medical detox in a professional rehab center, where the symptoms of fentanyl withdrawal can be properly monitored and treated. Like other opioid addictions, subsequent behavioral therapy and medication has proven to be an effective treatment approach for people with a fentanyl addiction.10
- Nelson, L., & Schwaner, R. (2009). Transdermal fentanyl: Pharmacology and toxicology. Journal of Medical Toxicology, 5(4), 230-241.
- Ramos-Matos, C.F, & Lopez-Ojeda, W. (2019). Fentanyl. StatPearls [Internet], Treasure Island (FL): StatPearls Publishing.
- U.S. Drug Enforcement Administration. (2017). Drugs of Abuse: A DEA Resource Guide.
- Substance Abuse and Mental Health Services Administration. (2019). Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health.
- Jones, C.M., Einstein, E.B., & Compton, W.M. (2018). Changes in Synthetic Opioid Involvement in Drug Overdose Deaths in the United States, 2010-2016. Journal of the American Medical Association, 319(17), 1819-1821.
- National Institute on Drug Abuse. (2019). Overdose Death Rates.
- Schiller, E.Y., & Mechanic, O.J. (2019). Opioid Overdose. StatPearls [Internet], Treasure Island (FL): StatPearls Publishing.
- Somerville, N.J., O’Donnell, J., Gladden, R.M., Zibbell, J.E., Green, T.C., Younkin, M., …& Walley, A.Y. (2017). Characteristics of Fentanyl Overdose — Massachusetts, 2014–2016. Morbidity and Mortality Weekly Report, 66(14), 382–386.
- U.S. Department of Health and Human Services. (2015). Opioid Abuse in the U.S. and HHS Actions to Address Opioid-Drug Related Overdoses and Deaths.
- National Institute on Drug Abuse. (2019). Fentanyl.