International Overdose Awareness Day: How to Recognize, Respond and Help
Recognize an Overdose. Know How to Respond.
Overdose is a medical emergency, but a timely response can save a life. This short video explains common warning signs, immediate response steps and how pharmacists, doctors, families and friends can support people at risk.
If you think someone is experiencing an overdose, call 9-1-1 immediately.
International Overdose Awareness Day is August 31. The observance asks communities to remember the people lost to overdose, support those who grieve, challenge stigma and act on evidence that prevents deaths.[1]
In Canada, 5,608 opioid-related deaths were reported in 2025, an average of 15 lives lost every day. The number was lower than in 2024, but harms remain far above pre-pandemic levels and emergency medical service responses increased nationally.[2]
Prepared by Sina Health Centre for public education using the Canadian, British Columbian and international sources listed below.
On this page
- The overdose crisis in Canada
- What can cause an overdose
- Signs that require urgent action
- How to respond
- How pharmacists and doctors can help
- How families, friends and coworkers can help
- B.C. support and naloxone resources
- References
The overdose crisis in Canada: the latest national picture
Canada's most recent national release covers January through December 2025. It reports 5,608 opioid-related deaths, or an average of 15 per day. This was a 23% decrease from 2024, but the Public Health Agency of Canada cautions that the burden remains unacceptably high and that not every jurisdiction or community experienced a decrease.[2]
The drug supply is also increasingly complex. The same federal update reports that benzodiazepine involvement in opioid toxicity deaths rose from 8% in 2018 to 34% in 2024. Sedatives in the unregulated supply can prolong unconsciousness and breathing problems; naloxone reverses the opioid component but does not reverse benzodiazepines or other non-opioid substances.[2][5]
In B.C., toxic drugs are the leading cause of death among people ages 19 to 39. The province emphasizes that an unregulated drug may be contaminated even when it comes from a familiar source, and that risk exists even with a small amount or a first use.[6]
About the language: You may see both “overdose” and “drug poisoning.” “Poisoning” recognizes that many people do not know the strength or contents of an unregulated substance. International Overdose Awareness Day uses “overdose” in its official name. Both terms describe medical emergencies deserving rapid, compassionate care.
What can cause an overdose?
An overdose occurs when a substance, or combination of substances, overwhelms the body's ability to function safely. The signs and treatment depend on what was taken. Opioids can slow or stop breathing; stimulants can produce dangerous overheating, seizures, extreme agitation, chest pain or abnormal heart rhythms. Alcohol, benzodiazepines and other sedatives can also suppress breathing and consciousness.[4][8]
| Risk factor | Why it matters |
|---|---|
| Unpredictable potency or contents | Fentanyl, fentanyl analogues, benzodiazepines and other substances may be present without the person's knowledge. Appearance, smell and taste cannot reliably identify what is in an unregulated drug.[2][6] |
| Mixing substances | Combining opioids with alcohol, benzodiazepines, sleep medicines or other sedatives can compound breathing suppression. Multiple drugs can also create competing effects that are difficult to predict.[8] |
| Reduced tolerance | Risk rises after a period without opioids, including after detoxification, hospitalization, incarceration or a pause in use. A previously tolerated amount may then be dangerous.[8] |
| Dose or medication errors | Taking more than directed, using someone else's medicine, confusing formulations, or combining prescribed and non-prescribed products can cause poisoning. Children and older adults may be especially vulnerable to accidental exposure. |
| Health conditions | Lung or liver disease, sleep apnea, frailty, mental health conditions and a previous overdose can increase risk. A medication review can identify risks specific to the patient.[8] |
| Using alone | When no one is present to call 9-1-1, give naloxone or provide breathing support, a survivable emergency can become fatal.[6] |
Signs that require urgent action
Possible opioid or sedative overdose
- Cannot be woken or is not moving
- Slow, irregular or no breathing
- Choking, gurgling, gasping or unusual snoring
- Blue, grey or purple lips or fingernails
- Very small pupils
- Cold, clammy skin
Possible stimulant overdose or toxicity
- Chest pain, racing or irregular heartbeat
- Severe agitation, panic, paranoia or confusion
- Very high body temperature or heavy sweating
- Seizure, collapse or loss of consciousness
- Severe headache, weakness or signs of stroke
When in doubt, treat the situation as an emergency. More than one substance may be involved, so an opioid overdose can be present even when stimulant signs are also visible.
How to respond to a suspected overdose
- Call 9-1-1 immediately. Tell the dispatcher the person is unresponsive or not breathing normally and follow their instructions.
- Try to wake the person. Call their name and firmly squeeze the fingertips or the muscle between the neck and shoulder. Do not leave them alone.
- Check the airway and breathing. Remove visible obstruction from the mouth. If the person is not breathing normally, provide rescue breathing or CPR according to your training and the 9-1-1 dispatcher's instructions.
- Give naloxone if an opioid may be involved. Follow the directions for the nasal or injectable kit. Naloxone is safe to give even if you are unsure whether opioids are involved.[5]
- Give another dose if there is no response in 2 to 3 minutes. Continue breathing support while waiting for the next dose to work.[5]
- Stay until emergency services arrive. If the person is breathing, place them on their side in the recovery position. Naloxone works for about 30 to 120 minutes, but many opioids last longer, so the overdose can return.[5][6]
Video: Centers for Disease Control and Prevention, public domain. For a current Government of Canada demonstration of nasal and injectable naloxone, see How to administer naloxone.[11]
How pharmacists and doctors can help
Overdose prevention is not a single conversation. Pharmacists and physicians can reduce risk before an emergency, help people enter evidence-based treatment, and support recovery after an overdose. Care should be individualized, confidential, culturally safe and free of judgment.
How a pharmacist can help
- Provide naloxone access and practical training. A pharmacist can explain the kit, demonstrate how to give a dose, check the expiry date and help family members prepare to respond.
- Review all medicines and substances. This can identify duplicate opioids, high-risk sedative combinations, confusing formulations and interactions with alcohol, sleep medicines or benzodiazepines.
- Support safer prescribed-opioid use. Pharmacists can reinforce the prescription directions, discuss missed doses and loss of tolerance, and arrange packaging or reminders when appropriate.
- Support opioid use disorder treatment. Community pharmacists are important partners in dispensing and monitoring medications used for opioid agonist treatment and in communicating concerns or missed doses to the prescriber.
- Protect the household. Pharmacies can advise on locked storage and accept unused or expired medicines for safe disposal.
How a doctor or nurse practitioner can help
- Assess overdose risk and the whole health picture. This includes pain, substance use, tolerance changes, mental health, pregnancy, breathing or liver conditions, and the medicines prescribed by every clinician.
- Diagnose and treat opioid use disorder. B.C. guidance supports evidence-based opioid agonist treatment and ongoing follow-up. The appropriate medication and setting depend on the person's goals, history and clinical circumstances.[7]
- Build a safer pain plan. A clinician can review whether an opioid is helping function, adjust treatment when risks outweigh benefits, and consider non-opioid and non-medication options when appropriate.
- Coordinate care after an overdose. Reversal with naloxone is only the first step. Follow-up can address withdrawal, injuries, treatment options, mental health, infection risks and the circumstances that led to the event.
- Connect patients to local services. This may include addiction medicine, counselling, supervised consumption or overdose prevention services, drug checking, peer support and social services.
B.C.'s clinical guideline recommends routinely offering conversations about safer drug use, take-home naloxone and referrals to harm-reduction services as part of standard care for people with opioid use disorder.[7]
How families, friends and coworkers can help
- Learn together before a crisis. Know where the naloxone kit is kept, how to use it and when it expires. Practice the response steps with everyone who may be present.
- Use respectful language. Ask open questions, listen without threats or shame, and focus on safety. Stigma can make people hide substance use or avoid healthcare.
- Make an emergency plan. Keep naloxone accessible, save the exact address for 9-1-1, and know who can care for children or dependants if emergency care is needed.
- Reduce isolation. Encourage the person not to use alone. In B.C., supervised consumption and overdose prevention services and the Lifeguard app can provide additional layers of safety.[6]
- Encourage treatment without trying to control it. Offer transportation, help arrange an appointment, attend if invited and support the person's own goals. Recovery may involve setbacks and more than one type of care.
- Look after the responder too. Witnessing an overdose or losing someone can be traumatic. Families and responders may need grief, peer or mental health support of their own.
B.C. support and naloxone resources
- Emergency: Call 9-1-1 for a suspected overdose.
- Non-emergency health advice: Call 8-1-1 in B.C.
- Free naloxone and training: HelpStartsHere B.C. and Toward the Heart site finder.
- Overdose prevention and response: Government of British Columbia response guide.
- Mental health and substance-use services: HelpStartsHere B.C..
- Sina Health Centre: Speak with our pharmacy or medical team about medication safety, naloxone education and the most appropriate next step for your situation. Contact us.
Frequently asked questions
Can naloxone harm someone if opioids were not involved?
Naloxone acts on opioid receptors. Health Canada states that it is safe for all ages and has virtually no effect if opioids are not present. If an opioid may be involved, give naloxone while waiting for emergency help.[5]
Why call 9-1-1 if the person wakes up after naloxone?
Naloxone's effect is temporary and can wear off while the opioid is still active. Breathing can slow again, and other substances or medical complications may still require treatment.[5]
Does naloxone reverse every type of overdose?
No. Naloxone reverses opioid effects. It does not reverse stimulant, alcohol, benzodiazepine or other non-opioid toxicity, but it should still be given if an opioid may be part of a mixed overdose. Call 9-1-1 and provide first aid as directed.
Where can I get naloxone in Vancouver?
Take-home kits are available without a prescription at most pharmacies, and free kits are available to eligible people through B.C.'s Take Home Naloxone program sites. Ask a pharmacist or use the provincial site finder before you need the kit.[5][10]
Media credits and reuse
- Remembrance photograph: SAMHSA/HHS, U.S. federal government work in the public domain; sourced through Wikimedia Commons.
- Canadian naloxone kit: Government of New Brunswick, dedicated to the public domain under CC0; sourced through Wikimedia Commons.
- Medication-safety photograph: CDC/Amanda Mills, public domain; source record CDC Public Health Image Library, image 13553.
- Doctor and family photograph: National Cancer Institute/Rhoda Baer, public domain; sourced through Wikimedia Commons.
- Naloxone video: Centers for Disease Control and Prevention, U.S. federal government work in the public domain; source record at Wikimedia Commons.
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Use of public-domain CDC/HHS materials does not imply endorsement of Sina Health Centre by CDC, HHS or the United States Government.
References
- International Overdose Awareness Day. International Overdose Awareness Day.
- Public Health Agency of Canada. Substance-related harms in Canada.
- Substance-related Overdose and Mortality Surveillance Task Group. Opioid- and Stimulant-related Harms in Canada. Public Health Agency of Canada.
- Health Canada. Opioid overdose. Government of Canada.
- Health Canada. Naloxone. Government of Canada.
- Government of British Columbia. Overdose prevention and response.
- British Columbia Centre on Substance Use, B.C. Ministry of Health, and B.C. Ministry of Mental Health and Addictions. A Guideline for the Clinical Management of Opioid Use Disorder. Second edition; updated 2025.
- World Health Organization. Opioid overdose. August 29, 2025.
- Health Canada. About the Good Samaritan Drug Overdose Act.
- Government of British Columbia. Naloxone: where to get a kit and training.
- Public Health Agency of Canada. How to administer naloxone.
- Centers for Disease Control and Prevention. Increased use of naloxone can help end the opioid overdose epidemic. August 6, 2019.
Statistics and service availability can change. Follow the linked federal and provincial sources for the latest information.