How to Prevent and Respond to Overdose

Preventing overdose, recognizing the signs of an overdose, and knowing how to respond can save lives. Learn how and when to use naloxone and find supervised consumption services in your community.

If you are using drugs, there are steps you can take to help reduce your chance of experiencing an overdose:

  • Use with someone else and take turns spotting for each other. A buddy system is safer than using alone.
  • Use a supervised consumption service. Locations and hours of supervised consumption services are available here.
  • If you must use alone, have a safety plan. Get someone to check on you either by phone or in person. Before you use alone, call the National Overdose Prevention Line at 1-888-688-NORS (6677) or you can connect to community members via the Brave app.
  • Consider your supply. Ask others about what they are experiencing with the same drug or batch.
  • Check what’s in your drugs at Toronto’s drug checking service.
  • Start with a small amount.
  • Mixing substances, including alcohol, increases risk of overdose.
  • Get naloxone. Find out which local agencies have free naloxone kits available here. Free naloxone kits are also available at some pharmacies. Find out more here or call 1-800-565-8603.

 

The following signs may indicate that a person you are with is experiencing an overdose:

  • Can’t wake the person up
  • Breathing is very slow, erratic or has stopped
  • Deep snoring or gurgling sounds
  • Fingernails or lips are blue or purple
  • Body is very limp

Download the signs of opioid overdose infographic.

If you suspect an overdose:

Step 1: Shout & Shake

Shout their name and shake their shoulders.

 

 

 

 

Step 2: Call 9-1-1

If the person is unresponsive, call 9-1-1 immediately.

 

 

 

 

Step 3: Administer Naloxone

1 spray into the person’s nostril and/or 1 ampoule into the person’s arm or leg.

 

 

 

 

Step 4:Start CPR

Do chest compressions and/or rescue breathing.

 

 

Step 5: Assess if it is working

If there is no improvement in 2 – 3 minutes, repeat steps 3 & 4.

 

 

 

 

Download this information as a PDF.

Benzodiazepines, or benzos, are a type of medication that “depresses” or slows down your brain activity. Since benzos decrease activity in the central nervous system, they can affect the way you think, feel and move. Benzos are typically used to treat anxiety, insomnia and alcohol withdrawal. Benzos are only legally available by prescription and usually in pill form, such as diazepam (brand name Valium), lorazepam (brand name Ativan), and alprazolam (brand name Xanax). Illicit benzos have been found in drug seizures in Ontario. Benzos can also be cut into other drugs that are sold in the unregulated street supply.

Drug checking services in Toronto have identified benzos (and benzo-related drugs) in samples of unregulated drugs sold as fentanyl. In late February and March 2020, benzo-related drugs, including flualprazolam and etizolam, appeared in higher numbers of expected fentanyl samples and in increasingly larger proportions of the samples than had previously been identified.

When someone takes benzos and opioids together (whether they intended to, or not), it increases the risk of overdose and death. Naloxone has no effect on benzos. However, if someone is overdosing, naloxone should be given to reverse the effects of any opioids contributing to the overdose. 911 should also be called so that paramedics can help manage the overdose.

Symptoms of benzodiazepine toxicity/overdose may last for hours:

  • drowsiness and sedation, feeling very sleepy or loss of consciousness
  • impaired balance and movement control
  • slurred speech
  • memory loss

Benzodiazepines may put people at risk of sexual violence. Benzodiazepines may also lower one’s inhibitions. Following a benzodiazepine overdose people may experience blackouts and memory loss.

Adapted from a resource by Vancouver Coastal Health

Resource:

You can tell Toronto Public Health about a bad reaction to unregulated drugs or an overdose that happened by emailing drugstrategy@toronto.ca. Emails will be kept confidential, and the information will be used by staff at Toronto Public Health to inform harm reduction actions. If you would like someone to contact you, please provide your contact information in the email.

If you would like to know what is in your drugs, learn more about the Toronto Drug Checking Service.

Toronto Public Health’s The Works provides programs and services to reduce drug-related harm for people who take drugs, including preventing the spread of communicable diseases. Learn about the services provided by The Works.

Find a full list of agencies that offer harm reduction supplies and services across Toronto.

Naloxone is a safe medication that reverses the signs of opioid overdose by blocking the effects of opioids in the brain. Get trained for free on how to use naloxone to respond to an opioid overdose, and find out where naloxone is available in near you.