If you use heroin, fentanyl, tramadol, dihydrocodeine or any other opioid based drugs you should carry a supply of naloxone, and always have it closely available when you are using.

An overdose means having more of a drug (or combination of substances) than your body can cope with. It's important to remember that any drug, including prescription medication, can cause an overdose.

Try a small amount of your dose first to check effects.

Do not use alone – use with someone else and take your dose in turns.

Signs of an opioid overdose include:

• Pinpoint pupils
• Shallow breathing/snoring
• Change to skin/lip/nail colour (blue)
• No response to noise or touch
• Loss of consciousness (unable to wake).

If someone shows these symptoms – call 999 for an ambulance and do not leave the person alone.

Use your naloxone supply, and if the person is not breathing and you know CPR, start now. The 999 staff will talk you through this – 30 chest compressions to 2 rescue breaths followed by one dose of naloxone in a cycle until paramedics reach you or the person regains consciousness. Naloxone is short acting, with the effects wearing off after 20-30 minutes which may mean that the person may return to overdose.

If you are using stimulants such as speed, amphetamine, cocaine, crack, ecstasy the signs of an overdose will differ.

Symptoms of a stimulant overdose include:

• Hot, flushed or sweaty skin
• Severe headache
• Chest pain
• Rigid muscles
• Tremors or spasms
• Uncontrolled movements or seizures and difficulty breathing

A person may also experience psychological symptoms such as:

• Panic
• Agitation
• Confusion
• Disorientation

If you are concerned that you or someone you are with is showing signs of a stimulant overdose:

Call for help on 999.

• Move the person to a quiet, safe place away from, noise, bright light, heat or other stimulation.
• If they are confused or panicking, try to reassure them.
• If you can't get a response or the person is unconscious, put them in the recovery position until help arrives.
• If muscle spasms or seizures occur, move anything from area that might cause them injury.

Alcohol Overdose

People may not consider alcohol to cause overdose, however alcohol is a depressant which slows down the messages travelling between brain and body. Alcohol depresses the nerves that control breathing and the gag reflex (which prevents choking). An excessive amount of alcohol can cause these functions to shut down.

Since alcohol is an irritant to the stomach, excessive vomiting is also common. If the person is unconscious, this could lead to death by asphyxiation.

Symptoms of alcohol overdose include:

• Confusion
• Co-ordination loss
• Vomiting
• Seizures
• Shallow/slow/irregular breathing - less than eight breaths per minute or a gap or 10 seconds or more between breaths
• Pale/blue tinged skin, passing out or unconsciousness.

If someone shows these symptoms – call 999 for an ambulance and do not leave the person alone.

If the person is not breathing and you know CPR, start now. The 999 staff will talk you through this – 30 chest compressions to 2 rescue breaths.