How to Respond to a Suspected Overdose While Waiting for Help

When someone overdoses, every second counts. It’s not about being a medic or having a medical degree-it’s about knowing what to do before the ambulance arrives. In New Zealand, as in many places, opioid overdoses are rising, and fentanyl is now a major player. But here’s the truth: overdose response isn’t about waiting for someone to wake up. It’s about acting fast, staying calm, and doing the right things in the right order.

Step 1: Check Responsiveness and Breathing

Don’t shake them or shout. That wastes time. Instead, tap their shoulder firmly and say, "Are you okay?" If there’s no response, check their breathing immediately. Look at their chest. Listen near their nose and mouth. Feel for air on your cheek. You have 10 seconds to decide.

If they’re not breathing or only gasping-like a snore or a weird wheeze-that’s not normal sleep. That’s an overdose. Gasping means their brain is starving for oxygen. Every minute without oxygen increases the chance of brain damage. Don’t wait. Don’t hope. Act.

Step 2: Call for Help Immediately

Dial 111. Even if you have naloxone. Even if you think they’ll wake up. Emergency services need to know where you are, what happened, and what drugs might be involved. The operator can guide you while you wait. In Auckland, ambulances typically arrive in 8-12 minutes. That’s longer than the 4-6 minute window your brain can survive without oxygen. So while you’re waiting, you become their lifeline.

Don’t hang up. Stay on the line. Tell them if you think it’s opioids, alcohol, or stimulants like meth or MDMA. This helps them prepare the right treatment before they even get there.

Step 3: Give Rescue Breathing

If they’re not breathing but still have a pulse, you don’t need chest compressions. You need breaths. This is critical. Most overdose deaths happen because breathing stops first. The heart follows later.

Open their airway by tilting their head back gently and lifting their chin. Pinch their nose shut. Cover their mouth with yours, making a tight seal. Give one breath every 5-6 seconds. Each breath should last about 1 second. Watch their chest rise. If it doesn’t, reposition their head. If you can’t make a seal, try using a cloth or shirt to cover their mouth while you breathe into it-better than nothing.

Keep going. Don’t stop after two or three breaths. People think naloxone will fix everything. But it can take 2-5 minutes to work. You might be giving breaths for 10 minutes or more. Muscle fatigue is real. If you’re tired, switch with someone else. If you’re alone, keep going. Your breaths are keeping their brain alive.

Step 4: Use Naloxone If Available

Naloxone reverses opioid overdoses. That includes heroin, fentanyl, oxycodone, codeine, and methadone. It does nothing for alcohol, benzodiazepines, cocaine, or meth. If you’re unsure, give it anyway. If it’s not opioids, it won’t hurt them. If it is, it could save their life.

Most naloxone kits in New Zealand are nasal sprays. Tilt their head back. Spray half the dose (one spray) into one nostril. If you have a second spray, use it in the other nostril. Don’t wait to see if it’s working. Give it now.

Even after naloxone, keep giving rescue breaths. Naloxone wears off in 30-90 minutes. Opioids like fentanyl can last longer. They can stop breathing again. You must keep monitoring them until help arrives.

Step 5: Put Them in the Recovery Position

If they start breathing on their own but are still unconscious, roll them onto their left side. This is the recovery position. It keeps their airway open and prevents choking if they vomit.

Here’s how: Kneel beside them. Straighten their legs. Bend their far leg at the knee. Place their far arm under their head. Gently roll them toward you, using the bent leg as a pivot. Their head should rest on their arm, mouth slightly downward. Their top arm should be out in front, bent at the elbow. Their bottom arm should be under their body. Their top leg should be bent at 90 degrees to keep them stable.

Check their breathing every 2-3 minutes. If they stop again, go back to rescue breathing. Don’t leave them alone. Don’t assume they’re fine just because they’re breathing now.

What Not to Do

Don’t put them in a cold shower or ice bath. That’s a myth. Cold shocks can trigger dangerous heart rhythms, especially with stimulant overdoses like MDMA or cocaine.

Don’t give them coffee, water, or food. You can’t sober someone up. Water might cause choking. Coffee won’t help. Let medical staff handle fluids.

Don’t leave them to sleep it off. People die this way every year. Overdose unconsciousness looks like deep sleep. But their body isn’t resting-it’s shutting down.

Don’t wait to see if they improve. If you’re unsure, treat it like an overdose. Better to act and be wrong than to wait and lose someone.

What If It’s Not Opioids?

Most overdoses are opioids-but not all. If it’s alcohol, the biggest danger is choking. Keep them on their side. Watch for vomiting. Don’t let them lie flat.

If it’s stimulants like meth or MDMA, they might be hot, agitated, or having seizures. Keep them cool-not cold. Remove excess clothing. Fan them gently. Don’t restrain them unless they’re in danger of hurting themselves. Call for help. Don’t try to calm them with force.

If it’s a mix of drugs-common now-treat it like an opioid overdose. Give naloxone anyway. Use rescue breathing. Call 111. Polysubstance overdoses are the new norm. The rules haven’t changed: breathe for them, get help, keep monitoring.

Why This Works

Studies show bystander intervention cuts overdose deaths by nearly half. In communities where people are trained in these steps, survival rates jump to 98%. In places where people only carry naloxone but don’t know how to breathe for someone, survival drops to 87%.

The reason? Rescue breathing keeps oxygen flowing. Naloxone reverses the opioid. But without breath, neither matters. You’re not just giving a shot-you’re keeping their body alive until professionals take over.

Preparing Ahead of Time

Keep a naloxone kit in your car, bag, or home. They’re free in many community health centers in Auckland. Ask at your local pharmacy or district health board. Practice the recovery position with a friend. Watch a 10-minute video on the Health New Zealand website.

Teach your housemates, your partner, your friends. Overdose doesn’t happen to "other people." It happens to people you know. Someone you care about might need you to act tomorrow.

After It’s Over

Even if they wake up, they still need to go to the hospital. Naloxone wears off. The drug can come back. They might have internal damage. Don’t let them talk you out of it.

You might feel shaken, guilty, or relieved. That’s normal. Talk to someone. Call a helpline. You did something brave. You saved a life.

What Comes Next?

After the emergency, the real work begins. Recovery isn’t just about surviving the overdose-it’s about what happens after. If you or someone you know has experienced an overdose, talk to a health professional. There are free support services in Auckland that help with addiction, mental health, and harm reduction. You don’t have to go through it alone.

And if you’ve made it this far-you’re already the kind of person who could save a life. Keep learning. Keep sharing. Keep being ready.