Mental Health

How to Respond to an Overdose



An essential step is to get someone with medical expertise to see the patient as soon as possible, so if no EMS or other trained personnel are on the scene, dial 911 immediately. All you have to say is:

Someone is not breathing.” 

Be sure to give a clear address and/or description of your location. Good Samaritan Law


Signs of Overdose, which often results in death if not treated, include:

Signs of Overmedication, which may progress to overdose, include:

Because opioids depress respiratory function and breathing, one telltale sign of a person in a critical medical state is the “death rattle.” If a person emits a “death rattle” — an exhaled breath with a very distinct, labored sound coming from the throat — emergency resuscitation will be necessary immediately, as it almost always is a sign that the individual is near death.


Ideally, individuals who are experiencing opioid overdose should be ventilated with 100% oxygen before naloxone is administered so as to reduce the risk of acute lung injury. In situations where 100% oxygen is not available, rescue breathing can be very effective in supporting respiration. Rescue breathing involves the following steps:

STEP 4: ADMINISTER NALOXONE (if you have access to it)

Naloxone (Narcan) should be administered to any person who shows signs of opioid overdose, or when overdose is suspected. Naloxone injection is approved by the FDA and has been used for decades by emergency medical services (EMS) personnel to reverse opioid overdose and resuscitate individuals who have overdosed on opioids.

Naloxone can be given by intramuscular or intravenous injection every 2 to 3 minutes. The most rapid onset of action is achieved by intravenous administration, which is recommended in emergency situations. The dose should be titrated to the smallest effective dose that maintains spontaneous normal respiratory drive.

Opioid-naive patients may be given starting doses of up to 2 mg without concern for triggering withdrawal symptoms.

The intramuscular route of administration may be more suitable for patients with a history of opioid dependence because it provides a slower onset of action and a prolonged duration of effect, which may minimize rapid onset of withdrawal symptoms.


All patients should be monitored for recurrence of signs and symptoms of opioid toxicity for at least 4 hours from the last dose of naloxone or discontinuation of the naloxone infusion. Patients who have overdosed on long-acting opioids should have more prolonged monitoring.

Most patients respond by returning to spontaneous breathing, with minimal withdrawal symptoms. The response generally occurs within 3 to 5 minutes of naloxone administration. (Rescue breathing should continue while waiting for the naloxone to take effect.)

Naloxone will continue to work for 30 to 90 minutes, but after that time, overdose symptoms may return. Therefore, it is essential to get the person to an emergency department or other source of medical care as quickly as possible, even if he or she revives after the initial dose of naloxone and seems to feel better.

Do’s and Don’ts in Responding to Opioid Overdose

NOTE: All naloxone products have an expiration date, so it is important to check the expiration date and obtain replacement naloxone as needed.

SOURCE - Arlington Opiate Outreach Initiative 

Local Treatment Resources

Acton Nursing Services provides Certified Home Health (VNA) and public-health services for residents of Acton and surrounding towns. For walk-in services for adult and childhood vaccinations and blood-pressure checks, call (978) 929-6650 before coming to assure availability of a nurse. Other services include home health aide assistance, medical social services, physical, occupational, and speech therapy plus skilled nursing.

Eliot Community Human Services provides 24-hour psychiatric emergency services and crisis stabilization, individual, group and family outpatient counseling, addiction services, in-home therapy, therapeutic mentoring, and early intervention services for children, and community outreach and case management to individuals with mental illness. Emergency (800) 988-1111.

First Connections equips parents with tools, strategies, and connections to other families and their communities to foster healthy parenting and guide them through the first years of the parenting journey. First Connections is on the Cross-town Connect bus route. Contact: Deborah Werneburg 179 Great Rd #104A, Acton, MA 01720 (978) 429-8284 x201

Metrowest Behavioral Health Center is an outpatient mental health clinic serving children and adults. Clinicians are trained in research-based therapeutic techniques for treating trauma. Parent-Child Therapy, the Pathways to Permanency Program for adoptive and foster parents, as well as the SMART Program and ARC Therapy. Contact Stephanie Lallier-Casal, LICSW, 360 Mass Ave, Suite 103, Acton, MA 01720 (978) 264-3500

Metrowest Community Based Services provides programs to reduce daily struggles, improve family functioning, stabilize and support families who are living with a child facing the challenges of mental illness. Services are provided in the home and community for children under age 21 who meet the medical necessity criteria for in-home therapy or therapeutic mentoring. Services are also provided for youth up to age 22 who may be transitioning from an out-of-home placement to home, or may be at-risk for an out-of-home placement. Contact Kate Picariello, 978-263-3427. Located at 360 Mass Ave #201, Acton. 

The William James INTERFACE Referral Service Freedman Center, is a mental health and wellness referral Helpline at 888-244-6843. Callers from participating communities are matched with licensed mental health providers from our extensive database. 

National Alliance on Mental Illness (NAMI) is the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. NAMI provides advocacy, education, support and public awareness so that all individuals and families affected by mental illness can build better lives. Call the NAMI Helpline at 800-950-6264 or text "HelpLine" to 62640.

SANS (See a New Sun Foundation) operates at a grass-roots level, working with schools, churches and local organizations to raise awareness of the true nature of suicide and substance abuse.  Meeting Place:  First Church Unitarian, Alliance Room, 19 Foster St, Littleton, MA 01460. Contact: Barbara Whitcomb, (978) 486-4928  

Samaritans provides lifesaving suicide prevention services in Massachusetts. Their volunteers have answered 3 million calls, chats, and texts from people who are struggling. Samaritans has trained more than 6,000 volunteers and provided suicide prevention workshops to 150,000 people. Call or text 988. Available 24/7.

Substance Abuse

Help Lines

If you are in crisis, call 911. If you need assistance, try these help lines:

Support Lines

For support, families can contact Learn to Cope, Inc. at
(508) 738-5148 or Support groups in Massachusetts

Support Groups

Section 35 

Medication Assisted Treatment Options

Grief Resources