This fact sheet has been developed to support the community to know the signs of an overdose and to appropriately respond to an overdose in which fentanyl is involved.
Fentanyl is a powerful synthetic opioid that can be up to 100 times stronger than morphine. It is used medically for severe pain, but illegally produced fentanyl is also found in the unregulated drug supply, sometimes mixed with other substances without people knowing. Fentanyl and its analogues, such as carfentanil, act quickly and carry a very high risk of overdose.
Signs of overdose:
Like all opioids, fentanyl slows down the central nervous system. It can produce relaxation and euphoria, but at high doses it suppresses breathing and heart rate. This can stop the body’s natural urge to breathe. A fentanyl overdose can lead to unconsciousness, brain damage, or death.
Signs of fentanyl overdose can include:
- No response to stimuli
- Shallow, irregular, or stopped breathing
- A person can seem like they are sleeping but can’t be woken up
- Snoring or gurgling sounds
- Grey/ashen or olive-green lips if a person has a dark skin tone; blue lips if a person has a pale skin tone
- Cold or clammy skin
- Floppy arms and legs
- Possible vomiting
If you cannot get a response from someone, do not assume they are asleep. Noisy, shallow breathing or unusual unresponsiveness are common signs of fentanyl overdose. Do not let people at risk ‘sleep it off’.
Overdose response:
Sometimes it can take hours for someone to die from a fentanyl overdose, but immediate action could save a life. If you think someone has overdosed, knowing how to respond is crucial:
- Follow the DRS ABCD order of first aid. Before you act, check for Dangers such as needles.
- Check for a response (AVPU consciousness scale – Alert, respond to Voice prompt, responds to Pain prompt-only, or Unconscious).
- Send for help by calling an ambulance. Stay on the line with emergency services.
- Administer naloxone (Narcan®) if available. Fentanyl overdoses often require more than one dose, so repeat if there is no response after 2–4 minutes.
- Put the person in the recovery position to protect the Airway or, if a person is trained and comfortable doing so, apply first aid including rescue Breaths, CPR/Compressions, Defibrillation.
Note: Naloxone only works on opioids such as fentanyl. It does not reverse the effects of other drugs. Always stay with the person until medical help arrives, as the effects of fentanyl can return when naloxone wears off.