Fentanyl Overdose: Signs, Symptoms, & Treatment

Fentanyl is a synthetic opioid that’s used in medical settings to treat severe pain. It is a pain medication that is much stronger than many other drugs in this category. Because of that, both prescription and illicit fentanyl come with a high risk of overdose if you use them in a way that is not prescribed, even in very small amounts.1

In recent years, fentanyl has also become a major part of the opioid crisis, especially since illicit fentanyl can show up in other drugs without people realizing it, increasing the chances of accidental overdose and underscoring how serious the issue has become.2

Learn more about the signs of fentanyl overdose below or contact our drug and alcohol rehab in Kansas City to begin addiction treatment. 

What Is a Fentanyl Overdose?

A fentanyl overdose happens if you take more fentanyl than your body can manage. It doesn’t take much fentanyl to overwhelm the body. When this happens, fentanyl can slow your breathing to a dangerous level, reduce oxygen to the brain, and cause you to become unconscious.2

Signs & Symptoms of a Fentanyl Overdose

Misusing fentanyl or accidentally taking drugs that you aren’t aware contain fentanyl can lead to an overdose. It is crucial to recognize fentanyl overdose signs, including2:

• Can’t respond or wake up
• Small or constricted pupils
• Extremely slow or stopped breathing
• Gurgling or snoring sounds
• Skin turning blue or gray
• Cold and clammy skin
• Low blood pressure
• Nausea and vomiting
• Confusion or disorientation
• Seizures (less common)

These fentanyl overdose symptoms, even if they seem mild, can be a sign of something more serious, like a fatal overdose. It is crucial to seek help immediately.

How to Help Someone Overdosing on Fentanyl

If you think someone might be overdosing on fentanyl, the most important thing is to stay calm and act quickly. You don’t have to do everything perfectly, but doing something can make a real difference. Follow these steps3:

• Call emergency services right away. Stay on the phone with the operator and follow their instructions.
• Give naloxone (Narcan) if you have it. Naloxone can reverse fentanyl overdose effects. If the person doesn’t respond after a few minutes, give another dose if available.
• Check their breathing. If they’re not breathing or breathing very slowly, try rescue breathing: tilt their head back, pinch the nose, and give one breath every 5–6 seconds.
• Try to wake them. Call their name, gently shake them, or rub your knuckles firmly on the center of their chest.
• Place them on their side. If they’re breathing but unconscious, put them in the recovery position to prevent choking.
• Stay with them until help arrives. Fentanyl overdoses can return after naloxone wears off, so it’s important not to leave them alone.

It is always better to call for emergency medical help, even if you aren’t sure if it is an overdose. You can save a life.

Narcan (Naloxone) for opioid overdoses

Narcan is a brand name for naloxone, a medication that can help reverse a fentanyl overdose. Naloxone works by attaching to the same spots in the brain that opioids attach to, but reverses the effects of an overdose. It can help you start breathing again and regain consciousness.4,5

The steps for using Narcan for opioid overdoses include4,5:

• Call for help as soon as you can.
• Lay them on their back.
• Tilt their head back slightly to help open their airway.
• Get the Narcan ready.
• Give the spray by placing the tip into one nostril and releasing the dose.
• Wait and watch. If there’s no response or breathing doesn’t improve after a few minutes, give another dose using a new spray in the other nostril.
• Help with breathing if needed. If they’re not breathing or breathing very slowly, give rescue breaths—about one breath every 5–6 seconds.
• Stay with them.

Once they start breathing again, roll them onto their side and stay until emergency help arrives. Because naloxone can wear off before the opioid does, an overdose may recur, so it’s still important to get fentanyl overdose treatment right away.4,5

Fentanyl Overdoses: Causes & Risk Factors

A fentanyl overdose can occur quickly, accidentally, and unexpectedly for many reasons. Knowing the causes and risk factors can help you make efforts to avoid an overdose. Common fentanyl overdose causes include6:

• Taking too much fentanyl at once. Because fentanyl is extremely potent, even a very small amount can overwhelm your body.
• Not knowing you are taking fentanyl. Fentanyl is often mixed into other drugs, like heroin, cocaine, and methamphetamines, without you knowing it.
• Combining fentanyl with alcohol, benzodiazepines, or other depressants increases the risk of slowed or stopped breathing.
• Using fentanyl after a break or reduced tolerance, such as after detox, treatment, or incarceration. Your body’s tolerance drops, making previous doses much more dangerous.
• Using alone. No one is with you to prevent or save you from an overdose.

If you have certain risk factors, they may increase your chances of a fentanyl overdose. For example6,7:

• Low or no opioid tolerance
• Having an opioid use disorder
• Previous overdose history
• Chronic health conditions, especially lung or heart disease
• Prescription misuse, such as taking higher doses or using fentanyl differently than prescribed
• Unpredictable drug supply, especially with illicit fentanyl, where the strength and purity vary

When you buy any drug illicitly, including stimulants or depressants, you risk it being mixed with fentanyl. Most of the fentanyl that contributes to fentanyl overdose deaths is found in illegally produced and distributed drugs.8

Risk of Fentanyl-Laced Drugs

You might think you’re taking a specific drug or a pill you believe is a prescription medication, without realizing fentanyl has been mixed in. Because it’s often added without warning, you can end up taking fentanyl without intending to do so. This raises your fentanyl overdose risks.8

What makes this even more dangerous is how strong fentanyl is. Even a small amount can have a powerful effect on your body. If you don’t know fentanyl is present, you may take what you think is a normal or safe amount, not realizing it could slow or stop your breathing quickly. This combination of surprise and potency is a big reason fentanyl has made overdoses more common and more severe.8

How to Prevent a Fentanyl Overdose

Harm reduction is a way to keep you as safe and healthy as possible, even if you continue to use drugs. The goal is to reduce your risk of injury, overdose, and death. It’s about teaching you how to make informed choices and take steps to protect yourself from overdose. Tips to help prevent an overdose include6,8:

• Don’t use alone. If possible, have someone nearby who can check on you or help in an emergency.
• Carry naloxone (Narcan). Having it on hand so someone near you can use it can save your life.
• Reduce the amount you use or start with a smaller amount rather than taking a full dose at once.
• Avoid mixing substances with alcohol, benzodiazepines, or other depressants.
• Be cautious after a break, when your tolerance is lower. Your body won’t be ready for the amount you took before the break.
• Test when possible. Using fentanyl test strips can help identify the presence of fentanyl in drugs.

Not every overdose is preventable, so it is crucial to know the signs so you can call for help immediately. Seeking fentanyl overdose recovery is another great way to prevent another overdose. You can learn the skills you need to stop using the substance and avoid the fentanyl overdose dangers associated with it.

Fentanyl Addiction Treatment in Kansas City

If you or someone you care about is ready to take the next step, Empowered Recovery Kansas City is here to help. Our rehab admissions team can walk you through the process, answer questions, and help determine the right level of care. We offer flexible ways to pay for addiction treatment, including using insurance for rehab.

On our Programs page, you can learn more about the different services we offer, including a range of evidence-based rehab programs designed to support recovery at every stage. Contact Empowered Recovery Kansas City today to speak with our team, verify your insurance benefits, and take the first step toward healing.

References

1. National Institute of Health. (2024). Fentanyl 101. MedlinePlus magazine. Retrieved on 1/10/2025 from https://magazine.medlineplus.gov/article/fentanyl-101.
2. Regina AC, Goyal A, Mechanic OJ. (2025). Opioid toxicity. Retrieved on 1/10/2025 from https://www.ncbi.nlm.nih.gov/books/NBK470415/.
3. National Institute on Drug Abuse. (2024). Understanding an overdose and how to respond to one. Retrieved on 1/10/2025 from https://nida.nih.gov/research-topics/parents-educators/lesson-plans/understanding-an-overdose-and-how-to-respond-to-one.
4. Jordan MR, Patel P, Morrisonponce D. (2024). Naloxone. Retrieved on 1/10/2025 from https://www.ncbi.nlm.nih.gov/books/NBK441910/.
5. Adapt Pharma. (2025). Narcan nasal spray: Quick start guide. Retrieved on 1/10/2025 from https://www.dhs.state.il.us/OneNetLibrary/27896/documents/19DOPP/NARCAN-Quick-Start-Guide.pdf.
6. Commonwealth of Massachusetts. (2026). Opioid overdose risk factors. Retrieved on 1/11/2025 from https://www.mass.gov/info-details/opioid-overdose-risk-factors.
7. MedlinePlus. (2024). Opioid overdose. Retrieved on 1/11/2025 from https://medlineplus.gov/opioidoverdose.html.
8. National Institute on Drug Abuse. (2025). Fentanyl. Retrieved on 1/11/2025 from https://nida.nih.gov/research-topics/fentanyl.