What Is a Drug Overdose?

An overdose is many things. The blanket term is used to describe a panorama of drug-related incidents that, for better or worse, scrubs out the gritty, grainy details from conversation. But what is a drug overdose? What does an overdose mean, do or look like?

An overdose is different for every substance – party or prescription – but what each does to the body is often left out of media reports and high school drug education.

John Ryan, CEO of Melbourne’s Penington Institute which launched International Overdose Awareness Day, said Australia was seriously lacking harm reduction education, which is why our overdose death toll is higher than our road toll.

“It’s not as simple as blaming the issue on reckless behaviours or the criminal drug supply, there is a vast range of situations that can result in an overdose,” Ryan told VICE.

“People are often lacking clear and reliable information about the risks associated with using different substances.

“Certainly more education about overdose – what it looks like for different drug types, how we can respond to an overdose when it is happening, and the risks of overdose for everyday Australians – would be hugely beneficial.”

While other terms can be used by different industries, communities and countries, like drug toxicity or poisoning, the word overdose is most common in Australia – but it has a different definition depending who you ask.

The Australian Drug and Alcohol foundation describes an overdose as a “severe adverse reaction” caused by a a toxic amount (or combination) of a drug.

Safer Care Victoria refers to an overdose as a person consuming “too much of a drug, medication or poison”, which may result in a toxic effect on the body, though the harm may not be immediately obvious.

It can also be described as when a substance “overwhelms” the body or, the word’s original use: when more than the recommended amount of a drug or medicine is consumed.

“An overdose occurs when someone consumes more of a drug – or multiple drugs – than their body can handle,” Ryan said.

“This can be either fatal or non-fatal. While most people might think of an overdose relating primarily to illegal drugs, it’s important to remember that overdose can include prescription drugs and even alcohol just as much as illegal substances.

“A hangover is essentially a non-fatal overdose from alcohol.”

In school, a drug overdose sounded terrifying, extremely likely with even one bump, and meant almost certain death, which is simply untrue.

“There’s not necessarily an issue with using one word to describe an overdose - but we need to ensure we are educating the community about what the word might mean in different contexts. Context is important,” Ryan said.

“Different drugs affect people differently depending on their unique physiology and the circumstances in which they are using drugs.

“For example, it is much more dangerous in extreme heat or extreme exertion such as dancing for hours. The unknown nature and potency of drugs is also a risk factor.”

Any drug can cause an overdose, and all can be fatal or non-fatal, life-threatening or non-life-threatening, intentional or unintentional. And the symptoms of an overdose and its effects on the body can be poles apart, from slowed breathing to vomiting to overheating.

Depressant drugs include any opioids like heroin, fentanyl, codeine and oxycodone, stress relievers known as sedatives or tranquilisers like benzodiazepines (not ketamine – we’ll get to that in a minute), and alcohol.

Depressants slow down the messages you brain sends to your body. The dangerous result of taking a large amount of a depressant is that it also slows down your breathing and blood circulation – that’s what can kill you in a depressant drug overdose.

Some signs of a depressant drug overdose are loss of consciousness, being unresponsive or limp, pale or clammy skin, blue lips or nails, shallow or irregular breathing or no breathing at all.

Stimulant drugs include amphetamines like cocaine, meth, speed and MDMA and study drugs like dexies, Ritalin and Adderall. Stimulants, as opposed to depressants, speed up the messages between your body and your brain, making an overdose look markedly different.

Stimulant drug overdose signs include irritability or agitation, confusion, anxiety, overheating, excessive sweating, seizures, severe stomach pain, chest pain and rapid breathing.

There are a few ways a stimulant overdose can become fatal: a rapid rise in heart rate leading to a heart attack, ie your heart stops working, a rapid rise in blood pressure causing a stroke, and a rapid rise in body temperature, causing dehydration, electrolyte imbalance and ultimately organ failure.

Ketamine is neither a depressant nor a stimulant but a dissociative drug used by doctors and vets as an anaesthetic. Like a psychedelic drug, dissociatives can make you hallucinate and feel detached from your body, happy and relaxed but it is also designed to reduce pain sensitivity and in higher doses cause unconsciousness.

However, the risk of death from ketamine alone is low, because the type of unconsciousness it renders has a minimal impact on airway reflexes or blood circulation, making it a preferable sedative choice for doctors. This means you can likely still breathe and function normally in a k-hole from a high dose of ketamine. But due to its ability to make you feel rather legless and blurry, the risk of accident and physical harm is high, so make sure you have friends nearby.

But further risk comes from mixing ketamine with other substances.

Signs of a ketamine overdose can include symptoms like difficulty breathing, nausea or vomiting, raised blood pressure or heart rate and unconsciousness. While a ketamine overdose itself will likely be non-fatal, ketamine users are at risk of pulmonary aspiration – when stomach contents are breathed into the airways – and therefore death by suffocation. When you’re is mixing ketamine with a depressant like alcohol, that risk increases.

If you think someone is overdosing, try to stay calm. Call Triple Zero (000) and ask for an ambulance.

The operator will ask for details like location, the number of people needing assistance, their age, whether they are breathing or unconscious and what substances they have taken, if you know. Once the ambulance is dispatched, the operator will stay on the line with you to monitor the person’s symptoms and situation, which they will feed through to the paramedics, so don’t hang up until instructed to.

They may also give you first-aid advice, like putting the person in the recovery position if required.

Aleksandra Bliszczyk is the Deputy Editor of VICE Australia. Follow her on Instagram.

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