​Health Effects

Opioid Overdose​

An opioid overdose may happen when a person takes too much of an opioid causing their body's vital functions to slow down or stop.

The risk of overdose is higher when a person:

• ​​​Uses an illicit opioid​

• ​​​Misuses a prescription opioid, such as using without medical guidance or not following the directions for use

• ​Takes drugs with stronger opioids (like fentanyl)
  

• ​​​​Takes a miscalculated dose

• ​Takes opioids by injection

• ​Mixes drugs​

• Starts using opioids again after a period of not using (such as after detoxification, stopping treatment, or release from an institutional setting)

• ​Uses a high dosage​

• Has a concurrent medical condition such as a liver or lung disease, mental health condition, or HIV​

​Signs of an opioid overdose usually include:

• Severely slow or shallow breathing

• Not breathing

• Unresponsiveness

• Unconsciousness

• Small, constricted "pinpoint pupils"

• Falling asleep or losing consciousness

• Choking or gurgling sounds
  

• Limp body

• Cold and/or clammy skin

• Discolored skin (especially in lips and nails)
  

Learn more about drug-related ove​rdoses.​

Naloxone

Naloxone is a medication that can be used to reverse an opioid overdose. It is also known by the brand name Narcan®. It is available as a nasal spray, an injectable needle solution, or an auto-injector. Anyone can carry naloxone, and it does not require a prescription. 

​Other Health Effects

Misuse of prescription and/or use of illicit opioids can lead to harmful health effects.

Short-term effects:

• Slowed breathing (“respiratory depression")

• Slowed physical activity

• Nausea

• Vomiting

• Constipation
  

Long-term effects:

• Substance use disorder or dependence

• Increased tolerance

• Infertility in women

• Liver damage

• Worsening pain (known as “opioid-induced hyperalgesia")

• Life-threatening withdrawal symptoms in babies born to mothers taking opioids​

Mixing Drugs​

Mixing opioids with other drugs can be very dangerous and increase risk of overdose.

If opioids are mixed with other depressants (such as alcohol, xylazine, Xanax, or Valium), it can slow breathing and cause extreme drowsiness. It also raises the risk of brain damage, damage to other organs, impaired cognitive function, and death.

If opioids are mixed with stimulants (such as methamphetamine or cocaine) the results can be unpredictable. Mixing such drugs may modify or mask the effects of one or both drugs. This may trick someone into thinking that the drugs have no effect on them, raising the risk of overdose.

Withdrawal

Withdrawal is the body's reaction when a person who regularly uses a drug suddenly stops or uses less.

Early opioid withdrawal symptoms can include:

• Sweating

• Runny nose

• Yawning

• Watery eyes
  

As withdrawal continues, symptoms may include:

• Nausea and vomiting

• Loss of appetite

• Restlessness
  

• Fast heart rate and higher blood pressure

• Drug craving

• Irritability

• Chills, heavy sweating, flushed skin

Withdrawal symptoms can be treated with medical care, including the use of drugs such as clonidine, methadone, and buprenorphine.​

​Treatment

Medications for Opioid Use Disorder (MOUD) is a safe, effective, and evidence-based treatment which uses Food and Drug Administration (FDA)-approved medication to treat opioid use disorder (OUD).

FDA-approved treatment for OUD includes:

• Buprenorphine
  
• Methadone
• Naltrexone

The term Medication Assisted Treatment (MAT) is sometimes used instead of the term MOUD. MAT can include both counseling and medication to support people with OUD. However, the term MOUD is sometimes preferred to emphasize that the OUD is what is being treated.

​What is CDPH doing?

The CDPH Substance and Addiction Prevention Branch (SAPB) works with many partners throughout the state to monitor and address current trends at the statewide and local level. CDPH works closely with local health departments and multi-sector partners to support local prevention and intervention efforts that address the specific and unique trends and needs of California's communities.

SAPB monitors fatal and non-fatal drug-related overdose trends over time in California, by sex, age, race/ethnicity, and drug type. These trends are available to view by county and zip code on the California Overdose Surveillance Dashboard.

CDPH has issued a statewide Naloxone Standing Order, which allows community organizations and other entities in California that are not currently working with a physician, to distribute naloxone to a person at risk of an opioid-related overdose or to a family member, friend, or other person in a position to assist.  

In August 2024, SAPB launched a statewide public education campaign called Facts Fight Fentanyl to raise awareness of life-saving naloxone and the prevalence and dangers of fentanyl. SAPB also provides other tools and resources for organizations to utilize to spread awareness of fentanyl dangers and overdose prevention strategies within their networks:

• Facts Fight Fentanyl Toolkit
  

• Fentanyl & Opioid Overdose Prevention Toolkit

The CDPH Office of AIDS (OA) funds harm reduction programs throughout the state that offer syringe services, naloxone, Fentanyl Test Strips (FTS), and other supplies and services to support the health of people who use drugs. The OA Harm Reduction Unit also provides technical assistance to local health jurisdictions and other local partners to add harm reduction services into health departments, clinics, hospitals, and community-based organizations.

Resources

• Persons Experiencing Chronic Pain

• Mixing Alcohol and Drugs

• Campus Opioid Safety Act

• Drug Overdose Response

• Polysubstance Use Facts

• Preventing Opioid Overdose 

• Preventing, Recognizing, and Treating Opioid Overdose

• Opioid Overdose

• Prescription Opioids Drug Facts

• Benzodiazepines and Opioids