Reviewed by clinical staff
An opioid overdose can unfold quickly and feel overwhelming for everyone involved. For families, the experience is often frightening and confusing. For the person who survives, it can be a turning point that raises urgent questions about safety, withdrawal, cravings, mental health, and what kind of help may come next. Knowing what an opioid overdose looks like and how to respond can save a life.
Learn more about this River City Recovery program and how an assessment helps determine fit.
At River City Recovery in Columbus, Georgia, we provide adult outpatient substance use and mental health treatment, including Partial Hospitalization, Intensive Outpatient, Evening IOP, and outpatient therapy. Treatment recommendations are based on an assessment, because each person’s needs, risks, and goals are different. If you are trying to understand next steps after an overdose, a calm and structured treatment plan may help you move from crisis toward stability.
What an opioid overdose is and why it happens
An opioid overdose happens when opioids slow breathing enough that the brain and body do not get the oxygen they need. Opioids include prescription pain medications, heroin, and fentanyl. According to NIDA and SAMHSA, overdose risk rises when a person takes a high dose, returns to use after a period of lower tolerance, combines opioids with alcohol or benzodiazepines, or uses a substance that contains fentanyl without knowing it.
An overdose is a medical emergency, not a sign of weakness or a lack of willpower. Opioid use disorder changes brain reward, stress, and decision-making systems, which can make it hard to stop even after serious harm. Mental health conditions, chronic pain, grief, trauma, and unstable living situations can also increase risk. Understanding the full picture matters, because effective treatment addresses more than the overdose event alone.
Common opioid overdose signs to recognize
Some signs are dramatic, but others can be subtle at first. A person may look as if they are sleeping, yet they do not wake when you call their name or rub your knuckles on the center of their chest. Breathing may become very slow, irregular, or stop altogether. Their skin may feel cool or clammy, and lips or fingernails may appear blue, gray, or purple depending on skin tone.
If you suspect an opioid overdose, do not wait for every warning sign to appear. Quick action matters. SAMHSA and the CDC advise treating any combination of severe sleepiness, slowed breathing, and inability to wake as an emergency. Even if you are not certain what substance was used, it is safer to respond right away and get medical help on the way.
- Very slow, shallow, or stopped breathing
- Pinpoint pupils
- Cannot be awakened or is limp and unresponsive
- Gurgling, choking, or snoring-like sounds
- Blue, gray, or pale lips, nails, or skin
- Cold, clammy skin or slowed heartbeat
Outpatient options after an opioid overdose
| Level of care | Best fit | Typical focus | Schedule fit |
|---|---|---|---|
| Partial Hospitalization | Higher support needs | Daily structure, therapy, stabilization | More time-intensive |
| Intensive Outpatient | Moderate support needs | Therapy, relapse prevention, skill building | Several sessions weekly |
| Evening IOP | Needs treatment with daytime duties | Structured care after work or family tasks | Evening-based |
| Outpatient Therapy | Lower acuity or step-down care | Individual therapy and ongoing support | Most flexible |
| Medication management with therapy | Opioid cravings or withdrawal concerns | MOUD follow-up plus counseling | Varies by plan |
How to respond in the moment
The first step is to call 911 right away. Give naloxone if it is available. Naloxone is a medication that can temporarily reverse the effects of an opioid overdose. Follow the product directions, and if the person does not respond in two to three minutes, give another dose if you have one. Stay with the person until emergency help arrives, because naloxone can wear off before the opioid does.
If the person is not breathing or is barely breathing, begin rescue breathing if you know how. If you are trained in CPR and there is no pulse, begin CPR. Place the person on their side in the recovery position if they are breathing on their own, especially if vomiting is possible. Try to keep the scene calm and remove anything that could cause injury.
After a reversal, many people feel confused, sick, or upset because withdrawal can come on quickly. They still need medical attention. An overdose can happen again after naloxone wears off, and other substances may also be involved. If possible, tell responders what was taken, when it may have been taken, and whether alcohol, benzodiazepines, or stimulants were also used.
- Call 911 immediately
- Give naloxone as directed
- Support breathing and start CPR if trained and needed
- Place the person on their side if breathing
- Stay until emergency responders take over
What treatment after survival may involve
Surviving an opioid overdose often signals a high-risk period. The days and weeks afterward can include cravings, withdrawal, shame, fear, and pressure from work or family. A thoughtful treatment plan starts with an assessment of substance use, overdose history, mental health symptoms, medical needs, safety concerns, home environment, and readiness for change. That assessment helps determine the right level of care and what services may be most helpful.
Treatment after an opioid overdose may include counseling, relapse prevention, family support, and medications for opioid use disorder, also called MOUD or medication-assisted treatment. ASAM, SAMHSA, and NIDA recognize medications such as buprenorphine and methadone as evidence-based options for many people with opioid use disorder. These medications can reduce withdrawal, cravings, and opioid use, but they are not the only part of treatment. Therapy and recovery supports still matter.
At River City Recovery, adults may be recommended for Partial Hospitalization, Intensive Outpatient, Evening IOP, or outpatient therapy depending on assessed needs. A person with frequent relapse, unstable symptoms, or a recent overdose may need a more structured program at first, while someone with stronger day-to-day stability may begin at a lower level of care. The goal is not a one-size-fits-all answer, but a plan that matches current risk and functioning.
Ready to talk about treatment? Compare our IOP program and PHP program, or call 706-617-4970 to start an assessment.
Comparing common outpatient treatment paths after an overdose
Families often ask what level of care makes sense after an opioid overdose. The answer depends on severity, safety, mental health, daily obligations, and whether the person can function outside of treatment without using. The table below offers a simple comparison. It is not a diagnosis tool, but it can help you understand how different outpatient options may fit different situations after an assessment.
How families can help without taking over
Family support can make a real difference after an opioid overdose, but support works best when it is steady, informed, and boundaried. Loved ones do not need to become investigators, negotiators, or therapists. They can focus on safety, clear communication, and connection to care. It may also help for family members to get support for themselves, especially when fear, anger, or burnout are affecting the home.
A helpful family response balances compassion with accountability. That might mean encouraging treatment attendance, storing naloxone where it is easy to reach, avoiding arguments when someone is intoxicated, and not minimizing the overdose because the person survived. Recovery often involves more than stopping substance use. Depression, anxiety, trauma, chronic pain, or grief may all need attention if long-term change is the goal.
- Keep naloxone available and learn how to use it
- Treat any future overdose concern as an emergency
- Encourage an assessment instead of debating labels
- Use calm, direct language rather than threats
- Set boundaries around money, transportation, and safety
- Seek support for your own stress and mental health
Related reading
- Intensive Outpatient Program: How IOP Treatment Works
- Can You Work While in an IOP Program?
- Does Insurance Cover an IOP Program?
- How Long Does an IOP Program Last?
- How Many Hours a Week Is IOP?
If you or someone you love has survived an opioid overdose, you do not have to sort through the next steps alone. River City Recovery in Columbus, Georgia offers adult outpatient substance use and mental health treatment with care recommendations based on an assessment. To talk through options for PHP, IOP, Evening IOP, or outpatient therapy, call 706-617-4970.
Start IOP or PHP at River City Recovery
If substance use or mental health symptoms are getting in the way of work, family, or safety, waiting rarely makes it easier. River City Recovery in Columbus, Georgia offers a Partial Hospitalization Program for daily structured treatment and an Intensive Outpatient Program that fits around work and home life. Call 706-617-4970 today to schedule an assessment and find out which level of care fits you.
Further treatment information
For more background when comparing options and preparing questions for a care team, consult these public health resources. They do not confirm appointment availability or recommend a particular local provider.
Frequently asked questions
Can someone overdose again after naloxone works?
Yes. Naloxone can temporarily reverse an opioid overdose, but its effects may wear off before the opioid leaves the body. That means breathing problems can return. The person still needs emergency medical evaluation and monitoring, even if they seem awake or say they feel fine after naloxone.
Is an opioid overdose always obvious?
Not always. Some overdoses look like very deep sleep at first. A person may be hard to wake, breathe slowly, make choking or snoring sounds, or have pinpoint pupils. If you are unsure and opioids may be involved, treat it as an emergency and seek help immediately.
What treatment is usually recommended after an overdose?
There is no single standard plan for everyone. Care decisions should follow an assessment of substance use, withdrawal risk, mental health symptoms, medical needs, safety concerns, and daily functioning. Treatment may include medications for opioid use disorder, therapy, family support, and a level of care such as PHP, IOP, Evening IOP, or outpatient therapy.
Does treatment after overdose also address depression or anxiety?
It should when those issues are present. Many people with opioid use disorder also struggle with depression, anxiety, trauma, or grief. Treating only the substance use problem may leave major relapse triggers unaddressed. A full assessment can help identify co-occurring mental health needs and guide integrated care.
How do I start treatment at River City Recovery?
The first step is to call and ask about an assessment. River City Recovery serves adults at 3822 Rosemont Drive, Columbus, GA 31904 and offers Partial Hospitalization, Intensive Outpatient, Evening IOP, and outpatient therapy. Recommendations are made after reviewing your situation, symptoms, risks, and treatment goals.