Call 911 and give naloxone if:
- Hard to awaken or unresponsive
- Slow, shallow, or irregular breathing—or not breathing
- Blue or gray lips or skin
- Seizure
- Severe confusion or collapse
- Dangerous agitation after use
Stay with the person. Provide rescue breathing or CPR if trained. U.S. Poison Help: 1-800-222-1222.
Why naloxone matters
Experimental and clinical signals support opioid-like respiratory toxicity from concentrated 7-OH, with naloxone-responsive depression in animal work and human arrest/poison-center reports. Give naloxone when opioid overdose is possible—even if the product was sold as “kratom” or a retail supplement.
Do not substitute street opioids
If the usual product becomes hard to find, do not try to “get through” with counterfeit pills, heroin, or fentanyl. That is how transitions like this become lethal. Call for clinical care and keep naloxone available. Photograph any packaging for the care team.
Seek prompt medical care (do not unsupervised home withdrawal) when there is:
- Pregnancy
- Seizure disorder
- Significant heart or lung disease, or sleep apnea with sedative use
- Repeated vomiting or diarrhea, dehydration
- Older age or frailty, or very young age
- Serious psychiatric symptoms
- Heavy alcohol or benzodiazepine use
- Concurrent fentanyl or prescription-opioid dependence
- Prior severe precipitated withdrawal
- Unreliable or unknown product (possible adulterants or analogues)
Factors that raise overdose risk
Alcohol, benzodiazepines, other opioids, gabapentinoids, and other sedatives can add respiratory depression. Product composition is often uncertain. Mixing is especially dangerous.
After the emergency
Surviving an overdose or severe withdrawal episode is the start of a care plan, not the end. Arrange follow-up for dependence treatment before retail access changes further. See patients & families, withdrawal course, and treatment framework.
Help lines
Immediate contacts
Emergency: 911
Poison Help: 1-800-222-1222
SAMHSA Helpline: 1-800-662-HELP (4357)
Patient referrals: (650) 308-4845 · office@eusomniamd.com