August 31 is International Overdose Awareness Day. When an overdose happens, the first person on the scene is rarely a paramedic. It is usually a roommate, a parent, a coworker, or a friend, standing in a room and trying to decide what to do.
The hardest thing about an overdose is that it does not look like an emergency at first. The person is slumped over, breathing oddly, hard to wake. The instinct in the room, nearly every time, is to let them sleep it off. That instinct is what costs the most time.
Peachtree Detox & Residential sits on GA-54 in Fayetteville, and the questions that reach us after a night like that are almost always practical ones. How do you tell the difference. Whether to call. Whether calling will make things worse for everyone in the house. Those questions have answers, and in Georgia, where fentanyl has been pressed into counterfeit pills sold across the south metro, the answers have gotten more urgent than they were a few years ago.
Georgia’s own numbers are the reason the state pushed naloxone onto pharmacy shelves without a prescription. Between 2019 and 2022, drug overdose deaths in Georgia rose 76 percent, and fentanyl-involved overdose deaths rose 308 percent, according to the Georgia Department of Public Health. Those are statewide figures. Fayette, Coweta, and Clayton counties are inside them.
Telling an Overdose Apart From Sleeping It Off
If you have ever stood over someone and told yourself they were fine, you were not being careless. From across a room, deep sleep and an overdose look almost identical. Up close, they do not.
The Georgia Department of Public Health and the National Institute on Drug Abuse describe the same cluster of signs. Any one of them is enough to act on.
- They cannot be woken: Not groggy, not slow. They do not respond at all to a loud voice, a hard pinch, or a knuckle rubbed up and down the sternum, the bony ridge in the middle of the chest.
- Breathing is slow, shallow, or stopped: Long gaps between breaths, or chest movement so faint you have to watch for it.
- The sound is wrong: Gurgling, choking, or a snoring-like rattle coming from someone you cannot wake up. People often mistake this for heavy sleep. It is the single most commonly missed sign.
- Color changes: Lips and fingernails turning blue, gray, or purple. Skin going pale, ashen, or clammy.
- Pinpoint pupils: Pupils shrunk down to dots that do not widen when light hits them.
- The body goes limp: Loose arms and legs, a faint heartbeat, an inability to speak, sometimes vomiting.
The wake-up test is worth doing deliberately, because it settles the question fast. Speak loudly, use their name, then rub your knuckles firmly up and down the breastbone. Someone who has had too much to drink or who is simply asleep will groan, flinch, or push your hand away. Someone who is overdosing will not move.
Georgia’s guidance to the public is plain about the uncertainty: if you are not sure, treat it like an overdose. Nothing you do in an overdose response harms a person who turns out not to be overdosing. Waiting, on the other hand, has a cost that cannot be taken back.
Call 911, and What Georgia’s Medical Amnesty Law Actually Covers
People hesitate to call, and it is almost never because they do not care. They hesitate because in the space of about four seconds they are doing math about who is on probation, whose apartment this is, and what an officer will see on the coffee table. Georgia wrote a law specifically to take that math away from you.
The Georgia General Assembly passed House Bill 965, known as the Medical Amnesty Law. The Department of Public Health describes it as providing limited immunity to a person seeking medical attention for themselves or for someone else. According to the department, that immunity covers possession of certain drugs or drug paraphernalia, violations of probation, parole, and other violations, and illegal possession and consumption of alcohol. The same law provides civil and criminal immunity for possessing and administering naloxone.
What “limited” is doing in that sentence
The state’s own wording is limited immunity, and the word matters. This is not a blanket pardon for everything that might be in a room, and nothing here is legal advice. What the law does is remove the specific charges that make people stall in the doorway. If you are weighing a possession charge against whether someone in front of you is breathing, Georgia has already answered that for you. Call.
When dispatch picks up, lead with the two facts they need to send the right unit: someone is unresponsive and not breathing normally, and the address. If naloxone is in the house, say so. If a second person is with you, one of you calls while the other starts working. Across Fayette County and out toward Tyrone, Brooks, and the far side of Coweta County, an ambulance can be several minutes away once you are off the GA-54 and GA-85 corridors. Those minutes belong to whoever is standing there.
Giving Naloxone, and Why One Dose Often Is Not Enough
Naloxone is the step people are most afraid of getting wrong. It is also the step that is hardest to get wrong.
Naloxone is an opioid antagonist, which means it pushes opioids off the receptors in the brain that control breathing and sits in their place, so breathing can restart. NIDA notes it has no effect at all on someone who does not have opioids in their system. That is exactly why it is safe to use when you are not certain what happened. In Georgia, naloxone is sold over the counter at most major pharmacies without a prescription, and a 2024 state law known as Wesley’s Law authorized keeping it in government buildings, courthouses, and on school property, with local school systems required to maintain a supply.
The response sequence Georgia’s health department teaches is short enough to hold in your head:
1. Try to wake them. Loud voice, then a firm sternal rub.
2. Give a dose. Nasal spray goes all the way into one nostril before you press the plunger. Injectable naloxone is drawn from the vial and injected into the thigh muscle, which is where it has to land to work.
3. Call 911 if nobody has yet. Naloxone buys time. It does not replace an ambulance.
4. Start rescue breathing. This is what keeps oxygen moving while the medication takes hold.
5. Give another dose every two minutes if normal breathing has not returned.
6. Roll them onto their side once they are breathing on their own, so they cannot choke if they vomit.
That instruction to redose every two minutes is not a formality. NIDA is direct about the reason: some opioids are stronger and may require multiple doses, and naloxone itself only holds for 30 to 90 minutes while many opioids stay in the body far longer. With fentanyl in the supply across Georgia, needing a second, third, or fourth dose is common and is not a sign that you did anything wrong.
There is one more reason a person may not come all the way back. Naloxone works on opioids and nothing else. It does not reverse xylazine, the veterinary sedative sold on the street as tranq, which is frequently mixed into fentanyl. NIDA still recommends giving naloxone when xylazine is suspected, because opioids are usually present alongside it. If breathing improves but the person stays deeply sedated, that is a reason to stay put and keep working, not evidence that the naloxone failed. The same is true in cases of polysubstance use, where more than one drug is doing damage at once.
Rescue Breathing Is What Buys the Time
Naloxone needs a few minutes to work. The brain does not have a few minutes to spare without oxygen. Rescue breathing fills that gap, and it is simpler than most people expect it to be.
Georgia’s instructions are specific. Get the person onto their back. Tip the head back to straighten the airway. Pinch the nose closed, seal your mouth over theirs, and give one breath every five seconds. Watch for the chest to rise; if it does not, reposition the head and try again. Keep going until they are breathing on their own or until EMS takes over. When breathing steadies, roll them onto their side into the recovery position.
Then stay. The state’s guidance is to remain with the person until emergency help arrives, and there is a clinical reason underneath the obvious human one. In the minutes right after a reversal, a person is at their least able to protect their own airway. Someone has to be watching.
Why They Still Need a Hospital After They Wake Up
This is the step that goes wrong most often, and it goes wrong for a reason anyone would understand. The person wakes up sick, humiliated, and furious, and wants every one of you out of the room.
Naloxone can trigger opioid withdrawal within moments. Georgia’s health department lists what that looks like: restlessness and irritability, body aches, dizziness, nausea and stomach pain, chills, sweating, a runny nose. Those symptoms are usually not life-threatening, and they are also genuinely awful, which is why a person in the middle of them will insist they are fine and try to leave.
They are not fine yet. Naloxone reverses an overdose for roughly 30 to 90 minutes, and many opioids outlast it. When the naloxone wears off, the opioid still circulating can take over again and breathing can slow a second time. NIDA’s guidance is to observe the person constantly until emergency care arrives and to keep monitoring for two more hours after the last dose. That is not something a living room can do reliably at three in the morning.
An emergency department can. Piedmont Fayette Hospital and the other emergency departments across the south metro can keep someone on oxygen, redose if breathing slows again, and check for the complications that follow a long stretch of shallow breathing. The hours after a reversal are also one of the few windows when a person will honestly consider what comes next, and hospital staff can connect that conversation to medically supervised opioid detox before the window closes.
What Comes After the Ambulance Leaves
Surviving an overdose is not the same as being out of danger, and most families sitting in a waiting room already sense that. What follows is usually some mix of relief, exhaustion, and a conversation nobody in the family wants to be the one to start.
An overdose is information about tolerance, about what is actually in the supply, and about how much a person is taking, not a verdict on who they are. Someone who has just survived a fentanyl exposure carries real risk of the next one, especially when counterfeit pills are involved. The window right after a close call is short, and it is the most workable one anybody in this situation gets.
Peachtree Detox & Residential is a medical detox and residential substance use program on GA-54 in Fayetteville, serving Fayette County and the towns around it, including Peachtree City, Tyrone, Newnan, Jonesboro, Griffin, and McDonough. The first days of opioid withdrawal happen here with medical oversight rather than alone, and medication-assisted treatment options including Suboxone, Sublocade, Vivitrol, and naltrexone are available where they are clinically appropriate. From there, residential care picks up the part detox cannot reach, with individual therapy from a master’s-level therapist, cognitive behavioral therapy, dialectical behavior therapy, and trauma-informed work. For military families, Peachtree Detox & Residential is in-network with Tricare East Select and Prime, and our team can check any other plan before you commit to anything.
Getting From a Close Call to a Safe First Step
If someone is overdosing right now, stop reading and call 911. If the emergency has already passed and you are the one still awake with a phone in your hand, that is its own kind of hard, and it counts for something that you are still looking.
Medical detox in Fayetteville puts the first days somewhere with clinical eyes on them, about 30 minutes south of Hartsfield-Jackson and close enough that families in Peachtree City, Tyrone, Newnan, and Jonesboro are not facing a long drive to begin. Our admissions team can walk through what coming in looks like and what your plan actually pays for, and you do not need the whole thing figured out before you talk to them. If you are not ready to pick up the phone tonight, nothing about that is a failure. Come back to it when you are, and you will get the same respect from us then.
If you or someone you love is in crisis, call or text 988 to reach the Suicide & Crisis Lifeline. For treatment referrals and information, SAMHSA’s National Helpline is 1-800-662-HELP (4357).
Frequently Asked Questions During Overdose Awareness Day and Beyond
The dividing line is whether they respond. Say their name loudly, then rub your knuckles firmly up and down the breastbone. A person who is asleep or very drunk will groan, flinch, or push your hand away. A person who is overdosing will not react at all. Look for slow, shallow, or stopped breathing, a gurgling or snoring sound from someone you cannot wake, blue or gray lips and fingernails, and pupils shrunk to pinpoints. If you are unsure, Georgia’s health department advises treating it as an overdose, because responding to an overdose that turns out not to be one causes no harm.
Georgia’s Medical Amnesty Law, House Bill 965, provides what the Georgia Department of Public Health describes as limited immunity for someone seeking medical help for themselves or another person. The department states that this immunity covers possession of certain drugs or drug paraphernalia, violations of probation, parole, and other violations, and illegal possession and consumption of alcohol, and that the law also gives civil and criminal immunity for possessing and administering naloxone. It is limited rather than total, and this is general information rather than legal advice, but the protection exists specifically so that fear of a charge does not delay a call.
No prescription is required. The Georgia Department of Public Health notes that naloxone is available over the counter at most major pharmacies for a fee, and the department maintains a list of harm reduction organizations across the state that distribute it free, including by mail. A 2024 Georgia law known as Wesley’s Law also authorized naloxone in government buildings, courthouses, and on school property, and requires local school systems to keep a supply on hand.
Yes. Naloxone reverses an opioid overdose for roughly 30 to 90 minutes, and many opioids remain active in the body longer than that, so breathing can slow again once the naloxone wears off. NIDA advises watching the person constantly until emergency care arrives and continuing to monitor for two more hours after the last dose. Naloxone also does not reverse non-opioid sedatives such as xylazine, which is often mixed into fentanyl, so a person can start breathing again and still be dangerously sedated. Emergency care handles both of those risks.
Sources
- Georgia Department of Public Health. (2025). What to do if you think someone is overdosing. Retrieved from: https://dph.georgia.gov/stopopioidaddiction/what-you-need-know-about-opioids/what-do-if-you-think-someone-overdosing. Accessed on August 28, 2026.
- Georgia Department of Public Health. (n.d.). Naloxone. Retrieved from: https://dph.georgia.gov/stopopioidaddiction/what-you-need-know-about-opioids/naloxone. Accessed on August 28, 2026.
- Georgia Department of Public Health. (2024). Fentanyl. Retrieved from: https://dph.georgia.gov/stopopioidaddiction/what-you-need-know-about-opioids/fentanyl. Accessed on August 28, 2026.
- Georgia General Assembly. (2014). House Bill 965 (Georgia Medical Amnesty Law). Retrieved from: https://www.legis.ga.gov/api/legislation/document/20132014/141366. Accessed on August 28, 2026.
- National Institute on Drug Abuse. (n.d.). Naloxone DrugFacts. Retrieved from: https://nida.nih.gov/publications/drugfacts/naloxone. Accessed on August 28, 2026.
- National Institute on Drug Abuse. (n.d.). Xylazine. Retrieved from: https://nida.nih.gov/research-topics/xylazine. Accessed on August 28, 2026.
- Substance Abuse and Mental Health Services Administration. (n.d.). Opioid overdose prevention and reversal. Retrieved from: https://www.samhsa.gov/substance-use/treatment/overdose-prevention. Accessed on August 28, 2026.
