Poisoning, Overdose and Accidental Medicine Exposure

A person can look well soon after a harmful exposure and still need urgent assessment. Do not wait for symptoms, make them vomit or invent a home antidote. Get professional advice immediately.

Poisoning happens when a harmful substance enters or contacts the body in an amount capable of causing injury. The substance may be a medicine, household chemical, alcohol, recreational drug, plant, pesticide, gas or workplace product. Exposure can occur by swallowing, breathing in, injection, or contact with the skin or eyes. Food poisoning from contaminated food is a different topic and usually follows a different pathway. Poisoning, overdose and accidental exposure An overdose means taking more of a medicine or drug than intended or safe. It may be accidental, caused by a dosing mistake, or taken deliberately. Accidental medicine exposure includes a child swallowing tablets, someone taking another person's medicine, using the wrong strength, repeating a dose, or confusing two products. The word poisoning describes harm or potential harm. It does not tell you how severe the outcome will be, and symptoms alone cannot establish the substance or dose. Do not wait for symptoms Some poisons cause symptoms quickly. Others can cause delayed toxicity, where important injury develops hours or days after the exposure. A person may initially feel well after taking too much medicine. Feeling well does not prove that the exposure is safe. Do not wait for vomiting, pain, drowsiness or breathing difficulty before seeking advice. Early assessment may allow treatment before serious injury becomes obvious. Choosing 999, A&E or NHS 111 Call 999 for unconsciousness, abnormal or absent breathing, severe breathing difficulty, a seizure, collapse, severe confusion or rapidly worsening symptoms. After a deliberate overdose, call 999 or go to A&E now, even if the person feels well. Use 999 when the person is drowsy, unwell, unsafe or cannot travel safely. NHS guidance advises immediate emergency assessment when someone may have swallowed, touched or breathed in something harmful. Do not drive yourself to A&E. Ask another adult to drive when it is safe, or call 999 for an ambulance. Call NHS 111 immediately when you are unsure whether a swallowed, touched or inhaled substance is harmful. Have the product, medicine packet or container available during the call. Children require particularly prompt advice because a small amount can represent a larger dose for their body size. Do not wait for a child to become unwell. Make the area safe Do not enter a contaminated room, smoke filled area or chemical spill without appropriate protection. Call emergency services and keep others away. For inhaled fumes, move into fresh air only when this can be done without exposing yourself. Do not re enter a building where carbon monoxide or another toxic gas may be present. For skin or eye contact, avoid touching the substance directly. Follow the product label and the instructions from 999 or NHS 111 about removing contaminated clothing and rinsing. What to do while waiting Check responsiveness and breathing. Start CPR if the person is unresponsive and not breathing normally. If they are unresponsive but breathing normally, use the recovery position when appropriate. Keep checking because breathing can become slower or stop. Keep the person calm and under observation. If they are awake, continue talking to them and report any increasing drowsiness, confusion, vomiting or breathing change. Find the packaging, container, medicine blister, prescription label or photograph of the product. Take it to hospital when possible. Try to establish the substance, strength, amount, time, route of exposure and whether anything else was taken. Do not delay the emergency call while searching for perfect information. What not to do Do not try to make the person vomit. Vomiting can cause choking, breathing problems or further injury from corrosive substances. Do not give food, drink, milk, salt water or another medicine unless a healthcare professional directs you. There is no universal home antidote. Do not give activated charcoal from a household or online product. Hospital teams use specific treatments only for selected substances and circumstances. Do not rely on internet dose calculators or compare the exposure with someone else's experience. Risk depends on the exact substance, strength, amount, timing, route and person. Medicine overdose Medicines that are safe at the recommended dose can be dangerous in overdose. Risk also changes when medicines are combined with alcohol, sedatives or other drugs. Do not use a single tablet count as a universal threshold. Some medicines cause serious harm at relatively small excess doses, while assessment of others depends on body weight and timing. Bring all medicine packets, including regular prescriptions and non prescription products. Several products may contain the same active ingredient under different names. A deliberate overdose is also a mental health emergency. The person needs immediate physical assessment and protection from further harm, even when they later say they feel well. Possible opioid overdose Opioids include medicines and drugs that can suppress breathing. Possible opioid toxicity should be suspected when someone is extremely drowsy or unresponsive and breathing slowly, irregularly or not at all. Very small pupils may support the concern, but they are not always present and do not confirm the diagnosis. Mixed overdoses and other medical emergencies can look similar. Call 999. If the person is unresponsive and not breathing normally, start CPR. Give naloxone if it is available and you have been trained to use it. Naloxone is an antidote that temporarily reverses opioid effects. Follow the kit instructions about further doses and tell the ambulance service what was given. Stay with the person because opioid effects can return after naloxone wears off. Alcohol and mixed substances Severe alcohol poisoning can reduce consciousness, slow breathing, trigger seizures and increase the risk of choking on vomit. Call 999 when alcohol poisoning is suspected or the person is difficult to wake. Do not assume someone is "just drunk." Head injury, low blood glucose, other drugs and serious illness may be present at the same time. Information clinicians need Emergency teams need the person's age, approximate weight when relevant, symptoms, medical conditions and regular medicines. They also need the suspected substance, strength, amount, time and route. State what is known and what is uncertain. A partly empty packet does not prove how much was taken, and the person's account may change. Clinical assessment may include observation, heart monitoring, blood tests and substance specific treatment. One normal early result may not exclude delayed toxicity. Preventing accidental exposure Keep medicines and chemicals in their original labelled containers. Store them out of sight and reach of children, ideally in a locked cupboard. Use one clear dosing record when several adults give a child medicine. Check the medicine name, strength and measuring device every time. Do not mix household chemicals or decant them into drink bottles. Install and maintain carbon monoxide alarms where fuel burning appliances are used. Return unwanted medicines to a pharmacy rather than storing large unused supplies or placing them in household waste. This page cannot determine whether a particular dose or exposure is safe. Contact 999, A&E or NHS 111 as described and follow professional instructions.

Suspected poisoning needs prompt professional advice even when the person feels well. Preserve information, monitor breathing and never induce vomiting or invent a home antidote.