Stimulants on their own do not cause overdose in the way opioids do (when someone stops breathing), but they are increasingly being found in combination with opioids during overdose. In 2022, more than 70% of overdose deaths in Philadelphia involved a stimulant – primarily cocaine.

Overdose deaths involving both a stimulant and an opioid can be a result of intentional mixing or because of a contamination of the stimulant drug supply. If you are using a substance of any kind – even if it is not an opioid – you should carry naloxone (Narcan) in case the drug contains an opioid.

Naloxone (Narcan) reverses overdoses caused by opioids. A majority (55%) of overdose deaths in Philly in 2022 involved a combination of opioids and stimulants. They are often used together, both on accident and on purpose.

If someone who has been using a substance is not breathing, they may be experiencing an overdose, and you should give them naloxone. Other symptoms such as racing heartbeat, overheating, or uncontrolled muscle movements cannot be controlled using naloxone.

Overamping (or “fishing out”) is an unplanned, negative physical or mental effect from stimulant use. Below, we’ll describe what overamping looks like, how to manage the symptoms, and how to know when it’s time to go to the hospital.

Overamping can look and feel different for different people. The symptoms and seriousness of overamping depend on several factors, including the type and dose of substance, the route of use (e.g. injection, snorting), the health status of the person using, and the environment they’re using in.

What are signs of overamping?

Physical signs/symptoms include: nausea and/or vomiting; falling asleep/passing out (but still breathing); irregular breathing or shortness of breath; convulsions, tremors, limb jerking or rigidity; severe headache; seizures; chest pain; focal weakness (e.g. facial droop).

Mental symptoms include: panic; paranoia; hallucinations; increased aggressiveness; restlessness or irritability.

How to respond to a non-emergency situation:

• Hydrate with water or a sports drink.

• Cool down with a cold/cool shower.

• Eat something.

• Try to sleep or rest.

• Take deep breaths, take a walk, or move to a quieter location if possible.

Call 911 if you, or the person you’re with, are experiencing signs of:

• Hyperthermia (body temperature at or above 104 F, confused, or unconscious).

• Heart attack (elevated heart rate along with chest pain, shortness of breath, dizziness, nausea, or unusual fatigue).

• Stroke.

• Seizures.

• Hallucinations or delusions.

Fentanyl test strips (FTS) and Xylazine test strips (XTS) can be used to see if those drugs are present in the substance you’re testing - here are instructions on how to use test strips.

While test strips are a great tool, they are not 100% accurate. Use universal precautions to stay safe.