Which combination of signs is commonly associated with opioid overdose?

• A. Shallow breathing, dilated pupils, agitation
• B. Nausea and dizziness
• C. Shallow breathing, constricted pupils, lethargy
• D. Hyperalertness and increased energy

Answer: (C)

Recognizing opioid overdose hinges on the classic signs of respiratory depression, pinpoint pupils, and altered mental status. Opioids slow breathing, so shallow or reduced respiration is a key warning sign. They also cause pupil constriction (miosis), a distinctive and common finding. Together with drowsiness or lethargy, these symptoms form the typical triad that points to an opioid overdose.

That’s why the combination of shallow breathing, constricted pupils, and lethargy is the best match. The other options don’t fit as well: shallow breathing with dilated pupils and agitation suggests a different type of intoxication, such as stimulants or withdrawal in some cases; nausea and dizziness can occur with many conditions but don’t reflect the main overdose pattern; hyperalertness and increased energy are indicative of stimulant effects, not opioid overdose.

In suspected cases, act quickly to secure help and consider naloxone if you’re trained to administer it.