Though less common at harm reduction sites than opioid overdose, overamp can happen to people who use stimulants at any time in any place, so it’s important that you first recognize and know how to respond in case it comes up at your site.

First, look for the physical signs of overamp, including:

• High temperature/sweating profusely, often with chills
• Fast heart rate, racing pulse
• Hypertension (elevated blood pressure)
• Irregular breathing or shortness of breath
• Headache
• Teeth grinding
• Convulsions/tremors
• Limb jerking or rigidity
• Feeling paralyzed while awake
• Nausea and/or vomiting
• Chest pain or a tightening in the chest

Next, look for the emotional signs:

• Severe anxiety/paranoia/panic
• Increased agitation, frustration and aggression
• Hypervigilance
• Visual and/or auditory hallucinations

Finally, look for the potential serious physical consequences of overamp, including:

• “Hyperthermia” (overheating)
• Seizures
• Stroke
• Cardiac arrest

What to do in case of overamp

Watch out for the most obvious signs of its most dangerous outcomes such as:

Hyperthermia*

• Agitated movement.
• High temperature.
• Hot dry skin.
• Acting confused or hostile.

*Note: hyperthermia is the opposite of hypothermia, which is what happens when people freeze to death.

Seizure

• Twitching and jerking.
• Frothing at the mouth.
• Sudden stiffening of the body.
• Sudden falling.

Stroke

• Sudden, severe, headache with no obvious cause.
• Sudden numbness or weakness in the face, arms, or legs, especially on one side of the body.
• Sudden confusion, trouble speaking, or difficulty understanding speech.
• Sudden trouble seeing out of one or both eyes.
• Sudden trouble walking, dizziness, loss of balance, or lack of coordination.

Cardiac Arrest

• Pressure, tightness, pain, or a squeezing or aching sensation in the chest or arms that may spread to the neck, jaw or back.
• Nausea, indigestion, heartburn or abdominal pain.
• Erratic pulse.
• Shortness of breath.
• Cold sweat.
• Lightheadedness or sudden dizziness.
• The person may appear pale or ashen.

What to do:

Hyperthermia

• Try to get the person to sit as still as possible.
• Get them to drink water or electrolyte drinks like Gatorade.
• Cool the environment by opening a window or putting on a fan or air conditioner.
• Place cold, wet cloths on their neck and face or anywhere over an artery to help cool the blood.
• If they become confused or agitated, call 911 immediately as this can be a sign that they are close to death.

Seizure

• Stay with the person until the seizure is over.
• Make sure the person is in a safe position—on one side is optimal.
• Move anything hard or sharp from around them.
• Remove any extraneous clothing like ties, scarves, or eyewear.
• Put something soft under the person’s head, such as a pillow or rolled up jacket.
• Call 911 if:
  • It is the person’s first seizure
  • The seizure lasts more than 5 minutes
  • They have multiple seizures in a short period of time
  • The person has difficulty breathing.

Stroke

• First double check your observation:
  • Ask them to smile, does one side of their mouth droop?
  • Ask them to raise both arms, does one drift down?
  • Is their speech impaired?
  • If you note any of these symptoms call 911 immediately!
• Note what time you notice symptoms started, medical staff need this information for treatment.
• Do not allow the person to go to sleep.
• Do not allow the person to drive.
• If possible, wait for emergency services, but even if the person insists, make sure they do not drive under any circumstances.

Cardiac Arrest

• Call 911 immediately and/or go to an emergency room right away BEFORE a person’s heart stops.
• If the person loses consciousness or their heart stops, perform CPR (100-120 chest compressions per minute) or use a portable defibrillator where available.