A Substance-Use Crisis

If you are in danger right now: if someone will not wake up, is struggling to breathe or is having a seizure, call an ambulance on 10177, or 112 from a mobile. Stay with them.

Maybe someone you love has taken too much. Maybe you are shaking and sick because you stopped. In a substance-use crisis, fear and shame can make people wait. Please do not wait. Getting help fast saves lives.

What is happening

A substance-use crisis is when alcohol or drugs put someone in immediate danger. This includes overdose, alcohol poisoning, mixing substances, dangerous behaviour while high, and severe withdrawal.

Signs of an overdose or alcohol poisoning include not waking up, slow or noisy breathing, blue or grey lips, vomiting while half-awake, seizures and a very fast or very slow heartbeat. If you see these, call 10177 straight away.

Stopping alcohol or some medicines suddenly after heavy use can also be dangerous, with shaking, confusion, seeing things or seizures. It is safer to stop with medical support. Helping someone in a crisis is about keeping them alive first. Treatment and recovery come next, and recovery is very possible.

Signs to notice

• Cannot wake them, or they wake and pass out again
• Slow, noisy or irregular breathing
• Blue or grey lips or fingertips
• Seizures, confusion or seeing things that are not there
• Talking about ending their life while using
• Heavy use for days, then stopping suddenly

30-second self-check

Answer yes or no. If you answer yes to the first question, stop here and get help now: call 10177 or 112.

• Is someone unconscious, struggling to breathe, fitting or badly hurt right now?
• Have they mixed alcohol with pills or other drugs?
• Is anyone talking about ending their life?
• Is someone shaking, confused or seeing things after stopping?
• Is the person alone, or about to drive?
• Has this happened before?

0-1 yes: If your yes was the first question, call 10177 or 112 now. Otherwise, stay close and keep watching.
2-3 yes: This is risky. Do not leave the person alone. Call the Substance Abuse Helpline on 0800 12 13 14 for advice.
4 or more yes: Please get emergency help now. Call 10177 or 112. If someone talks about ending their life, also call the Suicide Crisis Helpline on 0800 567 567.

What you can do next

• Today: Stay with the person. If they are breathing but drowsy, lie them on their side so they will not choke. Do not give more alcohol, coffee or a cold shower, and do not make them vomit.
• This week: Once safe, call the Substance Abuse Helpline on 0800 12 13 14, or SMS 32312, to talk about detox and treatment options.
• This month: See a doctor or clinic about safe withdrawal and treatment. Look into outpatient support, rehab and support groups.
• Remove car keys if someone is high or drunk, and keep medicines out of reach.

Your tool

Crisis Plan Builder - helps you write down warning signs, who to call and what to do in a substance-use emergency, so you can act fast.

When to get professional help

Get urgent help for any sign of overdose or severe withdrawal. Get ongoing help if use is causing harm to health, money, work or family. Addiction is a health condition and treatment works.
Who can help: emergency services (ambulance), addiction treatment services, doctors, social workers, counsellors

Getting help in South Africa

• Ambulance (10177) or 112 from a mobile: for any medical emergency.
• Substance Abuse Helpline (0800 12 13 14, SMS 32312): advice and treatment referrals.
• Public clinics and hospitals: medical detox and referrals.
• Department of Social Development: social workers and public treatment centres.
• Cleared Mind 24-hour Careline (0800 212 146): counselling for you or your family.