When to Call Poison Control vs. Emergency Services for Overdose

When someone overdoses, every second counts. But calling 911 isn’t always the right first step-and not calling it when you should can be deadly. The difference between life and death often comes down to one question: Do you call Poison Control or emergency services? It’s not about being cautious. It’s about knowing exactly when each service is designed to help.

Call 911 Immediately If There Are Life-Threatening Symptoms

If the person is unconscious, not breathing, having seizures, or their heart is racing or skipping beats, don’t hesitate. Call 911 right away. These aren’t "maybe" signs-they’re red flags that the body is shutting down. The CDC reports that 28.3% of fatal poisoning cases involve respiratory failure. If someone can’t breathe, waiting to get advice from a hotline could cost them their life.

Other clear emergencies include:

• Unresponsiveness-even when you pinch their skin or shake them firmly
• Seizures lasting more than 5 minutes
• Systolic blood pressure below 90 mmHg (a sign of shock)
• Blue lips or fingertips (oxygen deprivation)

These symptoms mean the overdose has already reached a critical stage. Emergency responders are trained to give naloxone for opioid overdoses, start breathing support, and get IV medications on the way. Poison Control can’t do any of that. They guide. EMS saves lives.

Call Poison Control When the Person Is Stable

If someone took too much of a medication but is still awake, talking, breathing normally, and has no symptoms, Poison Control is your best first move. They’re staffed by pharmacists and toxicologists who know exactly how much is dangerous, how fast it acts, and what to watch for.

Common situations where Poison Control is the right call:

• A child accidentally swallowed one extra pill
• An adult took two doses of their blood pressure medicine by mistake
• Someone ingested a household cleaner but feels fine
• A person took a supplement they didn’t recognize and is now worried

Poison Control handles about 2.1 million cases a year. Nearly half involve medications, and most of those are non-emergency mistakes. Their goal is to prevent unnecessary trips to the ER. In fact, one study found they help avoid 300,000 unnecessary ambulance rides annually-saving the system over $1.8 billion.

What Information to Have Ready

Whether you’re calling 911 or Poison Control, having the right details speeds up the response. For Poison Control, you need:

• The exact name of the substance (check the bottle-"ibuprofen" isn’t enough; is it Advil, Motrin, or a generic? What’s the strength?)
• How much was taken (in milligrams or milliliters-not "a handful" or "a few pills")
• When it happened (within 15 minutes accuracy)
• The person’s weight in kilograms (if you don’t know it, estimate as close as possible)
• Any symptoms and when they started
• What you’ve already done (did you give them water? Induce vomiting? Administer naloxone?)

Don’t guess. Look at the container. The label has the exact concentration, formulation (immediate-release vs. extended-release), and active ingredients. Extended-release pills can keep releasing poison for hours, while immediate-release hits fast. That changes everything.

Special Cases: Kids, Seniors, and Opioids

Children under 6 and adults over 75 are at higher risk-even from small amounts. A single pill that’s harmless to a healthy 30-year-old can be deadly to a toddler or an elderly person on five other medications.

For kids:

• Asymptomatic children who swallow one pill of most medications can often be monitored at home after calling Poison Control
• But avoid this for clonidine, sulfonylureas, or any heart or psychiatric meds-call 911 immediately

For seniors:

• Any significant exposure-no matter how small-should trigger a 911 call
• 83% of adults over 75 take five or more medications. Interactions can be unpredictable and deadly

For opioids:

• If you have naloxone (Narcan), use it right away
• Then call 911-even if the person wakes up
• Fentanyl and its analogs can wear off faster than naloxone, causing the person to stop breathing again

There’s a myth that if naloxone works, you’re fine. It’s not true. The overdose isn’t over until medical professionals say so.

Don’t Rely on Apps or Online Tools Alone

There’s a web tool called webPOISONCONTROL and a mobile app. Both are useful for low-risk cases. But they’re not substitutes for human advice when things are unclear.

• They can’t handle multiple substances
• They won’t work if the person has symptoms
• They can’t replace a real-time conversation with a toxicologist

One study found that 18.3% of app users tried to manage high-risk overdoses on their own after using the tool-and ended up in the ER anyway. The app is great for learning first aid steps, but if you’re unsure, call the hotline: 1-800-222-1222.

What Poison Control Can’t Do

They won’t send an ambulance. They won’t give you medicine. They won’t show up at your door. Their job is to assess risk and tell you what to do next. Sometimes that’s "watch them at home." Sometimes it’s "call 911 now."

And here’s the thing: if you call them and they tell you to go to the ER, go. Don’t second-guess them. They’ve seen thousands of cases. They know the patterns.

What Happens If You Call the Wrong Number?

If you call Poison Control and they realize it’s an emergency, they’ll transfer you to 911 automatically. If you call 911 and it’s a minor case, they’ll connect you to Poison Control. The system is built to handle mistakes.

But the longer you wait to act, the worse it gets. A 2023 study found that people who waited more than 30 minutes after an accidental overdose to call for help were 40% more likely to end up hospitalized. Speed matters.

Real-World Mistakes People Make

- "They’re sleeping it off." That’s not how overdoses work. Many people don’t wake up.

- "I didn’t see any pills, so it must be nothing." Fentanyl can be invisible. A tiny speck can kill.

- "I called Poison Control, they said to wait, so I did." If symptoms appear later, call 911 immediately. Don’t wait for them to call back.

- "I gave them coffee or a cold shower." These do nothing. They can even make things worse.

There’s no home remedy for overdose. Only medical intervention works.

What About Carbon Monoxide?

If you suspect carbon monoxide poisoning-even if the person seems fine-call 911 immediately. It’s not a typical overdose. It’s a silent killer. Symptoms like headache, dizziness, or nausea can seem mild, but 42.7% of people who survive the initial exposure develop brain damage days later. No waiting. No calling Poison Control first. Just call 911.

Bottom Line: When in Doubt, Call 911

You can’t be wrong for calling emergency services. You can be dangerously wrong for waiting. Poison Control is there for the quiet, hidden risks-the mistakes that don’t look like emergencies yet. Emergency services are for when the body is failing.

If you’re unsure, err on the side of caution. Call 911. Then call Poison Control after. Or call Poison Control first, but be ready to hang up and dial 911 if anything changes.

Keep the Poison Help number (1-800-222-1222) saved in your phone. Put it on the fridge. Tell your family. Overdoses happen fast-but help is faster if you know where to reach it.