How to Prevent Overdose with Patch, Liquid, and Extended-Release Medications

Every year, thousands of people die from overdoses involving prescription medications - not just street drugs. Many of these deaths happen because of how the medicine is made: patches that leak, liquids that are hard to measure, and pills designed to release poison slowly over hours. If you or someone you care about uses any of these forms, knowing the risks isn’t just helpful - it’s life-saving.

Why These Forms Are More Dangerous

Not all medications are created equal when it comes to overdose risk. Patch, liquid, and extended-release forms are designed to deliver drugs slowly. That’s good for pain control. But if they’re used wrong, they become time bombs.

Fentanyl patches, for example, are made to release a steady dose through the skin over 72 hours. But if someone cuts the patch open, chews it, or sticks it on a hot body part - like a heating pad - the whole dose can flood the system in minutes. That’s enough to stop breathing. One patch contains more fentanyl than most people can safely handle in a single dose.

Liquid opioids, like morphine syrup or cough medicine with codeine, are tricky because dosing is so easy to mess up. A teaspoon isn’t the same as a tablespoon. A kitchen spoon isn’t accurate. If someone uses the wrong tool or guesses the dose, they can take 5 or 10 times too much. And because these liquids often come in different strengths, mixing them up is a real danger.

Extended-release pills - like OxyContin or long-acting oxycodone - are built to last. But if you crush, chew, or dissolve them, you bypass the time-release mechanism. Suddenly, the full 24-hour dose hits your body all at once. That’s how someone who’s been taking one pill a day ends up dead after taking just one - because they didn’t know what they were really swallowing.

How to Use Patches Safely

If you’re prescribed a fentanyl or other opioid patch:

• Never cut, tear, or poke holes in the patch. Even a small tear can cause dangerous leakage.
• Apply only to clean, dry, flat skin - like the upper arm, chest, or back. Avoid areas with scars, burns, or irritation.
• Don’t heat the patch. No hot tubs, saunas, heating pads, or direct sunlight on the area. Heat makes the drug absorb faster - fast enough to kill.
• Store patches out of reach. Kids, pets, or visitors can accidentally stick them on their skin and overdose. Keep them in their original packaging, locked up if possible.
• Dispose of used patches properly. Fold the sticky side inward, put it back in the original foil pouch, and throw it in the trash. Don’t flush it. Don’t leave it lying around. Even a used patch can still contain enough drug to be deadly.

How to Use Liquid Medications Safely

Liquid opioids are often given to children, elderly patients, or those who can’t swallow pills. But they’re also the most common source of dosing errors.

• Always use the measuring tool that came with the medicine. That’s usually a syringe, cup, or dropper marked in milliliters. Never use a kitchen spoon.
• Check the strength. Liquid opioids come in different concentrations - like 5 mg per 5 mL or 10 mg per mL. Mixing them up is deadly. Write the strength on the bottle if it’s not clear.
• Keep liquids locked up. A child drinking even a small amount can die. A teenager thinking it’s just cough syrup can overdose.
• Don’t mix with alcohol or sedatives. Even a little beer or sleeping pill with liquid opioids can slow breathing to a stop.
• Use a pill organizer with a reminder if you take it more than once a day. Missed doses can lead to someone doubling up later, thinking they’re behind.

How to Use Extended-Release Pills Safely

These pills are made to work slowly. That’s why they’re often prescribed for chronic pain. But they’re also the most dangerous if misused.

• Never crush, chew, or dissolve these pills. Ever. If you can’t swallow them, ask your doctor for a different form.
• Take exactly as prescribed. Don’t take more because the pain isn’t gone. Don’t skip doses and then double up. The timing matters.
• Don’t combine with alcohol, benzodiazepines, or sleep aids. These all slow breathing. Together with extended-release opioids, they’re a deadly combo.
• Store them in a locked box. These pills are often targeted by people looking to abuse them. If someone else takes one, even once, it could kill them.
• Know the signs of overdose: slow or shallow breathing, blue lips, unresponsiveness, pinpoint pupils. If you see these, act fast.

Naloxone Is Your Best Backup

Naloxone - sold as Narcan or Kloxxado - can reverse an opioid overdose in seconds. It works on patches, liquids, and extended-release pills. But here’s the catch: it doesn’t last as long as the drug.

Extended-release opioids can keep releasing into the body for hours after naloxone wears off. That means someone can seem fine after one dose of naloxone - then slip back into overdose hours later.

That’s why:

• Always call 911 after giving naloxone. Even if they wake up.
• Keep naloxone nearby. If you’re using these meds, or live with someone who is, keep at least two doses on hand.
• Train everyone around you. Your partner, your roommate, your neighbor - anyone who might be there when it happens. Naloxone is easy to use. No medical training needed.
• Get it for free. In New Zealand, Australia, and many U.S. states, naloxone is available without a prescription at pharmacies. Some community centers give it out for free.

Other Critical Safety Steps

• Don’t use alone. If you’re taking any of these medications, have someone check on you. Text them when you take it. Ask them to call 911 if you don’t respond in 15 minutes.
• Use drug checking services. If you’re getting medication from a non-pharmacy source, test it with fentanyl strips. Even legal prescriptions can be contaminated.
• Ask your doctor about alternatives. Are there non-opioid pain treatments? Could a short-acting pill work instead of a patch or extended-release version?
• Dispose of unused meds properly. Don’t flush them. Don’t throw them in the trash loose. Take them to a pharmacy drop box or a take-back event. Unused patches and pills are a danger to others.

What to Do If Someone Overdoses

If you suspect an overdose - slow breathing, unresponsive, blue skin:

1. Call 911 immediately. Say: "I think someone overdosed on opioids. They’re not breathing." You won’t get in trouble.
2. Give naloxone if you have it. Spray one dose in each nostril, or inject into the arm or thigh.
3. Start rescue breathing if they’re not breathing. Tilt the head back, pinch the nose, give one breath every 5 seconds.
4. Stay with them. Even if they wake up, they need medical care. The drug may come back.

There’s no shame in needing help. The system isn’t perfect. But knowing these steps can mean the difference between life and death.

Final Thought: Safety Isn’t Optional

These medications can help manage pain. But they’re not harmless. The risks are real, and they’re often hidden in plain sight - in a patch stuck to the skin, a bottle of syrup on the counter, a pill meant to last all day. The best way to prevent overdose isn’t to avoid these medicines entirely. It’s to understand them. To treat them with care. To have naloxone ready. And to never, ever use them alone.