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 decision: poison control or emergency services?

When to Call Poison Control

Common situations where Poison Control is the best first move include:

• Accidentally taking a double dose of a prescription pill, like ibuprofen or blood pressure medication
• A child swallowing one or two pills from a bottle, and they’re acting normal
• Ingesting a household cleaner, like dish soap or laundry detergent, with no vomiting or breathing issues
• Someone taking too much of an over-the-counter medicine, like acetaminophen, but still alert and talking

Before you call, gather these details:

• The exact name of the substance (check the bottle-"Tylenol" isn’t enough; you need "acetaminophen 500 mg extended-release")
• How much was taken (in milligrams or milliliters, not "a handful")
• When it happened (within the last 15 minutes matters)
• The person’s weight in kilograms (most people guess this wrong-use a scale if possible)
• Any symptoms that started, and when

Experts say if no symptoms appear within 4 hours after exposure to most common drugs, the risk of serious harm drops sharply. Poison Control can tell you whether to wait, watch, or head to the ER. In 2022, over 82% of single-substance pediatric cases handled by Poison Control were safely managed without an ER visit.

When to Call 911 Immediately

These are the red flags that mean emergency services are needed:

• They can’t wake up, even when you shake them or pinch their shoulder
• They’re breathing very slowly, shallowly, or not at all
• They’re having convulsions or jerking movements that last more than 5 minutes
• Their skin is blue, gray, or cold to the touch
• They have a very low blood pressure (feels like they’re slipping away)

These signs mean the body is shutting down. In opioid overdoses, for example, breathing stops before the heart does. That’s why naloxone (Narcan) should be given immediately-if you have it-and then 911 must be called, even if they wake up. Synthetic opioids like fentanyl can wear off faster than the drug in their system, and they can stop breathing again minutes later.

Also, call 911 right away if:

• The overdose was intentional (suicide attempt)
• Multiple drugs were taken together
• The person is under 1 year old or over 79 years old
• They swallowed something unknown-like a pill they found, or a substance from a party

For older adults, even a small overdose can be deadly. Most take 5 or more medications daily, and mixing them can cause sudden, unpredictable collapse. For babies, their bodies process drugs differently-what’s harmless to an adult can be fatal to a toddler.

Why Not Just Call Poison Control for Everything?

Emergency responders have tools and training that Poison Control doesn’t. And when seconds matter, delay can be fatal.

Studies show that 68% of ER doctors have seen patients arrive after calling Poison Control for high-risk overdoses-like calcium channel blockers or beta-blockers-that caused sudden heart failure hours later. These drugs don’t always cause symptoms right away. Poison Control might say "watch and wait," but if the person’s heart starts to fail at 2 a.m., they won’t make it to the hospital in time.

Similarly, opioid overdoses involving fentanyl or carfentanil can appear mild at first. Naloxone might reverse the effects, but the drug lingers. Without EMS monitoring, the person can slip back into respiratory arrest. In one 2024 study, 61% of cases where people called Poison Control for suspected fentanyl overdoses ended up needing 911 within 20 minutes.

What About Online Tools Like webPOISONCONTROL?

But here’s the catch: it’s not for everyone. The system can’t handle:

• People who are already showing symptoms
• Multiple substance ingestions
• Intentional overdoses
• Children under 1 year or adults over 79

And here’s the problem: 18% of people who use the app think it’s a substitute for calling a real person. They skip the hotline and try to manage a dangerous situation themselves. That’s how preventable deaths happen.

Use the app only if the person is completely fine and you’re certain it’s a low-risk exposure. Otherwise, pick up the phone.

Special Cases That Change the Rules

• Carbon monoxide poisoning: Even if someone feels dizzy or has a headache, call 911 immediately. The damage to the brain and heart can show up hours later. Poison Control will tell you to get out of the house and call 911-no exceptions.
• Clonidine or sulfonylurea pills: These are rare, but deadly in tiny amounts. A child swallowing just one clonidine pill can go into a coma. Call 911, not Poison Control.
• Illicit drugs: If you don’t know what was taken, assume the worst. Call 911. Synthetic drugs like fentanyl, nitazenes, or benzodiazepine analogs can cause sudden, unpredictable collapse.

For kids under 6: If they swallow one pill and are acting fine, call Poison Control. But if it’s a heart medication, insulin, or psychiatric drug-call 911. The margin for error is zero.

What to Do While Waiting for Help

• Stay on the line. The dispatcher will give you instructions while help is coming.
• If you have naloxone and suspect an opioid overdose, administer it now.
• Do not give them anything to eat, drink, or vomit unless told to by a medical professional.
• Keep them on their side if they’re unconscious-this keeps their airway open.

If you’re calling Poison Control:

• Have the container in hand. The label tells them the exact strength and formulation.
• Do not induce vomiting unless they tell you to. It can cause more harm.
• Write down everything they say. You’ll need to repeat it to paramedics if you go to the ER.

What Happens After the Call?

If you go to the ER, bring the pill bottle or substance container. Emergency staff need to know exactly what was taken. Many overdoses involve multiple drugs, and without the label, they’re guessing.

Even if the person seems fine after treatment, follow-up matters. Some toxins cause delayed organ damage-like liver failure from acetaminophen-that doesn’t show up until 24-48 hours later.

Final Rule: When in Doubt, Call 911

Poison Control is a lifesaver-but it’s not a substitute for emergency care when the body is failing. The goal isn’t to avoid the hospital. The goal is to keep someone alive long enough to get the care they need.

If you’re unsure, call 911. Then call Poison Control while you wait. You can do both. They work together.