Minutes: protect life
Call 101, report breathing and consciousness, give the exact location and follow the dispatcher rather than testing home remedies.
This page separates the emergency from the recovery route
A suspected overdose is not an intake conversation. The first phase belongs to Magen David Adom and emergency medicine. MAAVAR CLINIC becomes relevant only after emergency professionals have taken over or the person has been stabilized.
Hours: establish stability
Emergency and hospital teams assess immediate toxicity, breathing, circulation, injuries and complications and determine the acute treatment.
Days: interrupt repetition
After stabilization, licensed addiction review and a direct residential handoff address access, reduced tolerance, mixed use and the route back to substances.
Intent boundary
This page answers the first-minutes overdose decision. The drug addiction page explains the wider loss-of-control pattern, while drug detox in Israel focuses on withdrawal, stabilization and the transition that follows.
Warning signs are about the body’s condition, not certainty about the drug
If the person cannot be woken, is not breathing normally or is rapidly deteriorating, do not postpone the emergency call while searching messages, packaging or explanations.
Breathing danger
Slow, shallow, irregular or stopped breathing, long pauses, unusual snoring or gurgling and blue or grey lips require immediate emergency action.
Consciousness danger
The person does not answer, cannot be woken, repeatedly loses consciousness, becomes limp or is too confused to remain safe.
Neurological or physical danger
A seizure, collapse, severe agitation, chest pain, overheating, injury, repeated vomiting or rapid deterioration needs urgent professional assessment.
High-risk context
Unknown pills or powders, injections, opioids, alcohol, sedatives, pregabalin, stimulants or several substances make home interpretation unreliable.
Emergency thresholdCall Magen David Adom at 101 for unresponsiveness, abnormal breathing, blue or grey lips, seizure, collapse or other immediate medical danger. Give the exact location and stay on the line.
The 101 response: four facts before any family investigation
The dispatcher can adapt instructions to the person’s condition. The family’s task is to make the call early, provide usable facts and continue observing until professional help takes over.
Response 1. Exact location
State the address, floor, entry instructions and callback number before the situation or connection changes.
Response 2. Breathing and consciousness
Say whether the person can be woken, whether the chest is moving normally, whether the lips or skin have changed color and what changed just before the call.
Response 3. Follow the dispatcher
Stay on the line. If positioning, resuscitation or another immediate action is needed, follow the dispatcher’s step-by-step instructions for the condition in front of you.
Response 4. Keep the route clear
Send someone to open the entrance when possible, keep packages or medicines for responders and do not leave the person alone while waiting.
Naloxone is a temporary opioid-overdose intervention, not the end of the emergency
Naloxone can reverse opioid effects and restore breathing. It is relevant when heroin, fentanyl, methadone, oxycodone, tramadol, morphine or an unknown opioid-containing substance may be involved.
Use the available product correctly
If naloxone is available and opioid overdose is suspected, use it according to the product instructions and the 101 dispatcher’s guidance.
Call before waiting for a response
Do not postpone 101 to see whether naloxone works. Emergency professionals are still needed to assess breathing, recurrence and mixed-substance effects.
Improvement can be temporary
Naloxone may wear off before the opioid effect does. The person can become unresponsive again and may need further naloxone and medical care.
Stay and observe
Remain with the person, watch breathing and follow the dispatcher even if the person wakes, speaks or wants to leave before responders arrive.
Unknown and mixed substances change what the family can safely conclude
A product name or the person’s report may be incomplete. Emergency clinicians need the entire possible mixture, while the family should avoid guessing that one stimulant or one waking moment has removed the danger.
Opioids with sedatives
Alcohol, benzodiazepines, sleeping medicines and other depressants can increase sedation and breathing risk when combined with opioids.
Stimulants do not neutralize depressants
A person may appear active or agitated while still facing serious cardiac, neurological or mixed-substance danger.
Unknown tablets and powders
Contents may differ from the expected name or dose. Preserve packaging or photographs when this can be done safely and give them to responders.
One response does not identify the mix
Waking after naloxone suggests opioid effect may have been present, but it does not rule out alcohol, sedatives, stimulants, injuries or other complications.
Dr. Moshe Golin
Psychiatrist, addiction physician, senior doctor with 40 years of experience
After emergency stabilization, Dr. Golin reconstructs the event as a clinical sequence: substances and medicines, timing, loss of consciousness, breathing change, naloxone response, hospital findings, previous overdoses, tolerance change, psychiatric state and the circumstances that led to use.
He and the MAAVAR CLINIC medical team are responsible for addiction and psychiatric assessment, diagnosis, medication review, detox or further stabilization when indicated, clinical follow-up and the decision about readiness for the residential stage. View the clinic license.
Event reconstructionSubstances, timing, breathing, consciousness and response.
Clinical aftermathWithdrawal, injuries, medication and psychiatric risk.
Repeat-risk mapTolerance, access, mixing and previous episodes.
Residential thresholdWhen participation is clinically appropriate.
The post-overdose clinical review asks why survival did not remove the risk
Emergency stabilization answers the immediate threat. The licensed addiction and psychiatric stage determines what remains active before the person returns to ordinary access or enters the residential villa.
Review the medical handover
Hospital instructions, tests, injuries, administered medication, naloxone timing and unresolved symptoms must travel with the person into the next assessment.
Clarify dependence and withdrawal
The team evaluates whether opioid, sedative, stimulant or mixed use creates a need for detox, medication or continued monitoring.
Assess psychiatric readiness
Suicidal thinking, impulsivity, shame, agitation, confusion, denial and the ability to participate safely influence the next setting.
Set a documented next threshold
The medical team decides what must remain clinically monitored and when the person can move into the structured residential day.
The post-overdose handoff must close the route back to immediate access
Discharge can create a dangerous gap: the person feels better, tolerance may have changed, old contacts remain one tap away and the family wants relief more than another difficult decision. The transfer is prepared before that gap opens.
Handoff 1. Clinical clearance
Dr. Golin and the medical team define what has stabilized, what medication or follow-up continues and which signs require renewed emergency assessment.
Handoff 2. Direct transfer
The person moves into the prepared villa without collecting money, visiting old contacts or spending an unstructured night in the previous environment.
Handoff 3. First protected day
The team establishes basic orientation, sleep and wake expectations, meals, contact rules and observation without turning arrival into a family confrontation.
Handoff 4. Shared risk record
The overdose sequence becomes a practical plan for craving, secrecy, access, medication, emotional triggers, family communication and emergency escalation.
The residential villa program turns a near-fatal event into practiced daily prevention
The program does not repeat emergency medicine. It works on the decisions and conditions that made the event possible and could produce another one after the immediate fear fades.
Stage 1. Restore a reliable day
Build consistent waking, meals, rest, prescribed-medication adherence and participation without using substances to regulate every transition.
Stage 2. Reconstruct the pre-overdose chain
Map the hours before the event: contacts, money, messages, emotional state, mixing, isolation, warning signs and moments when another choice was possible.
Stage 3. Replace relief with accountability
Use individual work, groups, Twelve-Step practice, tasks and honest reporting after the family’s fear is no longer providing temporary motivation.
Stage 4. Rebuild the family boundary
Agree on money, devices, medicines, contact, visits and what the family will do when promises conflict with observable risk.
Stage 5. Rehearse the next high-risk hour
Practice responses to craving, reduced tolerance, old contacts, shame, insomnia, discharge transitions and signs that require medical or emergency escalation.
Program boundary
The villa begins only after emergency and clinical stability make residential participation appropriate. New unresponsiveness, abnormal breathing, seizure, collapse or another immediate medical danger requires 101—not a routine program conversation.
The family’s most useful contribution is an accurate handover
Do not turn the emergency into an interrogation. Give responders and the later clinical team observations, times, products and records that can change decisions.
- Condition and timing. When the person was last responsive, how breathing changed, color, seizure, collapse, vomiting, injury and what happened immediately beforehand.
- Possible substances. Opioids, sedatives, alcohol, stimulants, pregabalin, prescriptions, unknown pills, powders or injections—including uncertainty and possible combinations.
- Emergency response. The time 101 was called, dispatcher instructions, naloxone product and dose if known, response, ambulance care and hospital findings.
- Relevant baseline. Previous overdoses, recent abstinence or reduced use, current medicines, physical illness, psychiatric history, pregnancy and allergies.
- Discharge reality. Who can receive the person, where substances or medicines remain, which contacts are active and whether a direct villa transfer is prepared.
Four delays that can turn uncertainty into greater danger
Waiting for the person to sleep
Unresponsiveness and abnormal breathing are not a safe sleep test. Call 101 and let the dispatcher assess the situation.
Searching for proof before calling
The exact pill, dose or dealer message can be clarified later. Breathing and consciousness determine the first action.
Using improvised countermeasures
Food, drink, a shower, forced walking or another substance can waste time, increase choking or injury risk and does not replace emergency care.
Calling survival the treatment plan
Leaving hospital without clinical review, access control or a prepared residential destination can return the person to the same risk with less family vigilance.
The turning point is not waking up. It is leaving no unprotected route back to the same high-risk hour.
Emergency medicine protects the immediate threshold. The next protected days must convert the event into a clinical record, a direct transfer, a daily recovery structure and a response plan that remains usable after the fear subsides.
Three questions that change after emergency stabilization
During the emergency
Is the person breathing, responsive and physically stable enough to wait for responders?
During recovery
Which access, tolerance, mixing and decision pattern could produce another overdose?
During the emergency
What did the dispatcher and medical team need to do to restore immediate safety?
During recovery
What daily structure and accountability must be practiced when the crisis is no longer visible?
Before discharge
What symptoms, instructions and clinical follow-up remain after the acute event?
Before returning home
Can the person and family use a clear relapse, overdose and emergency response plan?
Ramiz
Recovery mentor for motivation, Twelve-Step work, accountability and relapse prevention
After an overdose, fear can produce a short promise without changing the next ordinary day. Ramiz helps the person examine the sequence before the event, show up for the villa routine and translate “this cannot happen again” into completed actions, honest reporting and responsibility.
He supports motivation, Twelve-Step work, accountability and relapse prevention after the medical stage. He is not a physician and does not diagnose, prescribe medication, perform detox or make clinical decisions.
Event ownershipFacts examined without minimization or theatrical shame.
Daily accountabilityPromises converted into attendance and completed actions.
Twelve-Step workA structured recovery language beyond the crisis.
Relapse preventionHigh-risk hours rehearsed before discharge.
An anonymous family review of the second chance
“We had prepared for the ambulance, but not for the day after discharge.”“The emergency team handled the breathing danger, and our relative woke up. We thought the fear itself would be enough to stop everything. Within days, the old phone contacts and the same explanations returned. The change came when Dr. Golin’s team reviewed the event clinically and the villa transfer was arranged before another unstructured night. Ramiz helped turn the story from a promise into daily responsibility. Names and identifying details have been withheld.”
Official sources for emergency response, naloxone and continuation
These sources support the 101 emergency boundary, recognition of opioid overdose, the temporary role of naloxone and the importance of structured rehabilitation after the acute stage. They do not replace the dispatcher or individual clinical care.
Magen David AdomEmergency medical help in Israel — dial 101
Magen David AdomFirst response to suspected poisoning
World Health OrganizationOpioid overdose signs, risks and naloxone
Centers for Disease Control and PreventionLifesaving naloxone and emergency follow-through
U.S. Food and Drug AdministrationRecognizing opioid overdose and using naloxone
Israel Ministry of HealthRehabilitation after detox and structured recovery
Connected pages for substance risk and residential recovery
Drug overdose FAQ
What should I do if I suspect a drug overdose in Israel?
Call Magen David Adom at 101 immediately if the person is unresponsive, breathing slowly or irregularly, turning blue or grey, having a seizure, collapsing or otherwise medically unstable. Give the exact location, describe breathing and consciousness, stay on the line and follow the dispatcher’s instructions.
What are warning signs of an opioid overdose?
The World Health Organization identifies the combination of pinpoint pupils, unconsciousness and breathing difficulty as typical of opioid overdose. Other urgent signs can include failure to wake, shallow or irregular breathing, limpness and blue lips or fingertips. When in doubt, call 101.
What does naloxone do?
Naloxone temporarily reverses the effects of opioids and can restore breathing during a suspected opioid overdose. It is relevant to opioids such as heroin, fentanyl, methadone, oxycodone, tramadol and morphine. Use the available product according to its instructions and the emergency dispatcher’s guidance.
Do I still need to call 101 after giving naloxone?
Yes. Naloxone is temporary, more than one dose may be needed and the person can become unresponsive again. Call 101, stay with the person, watch breathing and follow the dispatcher until emergency professionals take over, even if the person wakes up.
What if the substance is unknown or several substances were mixed?
Do not delay the emergency call while trying to identify every substance. Tell the dispatcher and medical team what is known, what packaging or medicines were found, the last time the person was responsive and whether alcohol, sedatives, opioids, stimulants or unknown pills may be involved.
What information should I give the dispatcher and medical team?
Give the exact address, the person’s age if known, current breathing and consciousness, color changes, seizure or injury, what may have been used, when they were last seen well, medicines and medical conditions, and whether naloxone was given, at what time and with what response.
Does MAAVAR CLINIC replace an ambulance or emergency department?
No. A suspected overdose with breathing, consciousness or other immediate danger requires Magen David Adom at 101 and emergency medical care. MAAVAR CLINIC becomes involved after emergency professionals have taken over or after stabilization, with licensed addiction and psychiatric assessment and the next recovery route.
Why does risk remain after the person wakes up or leaves hospital?
Waking up does not establish why the overdose happened or remove access, reduced tolerance, mixed use, impulsive decisions, old contacts or family confusion. A clinical review and a protected continuation plan are needed before the event is treated as finished.
What is Ramiz’s role after stabilization?
Ramiz supports motivation, Twelve-Step work, accountability and relapse prevention inside the residential villa program. He helps turn the overdose history into daily commitments and an early-action plan. He is not a physician and does not diagnose, prescribe medication, perform detox or make clinical decisions.
How can I contact MAAVAR CLINIC after the emergency is stabilized?
Write on WhatsApp, call +972 54 757 8876, or email dhvny8@gmail.com after emergency professionals have taken over or the person is stable. Include the suspected substances, breathing and consciousness history, naloxone use, hospital care, previous overdoses and the current discharge or transfer plan.
If overdose may be happening now, call 101; plan the protected next stage only after professionals take over
For unresponsiveness, abnormal breathing, blue or grey lips, seizure, collapse or other immediate medical danger, give Magen David Adom the exact location, stay on the line and follow the dispatcher. If opioid overdose is suspected and naloxone is available, use it according to its instructions and the dispatcher’s guidance.
After emergency stabilization, Dr. Moshe Golin and the MAAVAR CLINIC medical team can review the clinical event and prepare a direct transition into the private residential villa program.
Call 101 now
MAAVAR CLINIC does not replace Magen David Adom, an emergency department or hospital care. Contact the clinic after emergency professionals have taken over or after stabilization.
Review the residential villa programWhatsApp after stabilization