Why Rescue Breaths May Be the Missing Piece in Overdose CPR
For years, the push in CPR training has been simple: if you see someone collapse, call 911 and start chest compressions. Compression-only CPR has saved countless lives because it’s easy to teach, easy to remember, and more bystanders are willing to jump in without worrying about giving breaths .
But when it comes to opioid overdoses, new research suggests we may need to rethink that approach.
A recent study published in JAMA Network Open looked at more than 10,000 out-of-hospital cardiac arrests. The researchers found something striking: in cases tied to opioid overdose, patients had significantly better survival and brain outcomes when bystanders provided both compressions and rescue breaths—not just compressions alone .
Why does this matter? Unlike a typical sudden cardiac arrest caused by heart rhythm issues, opioid overdoses often begin as a breathing problem. The drug slows or stops breathing, and without oxygen, the heart eventually follows. That means oxygenation—getting air into the lungs—can be just as critical as chest compressions .
Of course, this raises challenges. Many people are hesitant to perform rescue breaths, even in emergencies. Concerns about disease transmission or simply not knowing how to do it can stop someone from trying. That’s why training and awareness are so important. With the opioid crisis touching nearly every community, we need to equip more people with the skills and confidence to provide full CPR when it counts.
Compression-only CPR remains vital for most sudden cardiac arrests, especially when bystanders feel unsure. But when there’s any chance the collapse is overdose-related—such as when Narcan is already being used—adding rescue breaths may give that person a real chance at recovery .
At the end of the day, CPR isn’t “one size fits all.” The more we understand the context of cardiac arrest, the more prepared we’ll be to save lives.
References
Medscape. Why Rescue Breaths May Matter in Overdose CPR. September 2025. Available at: https://www.medscape.com/viewarticle/why-rescue-breaths-may-matter-overdose-cpr-2025a1000lt6
Christenson, J., et al. “Bystander CPR in Opioid-Associated Out-of-Hospital Cardiac Arrest.” JAMA Network Open, 2025.
