Respiratory depression is the most common cause of death with opioid, GHB/GBL, and benzo mixed use. If opioids are suspected: prepare or use naloxone nasal spray (available without a prescription in German pharmacies since 2024 as “Nyxoid”). With pure GHB/GBL, naloxone does not help — only breathing monitoring and 112.
Normal adult breathing rate: 12–20 per minute. Below 10/min is alarming, below 8/min is acute.
If breathing stops: start chest compressions immediately (see respiratory arrest).