Heroin Overdose

Part of the complete guide to understanding addiction
Learn more about Heroin addiction

Table of Contents
  1. Heroin Overdose
  2. What is Heroin
  3. Heroin Laced with Fentanyl
  4. Effects of Heroin
  5. Signs of Heroin Overdose
  6. Heroin Overdose Treatment
  7. Post-Treatment Recovery
  8. Resources

Heroin Overdose

The risk of a heroin overdose can be detrimental not only to the user, but also to their loved ones. In 2019, over 14,000 individuals died from a heroin-related drug overdose in the U.S.

Even more shocking is that roughly a third of all opioid-related deaths involved the usage of heroin. Additionally, it was reported that 64-97% of opioid users themselves had witnessed an overdose at least once.

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What is Heroin?

Heroin (diacetylmorphine) is a highly addictive drug that belongs to the opioid family and is derived from morphine. Morphine is the essential component of opium, a natural substance that is extracted from the seedpod of the opium poppy. Learn more about how Heroin is made.

In its appearance, pure heroin is a white powdery substance that dissolves in water. However, when it is sold on the streets, the color and texture can vary from batch to batch, depending on the producer. Like many other drugs, heroin can be combined or “laced” with additives such as baking soda (to add weight) or fentanyl, a prescription drug that is stronger than morphine

Most commonly, heroin is sold illegally, so the quality and strength of the drug are unregulated, leading to an increase in overdose cases.

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Heroin Laced with Fentanyl

Fentanyl is a synthetic drug originally created for use as an analgesic (painkiller). A major concern of fentanyl is that it is nearly 100 times more potent than natural painkillers like morphine. As a result, the drug has transitioned drastically from its original use as a painkiller by those who obtain the legal drug or manufacture their own illegal concoction.

It’s important to address fentanyl in the discussion of heroin overdose because it has become the leader of death by overdose in the opioid family for individuals in the United States. The risk associated with heroin “laced” with fentanyl only increases as even the tiniest doses of fentanyl can be lethal for some who are not opioid-tolerant. Some may even categorize the “lacing” of heroin with fentanyl as poisoning the user.

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Effects of Heroin

There are three different ways heroin can be used: smoking, injection, or snorting. Most commonly, when an individual uses heroin, the short-term health side effects that the person using may feel are:

  • Euphoria
  • Relief from pain
  • Loss of sex drive
  • Itching
  • Shallow breathing

The effect of heroin can depend on several things:

  • The dosage of the drug
  • The body metrics (weight, size, general physical and mental health) of the person taking the drug
  • If the drug is taken alone or if it is mixed with other substances

Heroin overdose is likely to occur when taken with other drugs (alcohol, tranquilizers, sleeping pills, etc.). Combining heroin with other substances is very dangerous, causing overdose, coma, or death.

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Signs of Heroin Overdose

Below are heroin overdose symptoms based on the different areas of the body:

  • Slow, shallow, difficult, or no breathing
  • Tongue is discolored
  • Pinpoint Pupils (extremely small pupils)
  • Dry mouth
  • Weak pulse
  • Low blood pressure
  • Blue nails and lips
  • Cold, clammy skin
  • Constipation
  • Spasms of the stomach/intestines
  • Coma (unresponsive)
  • Convulsions
  • Delirious
  • Drowsy
  • Muscular movements are uncontrolled

If someone has used heroin and is having a reaction such as gurgling or snoring, that person may have entered a coma and have trouble breathing. The most apparent sign of heroin overdose is that the person is unresponsive, where the person does not respond to yelling, shaking, and cannot physically or verbally interact.

Some other common signs of a heroin overdose are when someone falls asleep while standing up or mid-sentence, physically stumbles around, and while sitting, their head may be flopping around. Additionally, common mental signs of a heroin overdose are if the person isn’t making sense in their speech, slurring their words, or is increasingly angry when questioned.

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Heroin Overdose Treatment

If the individual is overdosing, seek medical help immediately! Do not try to get them to throw up unless otherwise advised by a medical professional. Also, do not leave an individual alone to “sleep off” the effects of the drug; heroin overdose is a gradual process, not a spontaneous one, as it’s often perceived in the media.

If you suspect someone has overdosed on heroin:

1 Perform a sternal rub
Rub the center of the patient’s chest with the knuckles of a closed fist. Learn how to do that here. If the patient remains unresponsive:

heroin overdose treatment sternal rub

2 Call 911 Immediately
Make sure to have the following information (if known): patient’s age, weight, current condition, the dosage of heroin taken, and how long ago they may have taken it.

call 911 in case of a heroin overdose

3 Perform Rescue Breathing
It is important to support the patient’s oxygen levels before administering Narcan. Rescue breathing can help with this.

administer rescue breathing

4 Administer Narcan (Naloxone)
Narcan is most commonly given through either nostril in the form of a spray. Many users carry Narcan, check their pocket or purse if you don’t have Narcan.

Learn more about Narcan

5 Check Breathing
Check breathing again, and continue rescue breathing if necessary for 3 – 5 minutes. If the individual doesn’t respond, administer naloxone for a second time

check breathing

6 Wait for Emergency Services
Do not leave the individual alone until emergency medical services arrive

emergency services

When someone overdoses on heroin, you need to call 911 immediately. Then, if you have access to naloxone, an opioid reversing agent, administer the drug directly at once—you do not need to be a licensed medical provider to use naloxone. Lastly, remember to put the individual on their side to help unblock their airways.

The effects of naloxone last roughly for 30-120 minutes (depending on what dose is given). Once emergency personnel arrive, they will take the individual to the hospital, where they will receive naloxone, if not yet administered, and other life-saving procedures that will stabilize the individual.

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Post-Treatment Recovery

It is important to note that treatment with naloxone alone should not indicate that an individual can be left alone or not need to receive care at a hospital. Medical professional monitoring is essential to maintaining the health of the individual who has overdosed.

Medical professionals may monitor and follow up with:

  • Urine tests
  • Blood tests
  • Breathing support
  • X-rays
  • Intravenous fluids
  • More doses of naloxone

Once an individual has been treated for an overdose, their post-treatment care is of utmost priority. Therefore, it’s important to create a plan that will work for the individual.

This may include:

  • Individual therapy
  • Group therapy
  • 12-Step facilitation therapy
  • Detoxification
  • Medications: methadone, buprenorphine, naltrexone (short-acting and long-acting forms)

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There are many resources available to family members, friends, and those struggling with substance abuse and addiction. SAMSHA has a national helpline (1-800-662-4357) that is not only free and confidential, but runs 24/7, 365 days a year.

Though this journey is difficult, it is important to know that help is available. If you would like training on how to use naloxone, GetNaloxoneNow has resources available for training and access to the life-saving drug.

For further information about the effects of heroin use, side effects, and overdose, please read the Heroin Research Report from the National Institute of Health (NIH).

Most importantly, someone who suffers from a heroin overdose should seriously consider a stint in a long term inpatient rehab center. Verify your insurance coverage, or call now to speak to one of our compassionate admissions counselors.

Aside from regular heroin, there is a drug called black tar heroin that is widely abused in the US. To learn about smoking black tar heroin read our online resource.

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