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What You Need to Know About a Heroin Overdose

One of the biggest problems with an illegal street drug such as heroin is that there is a possibility of overdose.  Now many people who overdose will actually do so not due to taking too much pure heroin, but more often from taking too much of the drug when it has been cut with other unknown drugs, or by combining it with other drugs or alcohol.  At any rate, overdoses can and do occur all the time, so I wanted to touch on them and provide some information about them.

Heroin is made from morphine which comes from the poppy plant. It is illegal, but sold on the streets, which causes problems with purity and creates unknown variances in strength. It has been banned from hospitals or from any other kind of legal medicinal purposes because of its highly addictive nature. Heroin addiction causes many adverse health problems, not the least of which is collapsed veins (due to continued use of needles to inject the drug). Additives to heroin on the street can cause infections that damage major organs; these additives do not always dissolve in the system and so can cause clogging of the blood vessels. Continued poor health in a user can cause pneumonia as well. Using heroin on a long-term basis causes the user to work up a tolerance to it, creating a need for more.

Inject
Creative Commons License photo credit: JuditK

Heroin Overdose Symptoms

Warning signs of a heroin overdose can be overlooked at first glance, if the observer does not realize that the symptoms of overdose are far more intense and serious than the actual immediate affects of the drug. It is ironic (and very unfortunate) that the overdose symptoms of the drug produce the pain that the user was trying to avoid in the first place by continuing use. “Normal” use of the drug creates many of the same symptoms as overdose. For instance, the user will normally experience a slowing of their breathing, dry mouth, a lowering of their blood pressure, slowing of movement, and dreaminess. Part of the appeal of heroin is the “rush” it creates and then the state of elation or pleasure. In an overdose, however; breathing may become difficult and much slower. There is a weak pulse, not just a low blood pressure. An observer should also notice in an overdose that the tongue becomes discolored and the pupils become very constricted. The fingernails and lips turn blue.  They may have muscle spasms. The person can experience hallucination, disorientation, and sleepiness, or can go into a coma if not treated immediately.

Heroin Overdose Treatment

As a matter of course, an observer who witnesses any overdose should call 911 or a poison control center immediately and should not induce vomiting unless told to do so by a health care professional. Although the obvious solution to avoid overdose on any drug is abstinence from the drug itself, overdose on heroin is not always fatal if the user is caught right away; so a user should not use the drug when alone, in a locked room. He or she should not mix heroin with any other drugs. In addition, buying the drug from the same dealer each time helps prevent discrepancies in purity. The treatment of an overdose involves the use of a drug called Naloxone. It is given intravenously, if possible, and counteracts the effects of overdose almost immediately. It can also be given intramuscular or subcutaneously if necessary. Although the drug in the form of an injection in an emergency kit is provided to heroin addicts in some states, it is best to use in a clinical setting. Sometimes the drug is so effective at reversing the symptoms that the user can go immediately into withdrawal. For this reason, dispersing of the drug should be monitored.

Now if you are interested in avoiding an overdose then you might consider getting some form of treatment.  The starting point of most treatment is heroin detox, where you will likely be supervised in a medical setting and probably given some sort of synthetic opiate or other medications to help control your withdrawal symptoms.  After approximately 3 to 5 days of detox, you will probably go into residential treatment where you might attend various groups and lectures so you can learn how to live without using heroin every day.  This is the brief outline of heroin treatment and will generally work for most any addict provided they really want to change their life.  Without a great deal of personal motivation from the individual addict they are not likely to succeed and will probably relapse shortly after leaving treatment.

Effective Emergency Procedures for Treatment of Heroin Overdoses

Respiratory failure and pulmonary edema resulting in coma or death may occur without effective emergency procedures for heroin overdoses. Heroin, a synthetic opiate, was originally derived from the white liquid from the opium poppy plant. In its pure form heroin is a white powder substance with a bitter taste. Street heroin is usually laced with unknown filler substances and is approximately ten times more toxic than morphine when administered through intravenous injection, the preferred method of delivery. Heroin users quickly develop tolerance and require higher amounts to achieve the desired euphoric effect. Most overdoses occur accidentally and can be immediately reversed through emergency medical treatment. Symptoms of overdose include respiratory distress, small pupils, low blood pressure, weak pulse, disorientation, drowsiness and seizures. Death can occur as a result of depressed breathing, cardiovascular complications and the inability to immediately clear airway obstructions due to vomit or fluid.

Emergency room protocol for patients presenting with suspected overdose begins with immediate assessment of respiratory function. Breathing support systems such as mask valve ventilation or mechanical ventilation are used to maintain the patient until heroin can be eliminated from the system. Invasive ventilation measures such as endotracheal intubation may be required in cases of respiratory failure.
The effects of heroin can be immediately reversed through the intravenous administration of an opioid antagonist agent such as naloxone or naltrexone. This class of medication causes an immediate return of consciousness, but may cause minor symptoms of withdrawal including mood changes, gastrointestinal upset, dizziness, seizures and headache. Opoid antagonist agents usually counteract the effects of heroin within one to two minutes after intravenous delivery, with effects lasting approximately 45 minutes. Once the patient is stabilized, respiratory function will be assessed and supportive care provided before release from the emergency department. 

In severe heroin overdose cases resulting in coma, emergency procedures may include endotracheal intubation and mechanical ventilation for rapid oxygen delivery. Laboratory tests may be performed for analyses of arterial blood gas, metabolic and creatine levels. Liver and renal function tests may be performed. Comatose patients may require pulmonary artery catherization or lumbar puncture. Chest imaging studies including CT scans and MRI scans are useful in assessing pulmonary complications. Brain scans may be performed to diagnose potential brain and central nervous system damage. Benzodiazepine therapy is often used to control seizures or convulsions.

Emergency medical treatment is vital in saving the lives of many overdose patients. Death often results due to unavailability of emergency care.

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{ 47 comments… read them below or add one }

breanna January 5, 2010 at 12:48 pm

herion is very bad dont ever do that

lauren February 15, 2010 at 3:14 pm

my brother in law just died from an overdose. it was his first time “trying” heroin. his friend didn’t call the EMS. if only he had, my brother would still be here.

Patrick February 15, 2010 at 3:20 pm

So sorry to hear that, Lauren.

Not sure what else I can say…..

jammo April 9, 2010 at 8:04 pm

i tried it for the first time 2 weeks ago, it took me a week to get over wanting more, never again

Mary May 31, 2010 at 3:49 pm

jammo I hope you don’t…We are burying my 21 year old nephew this Friday because he od’ed…I will keep you in my prayers.

David July 7, 2010 at 3:48 am

only way i’ve ever died with a smile on my face. its all perspective. The emt should have let me go

rachel w. July 12, 2010 at 11:56 pm

my sister died from an over dose becuase he boy friend didnt pay attention to how much he gave her. he didnt call 911 because he didnt want to get in trouble. this is the same guy that got my brother stuck on this crap. not good for you hard on yah and tears familys apart.

patty August 9, 2010 at 8:03 pm

My son died at the age of 37 two days ago I hate this drug God help us get the word out and try to save more children

Patrick August 9, 2010 at 9:04 pm

Sorry to hear of the losses here….I have been working in a rehab for 5 years now so I still see these stories play out over and over again as well….

Prayers for all who have passed, and those left behind too. Such tragedy….it really does suck.

kathy August 20, 2010 at 5:28 pm

I recently lost my beloved nephew to a heroine over dose,he was 26 . My sister’s family and i went thru a few years of trying to get treatment for him,and for awhile it seemed as if he would win the battle.But , we lost. I will never forget the way i last saw him,which now after the fact I realize he was on it then,his pupils were tiny and glassy,when i asked him ,he said he had just had a few drinks ect. and would b ok. I was the last family member to see him alive, cause a few short hours later my sister called to say he was dead.I would do anything to bring him back, but i know that wont happen.But, i would also do anything to stop another family from the pain of loseing a loved one this way.Its just not fair.

Audrie S. August 29, 2010 at 6:59 am

I almost lost my daughter to heroine. I decided that I will become CSI on her. I turned her in for needles, heroine, and when she was high. I got ahold of her phone records turned all those people in. It was the hardest thing I have ever done but I saved her. It was either death or jail and I chose jail. It’s not easy & not everyone can be saved. They have to eventually want it for themselves and finally she did. Just know we can’t save them all but the few I did save I lost just as many. It’s a never ending fight but I will continue to do it until either the drug is gone or the dealers. Pray for our children. That’s all we can do

unknown September 14, 2010 at 8:44 pm

I just lost my brother on aug.29 to this killer.
The user loses their life,then rests in peace. Its the ones left behind who struggles and carries the burden of such deep pain. I am angry that it works this way. I f any of you drug users have even just one person that loves you, and you check out for a moment of unreal euphoria, then you are selfish. You may think you are only hurting yourselves, but that is the lie, your are sticking a knife right through the heart of the people who love you.NOONE IS INVINCIBLE.This is a fact. I know.

grieving heart

Patrick September 14, 2010 at 9:03 pm

@ Unknown – God bless you. I agree completely, knowing that I used to be that selfish addict, who put people through misery. You are right. It is not fair.

unknown September 14, 2010 at 9:12 pm

@Patrick- Can you tell me why?

Patrick September 14, 2010 at 9:18 pm

Why it’s not fair?

Now I am on the other side of the fence…clean and sober for over 9 years now, and trying to help struggling addicts every day now. (I work a full time job in a drug rehab too).

I lived in long term rehab for 20 months. At least 5 of those people that I lived with have died since then.

It is not fair because I want so badly to help certain people, and there is nothing you can do. You can’t do anything because they are trapped. They cannot see a better way out, they do not believe recovery could work for them. I know this, because I used to be trapped.

I do not know what changed. I do not know how I became willing to face the fear of being clean and sober. That is what I write about on here, over and over again. The transition to recovery. It is an elusive thing to pin down.

That is why so many say it is a blessing from a higher power. You did not choose to get clean, your higher power blessed you with recovery, they say. I am at least half inclined to believe this, that I am simply blessed. But, I promise that I was just another drug addict and alcoholic….no more deserving of blessings than anyone else.

unknown September 14, 2010 at 9:24 pm

@ David- how ironic. David was my brothers name. To say somthing like you did, you must not love anyone.

unknown September 14, 2010 at 9:40 pm

@ Patrick- Thank you for answering me. I am so hurt by tthese drugs. They are killing people left and right. I wish I could wipe them off the face of this earth. I beleive with all my heart these are good people who make a difference in this world, I know my brother was. Its not like these drugs are killing evil people, they are killing wonderful, beautiful souls that other people in this world need.I’m glad you made it and found your way out.If I could have one wish in this world, I would wish for the freedom of all drug users, and put these drug dealers out of business who are making money from this killer. May you continue to be blessed.

walking dead October 12, 2010 at 7:34 pm

I od’d last friday, havent snorted heroin in 15 years but was in pain, and someone gave me a bad. My intent was not to die.

All I remember is snorting the line and then waking up in an ambulance vomiting, freezing and people all around me telling me to stay with them. I went into defib, I had 2 resperations a minute, at the hospital they told my family I might not make it. I did make it. I wasn’t trying to kill myself!!! But I almost died and I am all fucked up right now because I have to face the people I love, I put them through hell.

One time will kill you..

Desdemona December 2, 2010 at 11:10 am

I lost my 26-year-old stepson to a heroin overdose October 11 (the day after my son’s wedding). We helped him get clean (or so we thought) and although he didn’t take what was considered a lethal dose it was that night. Unfortunately his so-called girlfriend didn’t call emt (even though she couldn’t wake him up). So very sad how many beautiful young people are losing their lives to this stuff. :(

unknown December 15, 2010 at 1:44 pm

I to lost my nephew to this horrible drug just a couple weeks ago. The words can’t decribe what my family is going through right now. We didn’t even know there was an problem till the test came back. It was so shocking to us.

janice February 28, 2011 at 10:06 pm

My beautiful, sweet, loving nephew just died last Wednesday! His “friends” left him sleeping, He decided to “Try” it along with his beer, a little thing he was, soooooo sad he never woke up. He loved to sing,fish,camp, make people smile, and he loved his family! How sad he left his sister and brothers, in so much pain! Life will never be the same for them or for the others who loved him sooooo much! Why are so many children/people dying, isn’t there something we can do?

unknown 2 March 4, 2011 at 1:11 am

My sister just lost her best friend 2 days ago to an overdose. She just turned 18, a happy and always excited type of girl. She started hanging out with the wrong people who introduced her. Her fake friends that got her hooked just dropped her off at the hospital and left. My sister feels guilt because she kept trying to get her to quit. The girl has a scum boyfriend whom was a bad influence on her as well. I wish that teenagers would somehow realize the dangers. She left behind a wonderful family and loving friends. The people she would get high with dont even care. They could have saved her if they werent such scum. Why does this have to happen to such good people? She just couldn’t stop, and it is so terrible that this is a reality. I pray for all of you whom have lost someone and expecially those whom still do it. Please stay clean.

jr. March 4, 2011 at 5:05 am

i just lost my sister to this 2 weeks so sad please if you guys know anyone who is sufferung from this drug get them help….

Craig March 13, 2011 at 1:34 pm

Hi my name is Craig and im a Paramedic, my sympathies go out to all the people who have lost loved ones to this KILLER Drug. I have treated numerous cases of Heroin overdose, with great success because people called EMS quickly, but unfortunately when they call too late, and you can’t revive the pt that really hurts the EMS personnel and the family, the best advice I can give is never to try this drug.

carmen April 11, 2011 at 2:32 am

I’m struggling right now w/my addiction i come from old fashion latin family i want to quit soooo bad but its expensive, the bodypain and sadness u grow through is horrible…. my ex got me addicted…. now i’m left w/this addiction @26 yrs old i’m a college student i work but all my $ goes 2 it, it makes me :( i’m so disappointed in myself….i cant tell my family, they wld never understand…. thanks 4 letting vent and please pray me; carmen the brasilian girl from utah!

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