Guide to Heroin Overdose: Lifesaving Tips and Treatments

Last Edited: March 30, 2024
Author
Andrew Lancaster, LPC, MAC
Clinically Reviewed
Jim Brown, CDCA
All of the information on this page has been reviewed and certified by an addiction professional.

Overdose from heroin abuse represents a critical and often fatal consequence of opioid addiction, with the opioid crisis further exacerbated by the infiltration of fentanyl into the drug supply. Understanding the phases of a heroin overdose, recognizing its signs and symptoms, and knowing what measures to take can be life-saving.

Phases of a Heroin Overdose

A heroin overdose generally progresses through several phases, beginning with initial euphoria followed by dangerous physiological changes.

1. Initial Use and Euphoria: Immediately after taking heroin, individuals experience a rush of euphoria. This phase is characterized by a sense of warmth, relaxation, and detachment from physical and emotional pain.

2. Depressed Physiological Functions: As the drug impacts the central nervous system, critical bodily functions begin to slow. Breathing becomes shallow, heart rate drops, and blood pressure decreases. This phase poses the greatest danger, as the body’s vital systems are suppressed.

3. Hypoxia and Potential Unconsciousness: The significant reduction in breathing can lead to hypoxia, a condition where not enough oxygen reaches the brain. Users may become unconscious. Without immediate intervention, this phase can lead to coma or death.

What Happens When You Overdose on Heroin?

An overdose occurs when a person takes enough heroin to produce life-threatening symptoms or death. Heroin, particularly when mixed with fentanyl—a synthetic opioid up to 50 times more potent than heroin—greatly increases the risk of overdose. The drug overwhelms opioid receptors in the brain that regulate breathing, causing respiratory failure if not quickly addressed.

Signs and Symptoms of a Heroin Overdose

Recognizing the signs and symptoms of a heroin overdose is crucial for timely intervention:

  • Shallow, slow, or stopped breathing
  • Pinpoint pupils
  • Discolored tongue
  • Bluish lips and nails due to lack of oxygen
  • Weak pulse
  • Delirium, disorientation, or coma
  • Drowsiness leading to unconsciousness

Immediate action is required to address these symptoms and prevent fatal outcomes.

What Does a Heroin Overdose Feel Like?

Individuals experiencing a heroin overdose are often unable to accurately report their feelings due to the severe impairment of consciousness and bodily functions. Witnesses describe victims as appearing extremely drowsy, falling in and out of consciousness, or being unable to be awakened. The suppression of respiratory functions can lead to a sense of choking or an inability to breathe if the individual is partially conscious.

Going through Heroin Withdrawals

Heroin withdrawals are a harrowing experience for those attempting to break free from addiction. Symptoms can begin within just a few hours after the last dose, peaking between 24 to 48 hours and lasting up to a week. Individuals undergoing withdrawal may experience intense cravings, muscle and bone pain, restlessness, insomnia, diarrhea, vomiting, and cold flashes with goosebumps (“cold turkey”). These symptoms occur because the body, accustomed to the drug’s presence, struggles to adapt to its absence, leading to a painful recalibration of the brain’s chemistry. Despite the discomfort, withdrawal is a crucial step toward recovery and a life free from heroin dependency.

How Much Heroin Does It Take to Overdose?

The amount of heroin required to overdose can vary widely among individuals, depending on factors such as purity of the drug, body weight, tolerance level, and whether heroin is used in combination with other substances. The risk of overdose is heightened with the use of heroin laced with fentanyl, as even a small amount can be lethal. The unpredictable purity and composition of street heroin make every use a risk for overdose.

The Shadow of Fentanyl

Fentanyl has dramatically increased the danger associated with heroin use. This synthetic opioid is often mixed into the heroin supply without users’ knowledge, significantly elevating the risk of overdose due to its potency. Even seasoned users with high tolerance to heroin can easily overdose on a fentanyl-laced supply, often with tragic outcomes.

Dealing with a Heroin Overdose

Immediate treatment for a heroin overdose involves administering naloxone (Narcan), a medication that can quickly reverse the effects of opioid overdose. Calling emergency services is crucial, as naloxone is a temporary solution and further medical intervention may be required. Ensuring the person is breathing, lying on their side to prevent choking, and staying with them until help arrives are critical steps in addressing an overdose.

Prevention and Education

Preventing heroin overdose starts with education on the risks of opioid abuse and the availability of treatment for addiction. Communities and healthcare providers must work together to raise awareness about the dangers of heroin and the lethal risk posed by fentanyl. Increasing access to naloxone and addiction treatment services, alongside supporting recovery and reducing the stigma of drug use, are essential steps in combating the heroin overdose epidemic.

Heroin overdose is a dire consequence of the opioid crisis, exacerbated by the widespread availability of fentanyl-laced heroin. Understanding the phases of overdose, recognizing its signs, and knowing how to respond are essential in saving lives. As society continues to grapple with this issue, it is clear that prevention, education, and accessible treatment options are key to reducing the incidence of overdose and supporting those struggling with addiction on their journey to recovery.

FAQ’s

Q: What are the first steps to take if I suspect someone is overdosing on heroin?

A: If you suspect a heroin overdose, act immediately:

  • Call emergency services (911 in the US) right away, even before doing anything else.
  • If naloxone (Narcan) is available and you know how to use it, administer it according to the instructions.
  • Try to keep the person awake and breathing; gently stimulate them by calling their name or lightly tapping their shoulders.
  • Place the person in the recovery position (on their side, with a bent knee to prevent rolling and the head tilted back to maintain airway openness) to prevent choking.
  • Stay with the person until emergency help arrives.

Q: How can I tell if someone is overdosing on heroin rather than just being high?

A: Overdose symptoms are more severe than those of a typical heroin high and include:

  • Extremely shallow breathing or no breathing at all.
  • Blue or gray lips and fingernails (cyanosis) due to lack of oxygen.
  • Unresponsiveness or inability to be woken up.
  • Pinpoint pupils.
  • Weak pulse or low blood pressure.
  • Limp body. Recognizing these signs can be the difference between life and death.

Q: Can someone survive a heroin overdose?

A: Yes, with quick and appropriate action, it is possible to survive a heroin overdose. The administration of naloxone (Narcan), an opioid antagonist, can rapidly reverse the effects of heroin, restoring normal breathing and consciousness. However, naloxone is a temporary measure, and immediate medical attention is still crucial for the individual’s recovery and to address any potential complications.

Q: How much heroin does it take to overdose?

A: The amount of heroin that can cause an overdose varies significantly from person to person and is influenced by several factors, including the individual’s body weight, tolerance level, purity of the drug, and whether it’s mixed with other substances like fentanyl. There’s no “safe” amount of heroin use; even a small dose can be fatal, especially if the heroin is laced with potent substances like fentanyl.

Q: What is the role of fentanyl in heroin overdoses?

A: Fentanyl significantly increases the risk of overdose due to its potency, which is 50 to 100 times greater than morphine. It’s often mixed with heroin, sometimes without the user’s knowledge, dramatically elevating the chance of an overdose even in small amounts. The presence of fentanyl in the heroin supply is a major factor in the surge of overdose deaths in recent years, making it imperative to approach all heroin use with heightened caution.

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