Heroin Overdose: Signs, Symptoms, and Treatment

According to the Centers for Disease Control and Prevention (CDC), more than 13,000 people died from a heroin overdose in 2020. Due to the epidemic plaguing the United States, an average of 44 people died every day that year from an opioid overdose. Both illicit and prescription opioids continue to be a societal issue in the United States, with many states experiencing increased rates of opioid overdoses over the past few decades.

Heroin overdoses are life-threatening emergencies that should be taken care of immediately. If you suspect a family member or close friend may be a heroin user, being able to spot the signs of drug addiction and heroin overdose symptoms could potentially save their life.

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What is heroin?

Heroin is an opioid drug produced from morphine. It comes in the form of a brown or white powder or a sticky black substance known as black tar heroin. People typically snort, sniff, inject or smoke heroin either on its own or mixed with other drugs such as crack cocaine.

People who use heroin report feeling a rush or an intense feeling of euphoria or pleasure. As a highly addictive substance, heroin use poses a serious risk of developing into an opioid use disorder. If you’re worried someone may be struggling with a heroin addiction, common symptoms to look for include:

Dry mouth
Warm or flushed skin
Nausea or vomiting
Severe itching
Heavy feeling in the legs or arms
Clouded mental functioning

More severe symptoms can occur with long-term use, including insomnia, collapsed veins, liver or kidney disease, lung complications and mental illness such as depression.

Heroin overdose symptoms

According to the CDC, nearly 20% of all opioid deaths involve heroin. Recognizing the signs and symptoms that can result from a heroin overdose may prevent death. These include:

Loss of consciousness
Low blood pressure
Uncontrolled vomiting
Shallow breathing
Drowsiness
Slowed pulse
Clammy skin
Inability to wake the person up, even when applying a painful stimulus
Respiratory arrest
Choking or gurgling noises
Limp body
Pinpoint pupils

If someone you’re with starts experiencing any of the above symptoms, it should be treated as a medical emergency and professional help sought immediately.

Fentanyl’s role in heroin overdose

Fentanyl is a synthetic opioid about 50 times more potent than heroin and 100 times more potent than morphine. It can be acquired either as a prescription drug from a doctor to treat pain or illicitly on the streets. Fentanyl is one of the most commonly involved opioids in overdose deaths, with more than 150 people dying each day from the drug.

As one of the most dangerous substances on the market, powdered fentanyl looks just like many other drugs and is commonly mixed with heroin, cocaine, or methamphetamine. It also can be made into a pill that closely resembles other prescription drugs. Fentanyl is relatively cheap to produce, which is why many dealers sell fentanyl-laced heroin disguised as highly potent heroin.

It’s nearly impossible for a person to distinguish fentanyl-laced heroin from pure heroin, making it easy for a person with a substance abuse problem to unknowingly consume enough fentanyl to cause a fatal overdose. Fentanyl-related overdoses are also more difficult to manage than those from other types of opioids.

Heroin overdose causes & risk factors

A heroin overdose can occur anytime, even to first-time drug users, depending on the dosage taken. However, an overdose may be more likely to occur among people in certain situations such as:

People between the ages of 20 and 40
People who’ve overdosed before
People with severe medical or mental health conditions, such as HIV, breathing issues, depression, drug abuse or kidney and liver problems
Using drugs after a period of abstinence
Using heroin with other substances
Using heroin intravenously
Those of the male gender

What to do if someone overdoses on heroin

If someone is overdosing on heroin, seek immediate medical attention. Common symptoms to look for include:

Weak pulse and low blood pressure
Extremely constricted pupils
Tongue discoloration
Nausea or vomiting

The first step you should take is to call 911. Then, try rousing the person and turn them on their side to revive normal breathing. Administering naloxone, a reverse opioid overdose agent, can help treat overdoses but may result in the person experiencing severe withdrawal symptoms afterward.

If the person is awake and breathing, try keeping them awake until medical care arrives. If they are unconscious, laying them on their side will stop them from choking. It’s important to remain with the individual until they can be safely transported to the emergency room in case their condition worsens or they need extra assistance.

Breaking free from a physical dependence on drugs is difficult, especially once withdrawal symptoms kick in. If you or someone you know is struggling with a heroin addiction, medical support is available. Behavioral Health Centers offers a variety of addiction and dual diagnosis treatment options, including individual, group, and family therapy sessions.