Heroin Overdose: Symptoms, Risks & Treatment
Using heroin or any opioid puts a person at increased risk of overdose, which can be deadly.1,2 If you use heroin or you know someone who does, understanding the risk factors involved in overdose, knowing how to recognize an overdose, and being prepared to respond to an overdose can help you take informed action to mitigate risk and injury.
Keep reading to learn more about heroin overdose and its symptoms, how to respond to an overdose, the dangers of mixing substances with heroin, and how to find heroin addiction treatment.
Heroin Overdose
A drug overdose is a medical emergency that can occur when a person takes enough of a substance to overwhelm their body, causing serious and possibly life-threatening symptoms.3 People who overdose on heroin–or any opioid–suffer from severely depressed breathing and heart rate that can result in death if they do not receive immediate medical attention.1
Anybody who takes heroin is at increased risk of overdose, however. Additional risk factors for opioid overdose include:3
- Using heroin or other opioids in amounts greater than your tolerance level, or taking opioids that are stronger or more frequently than you usually take.
- Returning to use after a period of abstinence, since it decreases tolerance levels.
- Using heroin or another opioid after having experienced a prior opioid overdose.
- Mixing heroin with other opioids or with other sedating substances, such as alcohol or benzodiazepines.
- Using heroin or an opioid alone, without someone who can respond using an opioid overdose reversal medication.
It’s important to note that street drugs like heroin increasingly contain illicit fentanyl, a highly potent opioid that can significantly increase the risk of overdose and has been a key driver of the opioid overdose epidemic in the U.S.3
Heroin Overdose Symptoms
Heroin overdose symptoms are the same as overdose symptoms associated with other opioids and include:3
- Loss of consciousness or inability to wake up.
- Slow, shallow, or stopped breathing. People who cannot be awoken may make gurgling or choking sounds.
- Bluish or purple fingernails and lips. Lighter-skinned people may turn bluish-purple, while darker-skinned people can appear pale grayish or ashen.
- Small, pinpoint pupils or pupils that do not respond to light.
How to Respond to Heroin Overdose
If a person is displaying any of the above symptoms, it is crucial to take immediate action.3 You should:3
- Administer naloxone or another opioid reversal medication, if available. These medications are safe to use any time opioid overdose is suspected and will not harm a person who has not used opioids.
- Call 911 right away, make sure to tell them if the person is unresponsive and not breathing, and follow the operator’s instructions.
- Support the person’s breathing as needed and, if instructed by the 911 operator, place them on their side to support their breathing.
- Remain with the person until emergency help arrives.
Naloxone and similar opioid reversal medications can be life-saving opioid overdose antidotes that can quickly restore a person’s breathing and reverse other signs of opioid overdose.1,3
As mentioned above, using a drug like naloxone for overdosing will not cause any harm to a person if they have not used opioids, but if they have, it can save their life.3 In other words, it is better to be safe and provide naloxone or a similar opioid overdose reversal medication when you think a person is overdosing.3
If you’re not sure how to administer the opioid overdose reversal medication, you should follow the directions from the 911 operator or those that are included with the drug’s packaging. These drugs are typically available as a nasal spray that is simply inserted into a person’s nostril and sprayed while the person lays on their back.1
Alternatively, there are also pre-filled injectable or autoinjector forms that make it easy to inject the medicine into a person’s muscle or under their skin.5,6
Mixing Heroin with Other Drugs
Mixing heroin with other drugs, including central nervous system depressants like alcohol, benzodiazepines, or xylazine, can result in oversedation as well as significantly increase the risk of overdose.3,7
Benzodiazepines, alcohol, and other nervous system depressants have a sedating effect and can also slow breathing, which can compound the already-present risk of slowed breathing associated with opioids like heroin.7
Illicit benzodiazepines have been found in the unregulated opioid supply, which can mean that people who use illicit opioids like heroin may be exposed to benzos without their knowledge.7
As mentioned above, fentanyl—a highly potent synthetic opioid that is 50 to 100 times stronger than morphine—has been increasingly found in the illicit drug supply.3,8 Illicit fentanyl has been a primary driver of deaths associated with opioid overdose.3
People who purchase street drugs like heroin may consider using test strips or other drug-checking equipment to determine the presence of fentanyl and other drugs, which can help you be informed of the increased risk since taking a very potent opioid could be higher than their level of tolerance, which can lead to overdose.3
Xylazine is another substance that is increasingly being found in the illegal opioid supply.3 It is a non-opioid animal tranquilizer that is not approved for use in humans and can also seriously raise the risk of potentially lethal overdose when mixed with drugs like heroin.3
Xylazine, which may also be included in drug-checking measures, can complicate overdose treatment because even though it can cause symptoms that seem like opioid overdose, it is not an opioid and does not respond to naloxone.3,9
As previously mentioned, in addition to having naloxone or another opioid overdose reversal medication on hand, people who use heroin should seriously consider the use of drug-checking equipment like fentanyl and xylazine test strips, as they likely won’t otherwise know if their drugs contain these potentially lethal substances.3
Heroin Addiction Treatment in New England
If you or someone you love uses heroin or other opioids, you may be understandably concerned about the potential for overdose and addiction. The good news is that there are effective treatment options in Rhode Island and Massachusetts that can reduce these risks, treat addiction, and help people regain control of their lives.10
AdCare’s inpatient drug rehab in Rhode Island and inpatient rehab facility in Worcester offer customized treatment plans designed for your unique needs. We provide expert, evidence-based care that can help you, or your loved one, start the path to recovery.
Our facilities offer a complete continuum of care, including detox, inpatient, and outpatient treatment, which means that you can receive a comprehensive treatment plan, including aftercare, to support your ongoing recovery.
When you’re ready to reach out, please call us at to speak to an admissions navigator about your treatment options. You can also learn more about rehab admissions and insurance coverage for addiction treatment.
To quickly check your insurance coverage for rehab, simply complete our .