Accidental Heroin Overdose: Why It Can Happen So Easily

These days, it seems like heroin overdoses have become all too common. It’s easy to assume that people who overdose on heroin are knowingly pushing their limits or intentionally trying to end their lives. But often, that is not the case.

The American government doesn’t track death rates for every drug. But the National Center for Health Statistics at the Centers for Disease Control and Prevention (CDC) does collect information on the most commonly used drugs. They found that drug overdose deaths involving heroin rose from 1,960 in 1999 to 15,469 in 2016. Since then, it has remained steady with 14,996 reported in 2018. 

Heroin use is an illicit drug and those who sell it do so illegally. So there is no type of control over the strength or quality of the drug. Also, some dealers mix heroin with other substances, which can be poisonous. The number of deaths involving heroin combined with synthetic drugs has been increasing since 2014. The rise in deaths related to heroin use is compelled by the use of fentanyl.

Most people who overdose are already addicted to heroin although some people do overdose the first time they use it. Many individuals who abuse heroin also abuse prescription pain medications and other drugs including alcohol. Combining these substances can be extremely dangerous.

The Changing Demographics of Heroin Use

The use of heroin has sharply increased in the United States among men and women, most age groups, and all levels of income. The greatest increases occurred in demographic groups with past low rates of heroin use including:

  • Women
  • People with private insurance
  • People with higher incomes

It is now thought that addiction to prescription opioid pain medications is the gateway to heroin use for many people. If a person receives a prescription for a painkiller after surgery or an accident, there is typically a limit on the number of refills. If they develop a dependence or addiction to that opioid painkiller and the refills run out, they often turn to heroin. 

Heroin is easier to obtain and usually cheaper than buying prescription opioids off the street. A person who is new to heroin has no idea how much to use to get the relief they are seeking. The first use could end up being the last.

Why is Heroin So Dangerous?

  • Heroin is a highly addictive illegal opioid drug.  
  • An overdose can cause slow and shallow breathing, coma, and death.
  • Heroin is often used with other drugs or alcohol which increases the risk of an overdose.
  • Heroin users typically inject the substance but some may smoke or snort it. When it is injected, the individual is at risk of serious, long-term viral infections such as HIV, Hepatitis C and B, as well as bacterial infections of the bloodstream, heart, and skin.

How Much Heroin Does It Take To Overdose?

Unintentional or accidental heroin overdoses typically are the result of drug misuse, drug abuse and/or taking too much of the drug while taking other drugs

A major reason it’s so easy to overdose on heroin is that the user never knows how much will actually cause an overdose. This, along with the following factors, is why so many people tend to overdose on the drug.

  • The purity of heroin is impossible to determine before taking it.
  • High purity means a higher strength and possibly more than your body can handle.
  • Contaminants, especially fentanyl, can be incredibly dangerous and can cause an instant overdose.
  • Your body’s tolerance for respiratory depression caused by heroin can also change quickly. When people stop using heroin for just a little while and then relapse, their tolerance can drop without even realizing it.

Conditions That Increase Risk Of A Heroin Overdose

Several underlying conditions can increase a person’s risk of a heroin overdose. Keep in mind that having one or more of the following conditions does not mean that an overdose is certain. It does, however, mean that the chances of overdosing can increase greatly.

Prior Abstinence or Reduced Use

If a person used heroin regularly in the past, abstained for some time, and then uses heroin again, a fatal overdose may occur. This is due to reduced opioid tolerance. The person might resume using heroin at the same dosage as before his or her abstinence, which the person’s body can no longer tolerate.

The risk of a heroin overdose also increases when treatment ends abruptly. By adhering to treatment programs, one’s tolerance can reduce, thus increasing the risk of overdose in the case of relapse.

Polydrug Use

Using another drug while also using heroin has been repeatedly linked to overdose mortality. This applies to sedatives or stimulant drugs (like opiates or cocaine) and alcohol.

Alcohol is a depressant. By pairing it with another depressant in the form of heroin, there is an even greater chance of a fatal overdose as it can exacerbate the depressant effects of heroin.

Systemic Diseases Or Infections

Systemic diseases, dysfunctions, or infections typically affect the entire body. Having one of these can increase the risk of a heroin overdose.

  • Respiratory Infection. Heroin users are often malnourished and tend to exhibit poor hygiene. These factors can often lead to respiratory infections, thus making users more susceptible to an overdose.
  • Hepatic Disease. Heroin users have an increased risk of developing liver disease. Those who develop it due to chronic heroin use can also experience a decrease in opiate metabolism in their liver. This can then increase the overall period of heavy intoxication and thus increase the chances of an overdose.
  • Pulmonary Disease. Heroin users with reduced pulmonary function (having to do with the lungs) are much more susceptible to fatal respiratory depression, thus also have an increased risk of a heroin overdose.


Cigarette smoking is extremely common with heroin users. Many injection drug users often have bronchitis or other smoking-related respiratory conditions. This suggests induced pulmonary disease, which can increase the risk of overdose.

Heroin Overdose Symptoms

Heroin activates receptors in the user’s brain. These neurotransmitters are responsible for the feeling of euphoria and often cause a rush along with an intense feeling of pleasure. But with these highs come incredibly dangerous lows.

What happens when you overdose on heroin is an extreme and often deadly combination of physical effects:

  • The body literally “forgets” to breathe
  • Your heart beats irregularly
  • Your blood pressure drops
  • Fluids can back up into your lungs

More visible and obvious symptoms of heroin overdose may also include:

  • Vomiting
  • A low or weak pulse
  • Shallow or irregular breathing
  • Limpness or loss of consciousness
  • Gurgling or unusual “snoring” sounds
  • Blue, purple or black fingernails and/or lips

The Overdose and Suicide Connection

We know a lot about the opioid epidemic and the rising death toll. But hidden in the shocking number of overdose deaths is a substantial number of people who have decided to end their lives. 

A new study funded by the National Institutes of Health (NIH) found that people who went to an emergency room for an opioid overdose are 100 times more likely to die by drug overdose in the next year after being released. But they are 18 times more likely to die by suicide, including intentional overdoses, compared to the general population. 

The connection between opioid overdoses and suicide seems to intensify over time. An analysis of the National Vital Statistics showed significant increases in suicides involving opioids between 1999 and 2014 among all age groups except teens and young adults. In people aged 55-64, the rate quadrupled.

With the absence of a suicide note, we don’t know exactly how many opioid overdose deaths are actually suicides. It is estimated that up to 30% of opioid overdoses may be intentional.

These new findings show that overdose patients face an exceptionally high risk of ensuing death, not just from an accidental overdose, but also from suicide, non-suicide accidents, and natural causes. 

Research into the link between suicide and opioid use suggests that the two relate in multiple ways and for many reasons:

  • A 2017 study showed that people with substance use disorders (SUDs) frequently also have other disorders and are twice as likely to have mood and anxiety disorders. These disorders are associated with suicide risk on their own.
  • People suffering from chronic pain, the main reason for prescription opioids, and the possible turn to heroin, may also have a co-occurring depression or other mental condition. These people are at risk of suicide because of their constant pain.
  • Many pain patients are stigmatized as “addicts” by the healthcare system when they try to get treatment.

Can You Overdose From Smoking Heroin?

A common misconception is that heroin can only be injected. In the past, this was the primary way people used heroin. Now smoking and snorting the drug is much more common. Because of this, the drug can appear to be less intimidating which, unfortunately, has led to a rise in its use.

While smoking heroin may seem safer than injecting it, it still delivers the same dangerous results. When smoked, heroin attaches to opioid receptors in the user’s brain which creates a euphoric high. And just like other ways of using heroin, as you smoke the drug, you’ll build up a tolerance—diminishing the intended effects while increasing the risk of an accidental overdose.

Heroin Addiction Treatment

There is no single, perfect cure for heroin addiction or any other drug. There are many effective treatments that can help you get through withdrawal and into recovery. The types of treatment depend on:

Pharmacological (medically-assisted treatment) and Psychological (behavioral therapy) methods help build some sort of normalcy to your behavior and brain function. Studies have shown that the combination of both types of treatment, under medical supervision, is the most effective method. This brings us to the preparation for treatment: detox.

Heroin Detox

Withdrawal symptoms when you first stop using heroin can be quite severe. During this detoxification stage, medications are used to ease cravings and other painful withdrawal symptoms that often cause people to relapse. Symptoms include:

  • Pain
  • Diarrhea
  • Nausea and vomiting
  • Restlessness
  • Extreme muscle and bone pain
  • Sleep disturbances

Medically-Assisted Treatment

The medications used to treat opioid addiction work on the same brain receptors as the drug but are safer. They are not likely to cause the same negative behaviors typical in SUDs. Medications are chosen based on your needs and other specific factors relating to you. Three common medications are:

  1. Methadone—a slow-acting opioid. Only available in outpatient treatment programs and is dispensed daily.
  2. Buprenorphine—activates the opioid receptors with a limited response but reduces the cravings
  3. Naltrexone—blocks the receptors and prevents the reward effects of the drug.

Behavioral Therapies

Many effective therapies are available for treating opioid use disorder. They are used in residential, outpatient, and aftercare treatments. These therapies help you understand your personal triggers for drug use, including co-occurring mental or emotional issues that need to be discovered. 

Therapy will help you adjust your behavior and expectations as it relates to drug use. You will learn skills to cope with stress and how to deal with people, situations, and environments that had formerly defeated you. You will be able to re-establish relationships that were broken due to your heroin use.

Get the Help You Need With Daylight Recovery Services

If you suspect that someone you know has a heroin problem, recognizing the signs could help save that person’s life. Maybe you need to save your own life. Just know that there is comprehensive help available so you don’t have to address the issue on your own. Don’t wait any longer. An overdose could be in that next fix.

The best way to prevent heroin overdose is to seek professional help. With Daylight Recovery Services, you are never alone. Start down the road to recovery today. If you or someone you care about is displaying signs of heroin addiction, contact our recovery experts now. We’re available 24/7 for you.