Heroin overdose
Acetomorphine overdose; Diacetylmorphine overdose; Opiate overdose; Opioid overdose
Heroin is an illegal drug that is very addictive. This article discusses heroin overdose. An overdose occurs when someone takes too much of a substance, usually a drug. This can happen by accident or on purpose. A heroin overdose may cause serious, harmful symptoms, or even death.
Overdose
An overdose is when you take more than the normal or recommended amount of something, usually a drug. An overdose may result in serious, harmful sym...
About heroin overdose:
Heroin overdoses have been rising sharply in the United States over the last several years. In 2014, over 10,500 people died of heroin overdoses in the U.S. Heroin is sold illegally, so there is no control over the quality or strength of the drug. Also, it is sometimes mixed with other poisonous substances.
Most people who overdose are already addicted, but some people overdose the very first time they try it. Many people who use heroin also abuse prescription pain medicines and other drugs. They may also abuse alcohol. These combinations of substances can be very dangerous. Heroin use in the United States has been growing since 2007.
This is for information only and not for use in the treatment or management of an actual overdose. This article is for information only. DO NOT use it to treat or manage an actual overdose. If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.
Poisonous Ingredient
Heroin is poisonous. Sometimes, the substances heroin is mixed with are also poisonous.
Where Found
Heroin is made from morphine. Morphine is a strong drug that is found in the seedpods of opium poppy plants. These plants are grown around the world. Legal pain medicines that contain morphine are called opioids. There is no legal medical use for heroin.
Street names for heroin include "junk", "smack", dope, and "skag".
Symptoms
People use heroin to get “high.” But if they overdose on it, they get extremely sleepy or may become unconsciousness and stop breathing.
Below are symptoms of a heroin overdose in different parts of the body.
AIRWAYS AND LUNGS
- No breathing
- Shallow breathing
-
Slow and difficult breathing
Slow and difficult breathing
Most people take breathing for granted. People with certain illnesses may have breathing problems that they deal with on a regular basis. This arti...
EYES, EARS, NOSE AND THROAT
- Dry mouth
- Extremely small pupils, sometimes as small as the head of a pin (pinpoint pupils)
- Discolored tongue
HEART AND BLOOD
- Low blood pressure
- Weak pulse
SKIN
-
Bluish-colored nails and lips
Bluish-colored nails and lips
Cyanosis is a bluish color to the skin or mucous membrane that is usually due to a lack of oxygen in the blood.
STOMACH AND INNTESTINES
-
Constipation
Constipation
Constipation in infants and children occurs when they have hard stools or have problems passing stools. A child may have pain while passing stools o...
-
Spasms
of the stomach and intestines
Spasms
Muscle cramps are when a muscle gets tight (contracts) without you trying to tighten it, and it does not relax. Cramps may involve all or part of on...
NERVOUS SYSTEM
-
Coma
Coma
Decreased alertness is a state of reduced awareness. A coma is a state of decreased alertness from which a person cannot be awakened. A long-term co...
- Delirium
- Disorientation
-
Drowsiness
Drowsiness
Drowsiness refers to feeling abnormally sleepy during the day. People who are drowsy may fall asleep in inappropriate situations or at inappropriate...
-
Uncontrolled muscle movements
Uncontrolled muscle movements
Muscle cramps are when a muscle gets tight (contracts) without you trying to tighten it, and it does not relax. Cramps may involve all or part of on...
Home Care
Seek medical help right away. Do NOT make the person throw up unless poison control or a health care provider tells you to do so.
In 2014, the U.S. Food and Drug Administration (FDA) approved the use of a medicine called naloxone (brand name Narcan) to reverse the effects of a heroin overdose. This type of medicine is called an antidote. Naloxone is injected under the skin or into a muscle, using an automatic injector. It can be used by emergency medical responders, police, family members, caregivers, and others. It can save lives until medical care is available.
Before Calling Emergency
Have this information ready:
- The person's age, weight, and condition
- How much heroin they took, if known
- When they took it
Poison Control
Your local poison center can be reached directly by calling the national, toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.
Poison Help hotline
For a POISON EMERGENCY call:1-800-222-1222ANYWHERE IN THE UNITED STATESThis national hotline number will let you talk to experts in poisoning. This ...
This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.
What to Expect at the Emergency Room
The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated. The person may receive:
- Blood and urine tests
- Breathing support, including oxygen tube through the mouth into the throat, and breathing machine
- Chest x-ray
- CT scan (advanced imaging) of the brain if head injury is suspected
- EKG (electrocardiogram, or heart tracing)
- Intravenous fluids (through a vein)
- Medicines to treat symptoms, such as naloxone (see "Home Care" section above), to counteract the effects of the heroin
Outlook (Prognosis)
If an antidote can be given, recovery from an acute overdose occurs within 24 to 48 hours. Heroin is often mixed with substances called adulterants. These can cause other symptoms and organ damage. A hospital stay may be necessary.
Acute
Acute means sudden or severe. Acute symptoms appear, change, or worsen rapidly. It is the opposite of chronic.
If the person's breathing has been affected for a long time, they may breathe fluids into their lungs. This can lead to pneumonia and other lung complications.
Injecting any drug through a needle can cause serious infections. These include abscesses of the brain, lungs, and kidneys, and heart valve infection.
Because heroin is commonly injected into a vein, a heroin user may develop problems related to sharing needles with other users. Sharing needles can lead to hepatitis, HIV infection, and AIDS.
References
Bardsley CH. Opioids. In: Marx JA, Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 162.
Centers for Disease Control and Prevention. Injury prevention & control: opioid overdose. www.cdc.gov/drugoverdose/opioids/heroin.html . Updated March 14, 2016. Accessed March 30, 2016.
Doyon S. Opioids. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide . 6th ed. New York, NY: McGraw-Hill; 2004:chap 167.
Levine DP, Brown PD. Infections in injection drug users. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 317.
National Institute on Drug Abuse. Heroin. www.drugabuse.gov/drugs-abuse/heroin . Updated March 2015. Accessed September 15, 2015.
National Institute on Drug Abuse Research Report Series. Heroin. www.drugabuse.gov/publications/research-reports/heroin . Updated November 2014. Accessed September 15, 2015.
Zosel AE. General approach to the poisoned patient. In: Adams JG, ed. Emergency Medicine . 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 143.
Review Date: 7/14/2015
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.