What Happens to Your Body During a Heroin Overdose

10 Jan What Happens to Your Body During a Heroin Overdose

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Over the past decade in the United States, there has been an alarming increase in overdoses and deaths as a result of the US opioid crisis. This public health epidemic is now the leading killer of people younger than 35, surpassing car accidents as public enemy number one in recent years. To help paint a better picture, here is a daunting fact about America’s opioid crisis. According to the CDC, in 2017, more than 66,000 people died from opioid overdose-related deaths, a 16% increase over the numbers seen in 2016.

Approximately a fourth of these 66,000 deaths were caused by the most deadly and addictive of synthetic opioids, heroin. These heroin abuse and addiction statistics are frightening, and only appear to be getting worse each year. Although this potent drug has been in circulation for decades, in the last 15 years, we have seen the total number of deaths increase by 7.6 times. While this alone should be alarming, what is not accounted for in these tragic numbers are the countless lives ruined or indelibly altered, either directly or indirectly, by this all-consuming substance.  

Because this scourge does not appear to be going away any time soon, it is imperative that you are able to spot an overdose when someone you love is abusing heroin. If you know the signs of an overdose, you may be able to act quickly enough to save them from the brink of death. To that end, we will discuss in depth what exactly happens to your body during a heroin overdose.

What is Heroin

Heroin is classified as a Schedule 1 drug and can be injected, snorted, or smoked for instantaneous effect. The Controlled Substance Act, which was a portion of the 1970 Comprehensive Drug Abuse Prevention and Control Act, remains the cornerstone of the DEA’s enforcement and categorization of substances. All substances were divided into five categories, known as “schedules.” These schedules were based on four categories:

    1. A drug’s potential for abuse


    1. A drug’s safety


    1. A drug’s addictive potential


  1. Whether the drug has legitimate medical applications

Excluding marijuana, Schedule 1 drugs are considered to be the deadliest of all drugs, with the highest likelihood of physical or psychological dependence and abuse, with no medical use.

How Heroin Works

Heroin affects the brain and can cause complete havoc on the rest of the body. Heroin binds to and arouses the brain’s mu-opioid receptors, neurotransmitters responsible for handling pain, regular hormonal release, and producing feelings of well-being. Heroin mimics the structure of these natural neurotransmitters, allowing it to bind to the receptors.

Typically, dopamine release occurs in the pleasure center of the brain in waves, most often as a result of some life-preserving action taking place such as eating, drinking, exercising, sexual activity, or time in the sun. When a person does one of these things, a valve of sorts opens up, temporarily releasing a spurt of dopamine into the brain’s reward center, thus making a person feel good as well as reinforcing that type of behavior.

When heroin attaches to the receptors, that valve is artificially thrown wide open. Instead of a sudden spurt of dopamine, the dopamine levels in the body are dumped into the brain in a sudden, all-consuming, rush. This dopamine rush is the euphoric and intensely powerful high that heroin users quickly grow addicted to.

The Effects of Heroin

The effects produced by heroin are different for each user and can depend on an assortment of factors such as:

    • A family history of substance abuse


    • The frequency of drug use


    • Method of administration


    • The presence of other drugs in the dose or the user’s system


    • The purity of the dose


    • The size of the dose


    • The user’s drug history


    • The user’s gender


    • The user’s health


    • The user’s height and weight


  • Whether or not the user has underlying mental health issues

While everyone experiences the drug differently, you can generalize the effects to an extent. These effects (at a ‘reasonable’ does) would include:

    • Bewilderment


    • Decreased appetite


    • Depressed breathing rate


    • Diarrhea


    • Drowsiness


    • Dry mouth


    • Erratic behavior


    • Instant pain relief


    • Intense euphoria


    • Lowered blood pressure


    • Lowered cough reflex


    • Lowered heart rate


    • Lowered sexual drive


    • Nausea


    • Pupil constriction


    • Reduced coordination


    • Slow speech


    • Slurred speech


    • Strong sense of wellbeing


  • Vomiting

What Happens to your Body During a Heroin Overdose?

Because of the potency of the drug, a heroin overdose is a distinct possibility every time the drug is taken, especially if snorted or injected. This is true of both novice and chronic heroin users who have either:

    • Had their tolerance lowered due to detox


    • Taken a batch that was cut with fentanyl


    • Taken a batch that was more potent than expected


  • Taken too much

When an overdose occurs, a series of processes within the body begin to take place. It all starts with the rush.

The Rush

An overdose all too often begins benignly. The user administers the drug, and the effects occur almost immediately. As the drug courses through the bloodstream, the floodgates are released and dopamine floods the brain with feelings of euphoria and wellbeing. This rush causes many heroin users to pleasantly “nod off” and experience heroin dreams. While it may seem “normal” at first, this larger, stronger, or mixed dose sends a tidal wave of dopamine to the brain far exceeding what the body and brain have become accustomed to handling previously.

As a result, the body begins to short circuit and is unable to process the countless inputs and signals. This malfunction spreads, affecting various autonomic functions that would typically run without any hitch.

Breathing Slows

Heroin actively alters the function of the forebrain, the area of the brain responsible for:

    • Language


    • Motor function controls


    • Perception


    • Receiving and processing sensory information


  • Thought

Within the forebrain are two main divisions; the diencephalon and the telencephalon. The diencephalon has the hypothalamus and thalamus, which are in charge of:

    • Autonomic functions


    • Sensory information relays


  • Motor function controls

A heavy dose of heroin alters this respiratory control center, which reacts to carbon dioxide and oxygen levels within the blood, causing you to breathe automatically. When an overdose occurs, these sensors stop working optimally, resulting in a dangerous slowdown, if not a complete cessation of breathing. The body neglects to breathe and then does not wake up in time to resume the process.

The Heart Slows

Heart rates are profoundly affected by our natural breathing process. As the heroin suppresses the neurological signals to breathe, oxygen levels drop precipitously, causing the heart to beat at a torpid arrhythmic pace.  The rest of the body begins to dysfunction because of this dramatic slackening in heart rate. At this stage, a heroin overdose may cause a sudden onset of cardiac arrest.

The Body Shuts Down

When the lungs and heart stop working due to the false signals, the rest of the body begins to also cease functioning. As the nervous system shuts down, the lack of oxygen to the brain starts to suffocate it. Within four minutes, this oxygen deprivation can cause severe and fatal brain damage. The body’s temperature at this time can alter the amount of damage done to the brain. The colder it is, the less brain damage will likely occur. At this point, if friends or medical personnel can get to the overdose victim, CPR can alleviate or prevent brain damage.

Pulmonary Edema Sets In

Doctors remain unsure why noncardiogenic pulmonary edema occurs since, in the case of heroin users, there is no fluid backup as a result of a failing heart. Regardless, fluids make their way into the airspace of the lung, manifesting as foam or vomit seeping out of the mouth. Because the body’s gag response is stifled due to heroin’s alteration of the respiratory control center, a person overdosing may choke on this foam or vomit and die of asphyxiation. This is a reason why many heroin users who nod off will be propped up on their side rather than their back.

Long-Term Damage is Done

If these things occur without medical attention, long-term brain damage or death are serious possibilities. Heroin overdose patients who survive sometimes wake up in a hospital unable to speak or move their limbs as a result of lasting brain damage from oxygen deprivation.

Signs of a Heroin Overdose

It can be quite tricky to decipher whether a heroin user is just high or actually experiencing an overdose. There are some signs of a heroin overdose to look for though that can help you distinguish between the two. If you find yourself in a situation where you are unsure as to whether it’s an overdose or simply the ‘natural’ effects of heroin, it would be wise to handle it like a drug overdose, seeing as that could very well save their life.

A person who is very high on heroin will likely exhibit the following signs:

    • Muscles are slack and droopy, especially in the face


    • They “nod off” to sleep


    • They have slowed speech


    • They have slurred speech


    • They scratch continuously


  • Their pupils are contracted

If you find yourself in such a situation and are concerned about their wellbeing, do not leave them by themselves. If they are conscious, make sure you keep them awake and responsive. Talk to them, poke them, shake them, walk them around, and keep an eye on their breathing.

A person who is overdosing will likely exhibit the following signs:

    • Awake, but incapable of speaking


    • Black and blue fingernails


    • Black and blue lips


    • Ceased breathing


    • Choking sounds, also known as the death rattle


    • Erratic breathing


    • Erratic heartbeat


    • Limp body


    • Loss of cognizance


    • No pulse


    • Pale and sweaty face


    • Shallow and slow breathing


    • Skin turns bluish-purple or gray and ashen


    • Slowed heartbeat


    • Unresponsive to external stimuli


  • Vomiting

What to Do If Someone is Overdosing

If a person is exhibiting these symptoms, especially if they are making a choking rattle while asleep, it is vital you do everything in your power to wake them.

The sternum rub is practiced by EMTs and paramedics in the field to see if a person is responding to pain stimuli. The process works like this: “The sternum is rubbed vigorously with the knuckles of a closed fist to create pain. This technique is often performed for only a few seconds while watching for a reaction from the patient. If there is no response within a few seconds of stimulation, one would assume that the patient is unresponsive and the brain’s integrity is compromised. If the patient reaches up and makes an attempt to remove the stimulus or actually grasps your hand, one would assume the patient has a higher level of brain function, which is an encouraging assessment finding.”

If a person does not respond to this painful stimulus take the following steps immediately:

    • Call 911 at once. Tell them that you are with someone who is overdosing on heroin and calmly report their current status—whether they are awake or unconscious—and whether they are responding to external stimuli.


    • If you have it, administer Narcan, the widely available anti-overdose medication. This medication can immediately reverse the effects of a heroin overdose, producing instant symptoms of heroin withdrawal.


    • Roll the person onto their side and check their mouth to ensure that nothing is blocking their breathing.


    • If breathing has ceased or slowed dramatically, administer CPR.


    • If they vomit, manually clear both their mouth and nose as best as possible.


  • Remain with them until medics arrive.


Heroin is a sinister drug that is responsible for ruining or taking the lives of far too many people every single year. A drug overdose can be a deadly and tragic affair, so it is vital that you are aware of the signs and symptoms of such an event. If a loved one has OD’d, contact emergency services and follow the steps above. After that, all you can do is pray and encourage them to seek treatment in order to rid themselves of this horrid disease.

At the end of the day, using heroin in today’s climate is more dangerous than ever. If anyone you know or love is using, then they remain at risk for overdose. Learn the facts, equip yourself with knowledge, and help this person (or yourself) seek recovery. Just remember, heroin addiction is treatable and you can get help. You just have to be ready to accept it. For more information on how to find treatment for a heroin addiction, please call our Georgia rehab center today.


“A Look at the Physical Anatomy of an Overdose.” Drugabuse.com. 8 Mar. 2019. https://drugabuse.com/what-happens-to-your-body-during-an-overdose/

“Heroin Overdose.” Drugabuse.com. 8 Mar. 2019. https://drugabuse.com/heroin/overdose/

“Symptoms of Heroin Overdose.” American Addiction Centers. 8 Mar. 2019. https://americanaddictioncenters.org/heroin-treatment/overdose

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