Signs Of Heroin Overdose: What To Look For

10 Jan Signs Of Heroin Overdose: What To Look For

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In the drug climate of today, with overdoses climbing across the nation, it has never been more important to educate our country on drug abuse and its ramifications. As we continue to wage war against the US opioid crisis, it is paramount that people know exactly where this fire is spreading, who is being affected, and what sort of corollaries have surfaced.

One such byproduct of this problem is an influx in heroin usage. Being that opioids and opiates derive from the same family tree, it is easy to substitute or ‘swap’ one substance for the other. When opioids become too difficult to acquire, or simply too expensive, users turn to heroin in order to satisfy their addiction.

This, of course, is why we have seen a 400% increase in heroin related overdose deaths in the last decade alone. This number is expected to climb once the analytics have been solidified for our current year (2008). Thus, we are here to detail the signs of a heroin overdose, what happens to the body during a heroin overdose, and what to do if you suspect someone is overdosing.

A Current Overdose

While it isn’t exactly feasible that you are reading through this text because, in this current moment, someone around you is overdosing, but if that’s the case then: leave this article and call 911 immediately.

When it comes to overdose, time is of the essence. Most people that survive do so because they experienced a quick response either in the form of rescue breathing, naloxone, or a combination of both.

What Does Heroin Overdose Look Like?

Different drugs bring about different types of overdose. No two substances are created equal and this particularly true when it comes to something as poorly developed as street heroin. When it comes to heroin, what we’re dealing with is a depressant, in which case:

  • Heroin works to depress the CNS (central nervous system), lessening its responsiveness and blocking certain pathways of communication. The result of which is a suppressed respiratory system, which means normal breathing patterns are disrupted. This is also a reason that users tend to feel relaxed when they ingest heroin.
  • In tandem with the depressive CNS is a lowered heart rate, blood pressure, and pain threshold. This is particularly worrisome, being that if the user is going to overdose, often the signals they would otherwise feel are blocked by the heroin binding to mu-opioid receptors (MORs).
  • Another point to address is that, over a period of prolonged heroin use, the lack of oxygen can begin to cause organ failure. Being that the user is consistently on an analgesic, these signals can be blocked too. This means that the pain killing substance they are addicted to masks the problem beneath the surface and one day, after months or years of reduced airflow, the organ(s) can fail.

In which case, the most common type of overdose spurred by heroin occurs at the hands of respiratory depression. In short: the body no longer has enough oxygen to survive without medical help, which can in turn halt the cardiovascular system (stop the heart).

Warning Signs of a Heroin Overdose

In the brain stem, there is an area named the ‘medulla and the pons’ which directly governs our breathing; the rate and depth in which we intake oxygen. Being that this region has a surplus of opioid receptors—the exact proteins that heroin binds to—it is easily manipulated by the drug. In which case, when the breathing begins to wane, the carotid body (a small area in the neck) is responsible for raising the alarm that it’s time for some CO2.

The bond between the opioid receptors and heroin block this communication, rendering the alarm scant more than a squeak, with little response from the brain and body. This is why one of the most common—yet not entirely understood—heroin overdose symptoms include liquid around the nose and mouth.

  • One of the most overlooked and yet telltale signs of an overdose is frothy liquid seeping from the nose and mouth. This is indicative that the lungs are filling with fluid, a condition called pulmonary edema. The further the lungs fill, the harder it becomes for the lungs to regulate airflow. While not as discussed, if you notice a frothy, almost saliva-like liquid in those two areas, it can be indicative of a coming overdose.

Additionally, being that the CNS continues its great depression, a host of other symptoms can arise. While this goes without saying, if the person you are suspecting of an overdose loses consciousness, won’t respond to any stimuli, or falls into a coma-like state—then odds are something serious is happening. You shouldn’t hesitate before calling 911.

Other warning signs of a heroin overdose include but are not limited to:

  • Shrunken Pupils (little pinpoints)
  • Pallid Skin
  • Heat In The Chest
  • Dry Mouth
  • Extreme Drowsiness
  • Feint Pulse
  • Muscle Contractions (Wooden Chest Syndrome)
  • Bluish Lips
  • Difficulty Breathing

Essentially, what you need to remember is that in most cases, a heroin overdose is mutually exclusive to a rapid lack of oxygen. This is where the drowsiness, feint pulse, difficulty breathing, and lack of color stem from. If you feel or notice any of symptoms of a heroin overdose, it’s time to call for help.

What to Do in The Case of an Overdose?

If you are ever in a situation where someone is overdosing, then as we mentioned before, time is of the essence. Overdoses can be reversed but the more time that passes, the higher the risk of death or permanent damage (due to a lack of oxygen). In which case, the first response should always be to call 911. You are going to want first responders to arrive as soon as possible, being that they will carry a drug called Naloxone (Narcan) with properties that can reverse opiate overdose. We’ll dive into that a bit further down.

Are They Responsive?

To gauge the severity of the overdose, it is important to deem whether or not the person is responsive. You can accomplish this by clenching your hand in a fist and running your knuckles against the front of their chest. If they remain unresponsive and you weren’t sure before, it’s time to call 911.

Aided Breathing

If they have a pulse, however feint, providing rescue breathing can be the difference between life and death. By this point, you should know that respiratory failure is most likely the cause of the overdose, in which case the person is in dire need of more oxygen. If this is the case, then perform the following steps:

  • Place them on their back: ensure that the person overdosing is on their back.
  • Tilt their chin upwards: do this in order to open their airway.
  • Check their mouth for anything that could block their airway or cause harm to you: this could be anything from pills that have yet to dissolve, a syringe cap, fentanyl patch, to gum or a toothpick.
  • Plug their nose: ensure that their nose is plugged and seal their lips with your own. Provide two even breaths in aims of filling their lungs with air. If their chest doesn’t rise, try tilting their head back even further to expand the airway.
  • Repeat the breathing: provide one breath every 5 seconds.

While there is certainly an art to CPR, having this knowledge can absolutely be the difference between life and death. Even just providing enough air to keep them alive before the paramedics arrive is a major help.


Naloxone is the drug engineered to reverse an overdose. When it enters the bloodstream, it removes the heroin from the mu-opioid receptors, thus breaking the bond. This then alleviates the weight placed on the central nervous system, reversing the effects of the opiate. If administered quickly enough, it can curb an overdose, mitigate the chances of death, and at the end of the day save lives.

The kits for naloxone come in two different forms; intranasal and injectable. With the intranasal kit, you’ll have to take the cartridge, pry off the top and then administer it as a nasal spray (once up each nostril). With the injectable kit, you’ll have to administer 1cc of naloxone via a syringe. When administered this way, you’ll want to target a major muscle; shoulders, thighs, etc.

Good Samaritan Laws

Under the Good Samaritan Laws, if you see someone experiencing drug overdose signs, such as heroin overdose signs, you should call 911 immediately and report the emergency. After calling 911, emergency responders will arrive at the scene and give medical attention to the patient. Under these laws, the person calling will have limited protection from prosecution for possession of drugs and/or alcohol. In addition, the person who overdosed could receive the same immunity for the possession of small amounts of illicit drugs. It is important to help the overdose victim get the treatment they need and prevent the worse outcome from happening, an overdose death.


Who is at Risk of Overdose?

The correct answer here is anyone. Whenever heroin is used, there is always the risk of overdose. This phenomenon is exacerbated now that fentanyl is part of the equation.

What Is Fentanyl?

Fentanyl is an extremely powerful opioid (50 times stronger than heroin and 100 times stronger than morphine per microgram) that is now being replicated in bootleg labs, where chemists are engineering a street version of the opioid that can be nearly 3 times stronger than the FDA approved medication. Although heroin and fentanyl may seem similar, fentanyl is significantly stronger, able to kill a user after a single small dose.

Being that it’s a cousin of the opiate family, dealers are adding this incredibly deadly substance into their drug batches (everything from cocaine, counterfeit prescription pills, to heroin) in order to make them more potent. The rationale is rather simple; they can use a small amount of an incredibly power opioid to enhance the ‘quality’ of their low-grade drugs.

Unfortunately, not a decade ago overdoses due to fentanyl were around 3000 per year. In 2018, that number is supposed to add another zero. If that’s not terrifying enough, the sad reality is that often these drug dealers will neglect to inform their customers that their batch might be stronger than usual. The user will then use the substance in the same capacity as normal, unknowing that they’re actually ingesting triple or even quadruple the potency. This ignorance results in overdose.

We address this point because it has never been more dangerous—in any point in history—to be using heroin. Now that illicit drug syndicates have their hands on fentanyl, using heroin, or any drug for that matter, comes with deadly risk. Statistics continue to remind us that the juice just simply isn’t worth the squeeze.

Tolerance & First Times

Another factor of heroin overdose comes from tolerance. Our bodies build a tolerance to nearly every substance we encounter. It’s not just reserved for drugs. However, tolerance to an opiate like heroin can develop rather quickly, while one for say, alcohol, might take a bit longer.

Over time, the more the user allows heroin to influence his or her brain structure, the less efficacy the a dose of heroin will have. This will then prompt the user to take higher doses. As they chase the desired outcome (usually considered to be the feeling of the first ‘high’), finding that euphoria becomes harder.

Yet, while their brain may be saying ‘this just isn’t enough,’ the central nervous system is drowning in the influx of concentrated potency. This means that it may ‘feel’ like their original dosage isn’t doing the trick, but really they’re flooding their body—pushing it towards overdose—every time they use.

Additionally, this can be especially concerning when someone who hasn’t used before decides to try heroin. If they’re in the presence of those who have developed tolerances, they might administer a dosage much too high or intense for the novice user. This, of course, can lead to overdose.


Being able to identify the warning signs of heroin overdose, in this day and age, is important. Sadly, the heroin epidemic is not partial. The demographic of opioid users across the nation are shifting, in which it is no longer reserved specifically for minorities or low-income housing areas.

Anyone in any tax bracket is susceptible to heroin and opioid addiction, as we are now seeing by the sheer fact that overdose—due most prominently to opioids and opiates—is the number one cause of death for Americans under the age of 35. If you are armed with this knowledge, then perhaps if anyone around you ever experiences this tragedy, you’ll be there to save their life. Just remember, heroin addiction is treatable and you can get your life back by seeking help and with the right course of heroine addiction treatment. To learn more about heroin withdrawal symptoms and treatment methods, please call our Georgia drug rehab center today.


“Symptoms of Heroin Overdose.” American Addiction Centers. 15 Mar. 2019.

“Signs Of A Heroin Overdose.” Addiction Campuses. 13 Aug. 2018. 15 Mar. 2019.

“Signs of a Heroin Overdose.” Dual Diagnosis. 15 Mar. 2019.

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