Heroin Overdose

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Calendar icon Last Updated: 05/7/2021

Reading Time: 8 minutes

In 2019, nearly 50,000 people died due to opioid-related overdoses in the United States—these opioids include heroin as well as prescription opioids like oxycodone and synthetic opioids, such as fentanyl.1 And of those 50,000 overdoses, about 14,000 (28%) involved heroin.2

If you or someone you love uses heroin, it’s important to know the signs of a heroin overdose, emergency protocols, and how to save someone’s life with naloxone, the opioid overdose reversal medication.

What is a Heroin Overdose?

Between 4% and 6% of people who misuse opioid painkillers wind up transitioning to heroin; likewise, about 80% of those who use heroin first used prescription opioids.1 This may be because heroin is commonly seen as cheaper and easier to access than prescription opioids.3

A heroin overdose occurs when a toxic amount of heroin has been used, resulting in severe and possibly life-threatening consequences. Although using any type of opioid can lead to overdose, heroin is of particular concern due to its unregulated potency and potential to be cut with deadly substances, such as fentanyl. A heroin overdose can affect several parts of your body.4

Heroin comes from a class of synthetic opioids. This substance, derived from morphine, acts as a central nervous system (CNS) depressant, which means that it slows your respiratory and heart rate. A heroin overdose may cause you to stop breathing, which can result in death.5

Signs and Symptoms of a Heroin Overdose

Some signs and symptoms of heroin overdose include:4,5

  • Difficulty breathing
  • Slow or shallow breaths
  • Dry mouth
  • Small pupils
  • Tongue turns different colors
  • Low blood pressure
  • Weakened pulse
  • Blue nails
  • Blue lips
  • Stomach or intestinal spasms
  • Disorientation
  • Extreme drowsiness
  • Coma

If you or someone you know has overdosed on heroin, call 911 right away and stay with the person until medical personnel arrives.

Long-term Complications of Heroin Overdose

The profound respiratory depression a person may experience during a heroin overdose can lead to a lack of oxygen in different parts of the body, an experience known as hypoxia.6 Hypoxia can result in fatal or non-fatal consequences.

Health complications related to hypoxia caused by heroin or another opioid overdose can become long-lasting. These chronic complications may include:6,7

  • Heart problems
  • Build-up of fluid in the lungs
  • Pneumonia
  • Seizures
  • Damage to nerves
  • Temporary paralysis
  • Kidney failure
  • Stroke

Some research has revealed that hypoxia can result in brain damage for people who have experienced several opioid overdoses and survived.6,7 When someone stops breathing during an overdose, using CPR until emergency medical personnel arrive can increase a person’s chances of survival. If you have naloxone, administer that as well in order to reverse the heroin overdose.8

Not all overdoses result in death. Still, a heroin overdose can increase the risk of long-term consequences. The right type of heroin addiction treatment can help prevent an overdose by providing you with the tools you need to quit using heroin or other opioids. Call 800-926-9037 (Info iconWho Answers?) today to speak with a treatment specialist about which recovery option best fits the needs of you or your loved one.

How to Treat a Heroin Overdose

Heroin overdose treatment starts by contacting emergency medical service providers.8 They can evaluate you or your loved one for any effects from heroin overdose which require medical attention.

When you call emergency services, be prepared to provide information about the person experiencing an overdose. Emergency responders will want to know the following information:5

  • The amount of heroin used and when
  • Whether any other substances were used
  • The age, gender, and weight of the individual
  • The health status of the individual

The more information you can provide, the more insight the first responders will have when they arrive. If possible, it’s also important to provide information on the route of administration, such as injecting, snorting, or smoking. Different routes of administration can lead to other complicating health factors. With injection, you may experience collapsed veins, abscesses, and tissue damage near the injection site.7

If you know CPR, you can administer CPR to someone experiencing a heroin overdose while waiting for the first responders to arrive. If you have naloxone, you should administer that in order to reverse the overdose. If not, the first responders are likely to have it and they will administer it. Sometimes more than one dose of naloxone is necessary to save a person’s life, which is why it’s important to call 911 or get the person to an emergency department even if you have naloxone on you.

How Naloxone Works and Where to Get It

Naloxone, prescribed under the brand name Narcan, comes in many forms and can work as an immediate life-saving treatment for an opioid overdose.4,7 This medication binds to opioid receptors, blocking those sites and limiting the effects of heroin or other opioid substances on the person who took them.7

Offered in nasal spray or injectable forms, an emergency medical provider or a loved one can administer naloxone to counter the effects of an overdose.4 Some states have passed laws that allow pharmacists to offer this potentially life-saving medication over the counter.7

Overdose Treatment at the Hospital

When a person experiencing an overdose arrives at the emergency room, they can expect to have baseline measurements taken and receive treatment for overdose symptoms.4 This treatment may include:4

  • Breathing support
  • Urine and blood samples
  • X-rays
  • Heart-tracing
  • Administration of fluids through the veins
  • Scans of the brain to check for any injuries

Given the risks associated with heroin administration and the impact of other substances or added elements, heroin overdose treatment may require a hospital stay.4

Who is at Risk of Overdose?

Clinicians who treat substance use disorders note that people who use heroin come from a variety of backgrounds.5 However some people are at an increased risk of experiencing an overdose, such as those who:10

  • Engage in poly-substance use
  • Have poor nutrition or a weak immune system
  • Have heart problems
  • Have HIV or hepatitis C
  • Have survived a past overdose

If you have recently gone to treatment, detox, jail, or otherwise experienced a period of abstinence, your tolerance is going to be lower than it was before you stopped using. This increases your risk of heroin overdose because you may return to using the same amount of the opioid you used prior to abstinence despite your body no longer being accustomed to that high of a dose.10

The rise in the use of heroin laced with fentanyl correlates with increased incidents of death or severe overdose symptoms as well. Fentanyl is an extremely potent and fast-acting synthetic opioid that is often mixed with or sold as heroin. People who use heroin aren’t typically aware that their heroin is cut with this deadly opioid, which is responsible for a surge in opioid overdose deaths.10

Other health concerns, physical and mental, may impact your likelihood of using heroin and experiencing an overdose.6 Research has shown a potential link between depression, suicidality, and heroin overdose. Though research may not fully explain the exact nature of the relationship, the combination of mental health conditions and substance use disorders presents as a risk factor for overdose, accidental or intentional.6

Research also demonstrates a relationship between traumatic events, a history of suicide attempts, intravenous heroin use, and increased risk of intentional overdose.11 These same researchers noted that a lower quality of life, lack of social support, and lower quality of free time contributed to a higher risk of a heroin overdose.11

If you are addicted to heroin, professional treatment can not only help prevent an overdose but can also assist you on the path to sobriety. Call 800-926-9037 (Info iconWho Answers?) to speak to a treatment support specialist who can discuss rehab options with you.

Transition to Heroin Addiction Treatment

Getting help following an overdose may seem scary, especially if you have concerns about the legal implications of your substance use. Medical service providers have legal obligations to protect your privacy and may only release information to others, including law enforcement, under special circumstances. Ultimately, safety takes priority when considering how to develop a plan for treatment and intervention following a heroin overdose.

After your initial recovery from an overdose, several heroin addiction treatment options can help you stay in recovery and prevent overdose from occurring in the future. The two main treatment settings include:

  • Inpatient rehab: You live at the facility for the duration of your addiction treatment, which can help you to focus on your recovery free from drug-using triggers and friends.
  • Outpatient: You attend therapy and counseling during the day and return home at night, which gives you the freedom to still attend school or work while recovering from heroin addiction.

The right opioid treatment setting for you depends on the severity of your addiction, as well as your individual needs and preferences. Medication, such as methadone or suboxone, alongside mental health and substance use counseling, can help you understand the underlying issues that lead to your heroin use and how to rectify maladaptive patterns of behavior.12 Cognitive-behavior therapy (CBT) can help you better understand the connection between your thoughts, feelings, and behaviors associated with heroin use.7 Therapy can also provide you with relapse prevention techniques and coping skills, as well as help you maintain motivation for recovery.12

Following your initial heroin addiction treatment program, you may want to consider then transitioning into some form of aftercare, such as sober living or community support groups to guide you in your recovery. The benefits of stable, recovery-oriented relationships can help you get back to the life you want to live.

Commit to your health and the relationships that matter. Seek support in finding the best course of treatment by speaking with a specialist today 800-926-9037 (Info iconWho Answers?) .


  1. National Institute on Drug Abuse. (2021, March 11). Opioid Overdose Crisis
  2. Centers for Disease Control and Prevention. (2021, March 18). Heroin
  3. National Institute on Drug Abuse. (2020, May 13). Heroin Research Report: Overview. 
  4. Ciulla-Bohling, R. (2020). Heroin. Salem Press Encyclopedia of Health. Salem Press.
  5. Heller, J. L. (2019, July 2). Heroin overdose: MedlinePlus Medical Encyclopedia. MedlinePlus.
  6. Zibell, J., Howard, J., Clarke, S. D., Ferrell, A., & Karon, S. L. (2019, September 5). Non-fatal opioid overdose and associated health outcomes: Final summary report. Office of the Assistant Secretary for Planning and Evaluation. 
  7. National Institute on Drug Abuse. (2020, July 24). Heroin DrugFacts
  8. U.S. Department of Health and Human Services. (2020, August 19). Opioid Overdose. Substance Abuse and Mental Health Services Administration. 
  9. American Psychiatric Association. (2013). Substance-related and addictive disorders. In Diagnostic and statistical manual of mental disorders (5).
  10. Mass.gov. (n.d.). Opioid Overdose Risk Factors.
  11. Dragišić, T., Jovanović, M., Dickov, A., Bugarski, T., Ivetić, O., & Mišković, M. (2018). Heroin overdose — suicide or accident? Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journal of Serbia, 75(9), 905–910. 
  12. Miller, W. R., Forcehimes, A. A., & Zweben, A. (2011). Treating addiction: A guide for professionals. The Guilford Press.