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Signs of a Heroin Overdose

In recent years, the number of people affected by heroin has increased so dramatically that authorities now speak of a veritable opioid crisis. The epidemic is linked to excessive painkiller prescribing in the United States. While the rate of pain reported by Americans has not changed over the years, the number of overdoses involving prescription opioids in 2016 is five times higher than it was in 1999. The Center for Disease Control and Prevention (CDC) found that around three out of every four new heroin users have used prescription painkillers before taking up heroin.

This means that while opioid overdoses are on the climb, so too are those related to heroin. Thus, it is paramount that the masses are educated on the signs of heroin overdose and how to act when faced with the tragic event.

The Heroin Connection

People struggling with opioid addiction reportedly turn to heroin as a cheaper alternative to prescription opioids. The three most common drugs that pave the way to heroin use and fatal overdoses are:

  • Methadone, typically used to relieve severe pain. Often used as a weigh-station to wean patients off more potent opiates.
  • Vicodin, also known as hydrocodone, prescribed to deal with moderate but not extreme pain.
  • Oxycodone, more familiar in its forms Percocet or OxyContin and two times stronger than morphine. OxyContin is the most common drug to lead to opioid addictions.

These painkillers are most often prescribed to people who are not inclined to take up heroin. The demographic groups that have experienced the greatest increase in heroin addiction in the last decade have historically displayed low rates of heroin use. These are:

  • Individuals with higher incomes
  • Individuals with private insurance
  • Women

Although these new demographic groups tend to be wealthier than the homeless or otherwise financially-challenged people once associated with drug addiction, keeping up an addiction to prescription medication gets too expensive for most. With the only economically viable option to turn to illicit drugs that promise similar, if not more intense, “highs,” people struggling with addiction to prescription pills are taking up heroin.

So begins the terrible cycle of addiction, which can easily lead to fatal overdoses. With little exposure to heroin culture, these communities are unfamiliar with how to manage overdoses. But before we get into the actions required to save a life, it is vital to understand what an overdose is and how heroin affects the brain.

How Does Heroin Affect the Brain?

To define an overdose, we must first look at how heroin acts on the brain. As semi-synthetic opioids, prescription painkillers share the same pain-relieving properties as heroin. They act on the brain in a similar way as heroin. The main difference is that heroin is less expensive, therefore more appealing for a person struggling with addiction.

How Heroin Manipulates Pleasure

Also known as diamorphine, heroin is derived from morphine. It is either snorted, smoked, or injected directly into a vein using a syringe. When ingested, heroin is absorbed into the body as morphine. This means that your brain interprets heroin as morphine, which binds to the receptors in your brain that are responsible for communicating the two most powerful messages known to living beings: pleasure and pain. Heroin thus quickly manipulates the natural opioid system dedicated to administering the pleasure chemical dopamine.

How Heroin Blocks Pain

By flooding your limbic system, the pleasure center of the brain, with dopamine, heroin produces a rush or “high” that has historically been likened to bliss, euphoria, and even Heaven. Heroin also blocks the transmission of messages relating pain via the spinal cord. As is the case with painkillers, heroin cloaks and disrupts the production of norepinephrine, the neurotransmitter that communicates pain. The heartbeat lowers, and respiration slows, so much so that some users can die from their heart stopping. In this way, heroin is a lethal depressant, in the sense that it slows down bodily functions and can even lead to death.

What is Addiction?

It is unusual for a person to seek out overdosing, since the very act of chasing the “high” is to, well, get “high.” All this to say that overdosing comes from wanting to feel good, and not from wanting to die. Overdoses happen from chasing the “high.” The tragedy of heroin is that, as you use more, you need more to feel the rush. Tolerance increases as the intensity of the rush decreases because your body now has a dependency on the drug. The initial “high” is nearly impossible to recreate, demanding a continuous pursuit, eventually leading to addiction.

What is Tolerance?

That first “high” is the most intense because heroin acts best on a balanced brain. But with continued heroin use, the brain cannot maintain the optimal levels that heroin works to imbalance. The brain will adapt to manage the influx of dopamine that heroin forces upon it. Generating more opioid receptors, that in turn require more heroin to match, the brain changes with heroin usage. As addiction turns into dependence, a heroin user’s brain will confuse dopamine for heroin.

What is Dependence?

Unable to secrete dopamine without the trigger of heroin, the brain is therefore unable to create any sensations of pleasure on its own. Simply put, heroin destroys your brain, attacking the areas where it is most active: your limbic system, spinal cord, and brainstem. The actual structure of your DNA changes as heroin eats up the white matter in your brain, which impacts your behavior and cognitive capacities.

In addition to ruining the normal process of pleasure, heroin warps the healthy communication of pain in the body. With continued heroin use, a person becomes hypersensitive to pain and sounds. Life as it once was becomes unbearable, inviting the user to double-down on escaping into the alternative, short-lived reality that heroin promises. At this point, every effort is geared toward securing the next “high.”

What is Overdosing?

A person struggling with addiction is most vulnerable to overdosing at this stage of dependence. Overdosing involves a person losing consciousness from taking too much heroin. Lulled by the pain-relieving qualities, heroin will shut down your nervous system. Blood pressure drops, breathing slows down with the heart. As drowsiness increases, you can forget to breathe. Other causes of death from heroin overdose are:

Arrhythmia

Unable to pump enough blood throughout the body, the heart malfunctions. The irregular heartbeat starves the organs from oxygen, resulting death.

Pulmonary Oedema

Heroin is not the only drug that can cause pulmonary oedema, a condition that is best described as choking to death. Note that cocaine and even a mild drug like aspirin can cause the same effect of excess fluid in the lungs.

Infectious Endocarditis

The method of ingestion also increases the risks of lethal overdosing. Besides the more obvious risks of intravenous diseases like HIV or hepatitis, studies have found that people using needles to inject heroin are 300 times more at risk of dying from a heart infection like infectious endocarditis.

When to Call an Ambulance

If a person in your midst is displaying any of the following signs and symptoms, you should act as quickly as you can. Call an ambulance if you witness:

  • Choking sounds from the throat
  • Gurgling noises
  • Vomiting
  • Abnormal or erratic breathing
  • Slowed breathing
  • Slowed pulse, or even no pulse
  • Blue or black lips and/or fingernails
  • Vomiting
  • Loss of consciousness often displayed by the body going limp
  • Convulsions
  • Cold and/or sweaty skin
  • Low body temperature

While a person addicted to heroin may seem like they are just sleeping, they could be choking on their tongue that has fallen back in their throat. What you see is not necessarily what you may expect, so do not take any chances. If you suspect for any reason that this person may be overdosing from heroin, dial 911 to call an ambulance as fast as possible.

The Antidote Naloxone

Usually administered either as a spray in the nose or injected directly into a muscle, Naloxone is a medication that can counteract the depressant effects that an opioid overdose has on the nervous and respiratory systems. Used by medical professionals and emergency responders, Naloxone makes breathing possible for a person suffering from a heroin overdose. In some cases, other people may be trained to handle this nonaddictive, prescription medication.

That being said, Naloxone is not a failsafe remedy. Prevention is the best medicine to avoid an overdose with this type of substance abuse. The best way to prevent is to educate yourself and others. Start by taking a look at your immediate surroundings to learn about how you can help. Certain states have dramatically higher rates of deadly overdoses involving heroin. Your home state may be one of them.

Mapping Fatal Heroin Overdoses

Though geographic statistics do not guarantee or prevent a heroin addiction, living in certain states can greatly increase you or your loved ones’ exposure to heroin. It is important to determine whether your home state is an area with a higher rate of death by heroin overdose. You may be surprised or shocked at the numbers relayed in the list below.

Highest Increase in Fatal Overdoses by State

Between 2015 and 2016, eleven states reported increases in the number of deaths caused by heroin overdoses. The CDC deemed the statistic changes of the following states worthy to report.

Colorado

With the most staggering increase of all the states that met the inclusion criteria, Colorado saw an increase of 50% of deaths related to overdoses that involved heroin. The number jumped from 159 deaths in 2015 to 234 deaths in 2016. The need for heroin addiction treatment in Colorado has thus increased, with Colorado Springs’ Peaks Recovery Center offering the best care available to safely detox from heroin addiction.

North Carolina

Second in line after Colorado, North Carolina saw a jump of 39% in fatalities caused by heroin overdoses between 2015 and 2016. The number of deaths rose from 393 in 2015 to 544 in 2016.

Wisconsin

With 37.7% more deaths by heroin overdose in 2016, Wisconsin is a close third following Colorado and North Carolina.

Illinois

22.4% more deaths were reported in the state of Illinois between 2015 and 2016. Compare 1040 lethal overdoses involving heroin in 2016 to 844 in 2015.

Missouri

Illinois’ neighboring state reported a slightly more important increase in the number of deaths by heroin in 2016. Missouri experienced 26.4% more fatal overdoses in 2016.

Tennessee

In the same ballpark as its adjacent state Missouri, Tennessee accounted for a 24.2% increase in the number of heroin-related deaths. That’s 260 deaths in 2016, compared to 205 in 2015.

Arizona

Between 2015 and 2016, the number of deaths due to heroin overdose in Arizona increased by 18.4%, with a reported 299 deaths in 2016.

Utah

With nearly double the statistic of Arizona, the number of deaths caused by heroin in Utah increased by 30.2% during the period of consideration, with a reported 166 deaths in 2016.

New York

The Empire state disclosed 20.4% more deaths by overdose between the years 2015 and 2016. Home to the most densely populated metropolis in the nation, New York state counted a record of 1,307 deaths by heroin overdose in 2016.

West Virginia

While the increase is less significant than that of other states, the rate of deaths related to heroin in West Virginia is the highest in the nation. A study found that in 2017, 750 of total deaths recorded in West Virginia involved at least one type of opiate, 508 of which were caused by the street drug fentanyl.

Virginia

In 2016, heroin claimed the lives of 450 people in Virginia, which represented an increase of 27.9% for the CDC study’s years of consideration.

Highest Rate of Fatal Overdoses by State

Note that the criteria for this state-by-state listing considered increases in the rate of heroin-related deaths by overdose, not the rate of drug overdoses that can be stable and higher. Most of the states with the highest rate of overdose deaths were not included in this list because their numbers did not reveal a significant enough increase from one year to the next. However, according to the CDC’s data on drug overdose deaths in the United States, the ten states that have the highest rates are:

  • West Virginia
  • Ohio
  • New Hampshire
  • Pennsylvania
  • Kentucky
  • Maryland
  • Massachusetts
  • Delaware
  • Rhode Island
  • Maine

Information is Prevention

Heroin overdoses killed more than 15,500 people in 2016, a mere fraction of the 1.5 million people in the United States regularly using the drug today. More usage begets more overdoses. This means that 1.5 million people and their loved ones need to be aware of what a heroin overdose looks like in order to know how to act, get help, and save lives. With the right help and guidance, heroin addiction is treatable. Call our Colorado rehab center today for more information on our heroin detox program and treatment.

sources:

Center for Disease Control and Prevention “Opioid Overdose”

Harm Reduction Coalition “Understanding Naloxone”

National Institute on Drug Abuse. “Heroin”