Did you know that nearly 80 percent of heroin users reported using prescription opioids before their heroin use? Data released by the National Institute on Drug Abuse (NIDA) showed that from 2002 to 2012, heroin initiation was 19 times higher among those who reported prior non-medical pain reliever use than those who did not.

A study in 2008 and 2009 found that 86 percent of those interviewed had used opioid pain relievers, non-medically, prior to using heroin, and their start on opiate drugs came from three primary sources – family, friends, or personal prescriptions.

We are amid an epidemic of gigantic proportions, and the country hasn’t seen a disease of such magnitude in hundreds of years. While we’ve faced crises with drugs, there has never been something that decimates our population.

One hundred thirty people die every day in the United States as a result of opioid overdose, which includes heroin, prescription drugs, and synthetic drugs like fentanyl. You may wonder how we got to this point – in the late 1990s drug companies approached doctors in the medical community and reassured them that their product was not addictive.

After getting through to a few prominent figures, doctors began prescribing the drugs at alarming rates. It led to the widespread misuse of the medications, and it was inherently clear they were more addicting than pharmaceutical reps led them to believe.

In 2017 alone, 47,000 Americans succumbed to overdose and died. In that same year, 1.7 million people struggled with a substance use disorder relating to opioids, with 652,000 of them suffering from a heroin use disorder.

With the crackdown on prescription opioids, many who became addicted moved to heroin because it’s a stronger and more cost-effective alternative. Many of those who simply cannot afford their prescription pill habit move onto the drug, and it is typically the final step in an addiction. By doing this, it has exacerbated the problem, and opioid addiction has exploded.

Heroin is one of the most potent and addictive drugs on this planet, and someone who actively uses, or who is interested in using, may wonder if there is a lethal dose of heroin. The problem with that question is the many variables surrounding heroin use.

Is there a Lethal Dose of Heroin?

Heroin is a dangerous and illegal opioid drug, and those who use it experience profound effects immediately after administering that can last several hours. In 2015 alone, 81,236 emergency room visits occurred for unintentional, heroin-related overdoses in the United States. The number translates to a rate or 26 per 100,000 people.

As we’ve highlighted extensively above, prior misuse of prescription opioids is the most common risk factor when it comes to heroin abuse, which is true among those who became dependent on or abused prescription opioids in the previous year.

The definitive answer about a lethal dose of heroin is difficult to answer, and a bag of heroin may not contain heroin. Fentanyl-laced heroin was emerged due to the low cost and extreme potency of fentanyl. A little bit of the drug can increase profits for drug dealers exponentially, and create a much more intense high for the user.

Heroin is commonly cut with the drug, and in the Northeast, it is laced and even given its own brand name to alert the user of the fentanyl presence.

Fentanyl is nearly the most potent opioid on the planet. It is known to be stronger than a standard dose of heroin by 50 to 100 times.

Unfortunately, there is no answer to what causes a lethal dose or how much to avoid, but one definitive answer to that question is not to use the drug at all. If you are struggling with prescription opioids and have been considering heroin, it’s time to take the next step and discuss treatment.

There are so many variables that determine what a lethal dose is for one person, and what is just enough for someone else. Is there fentanyl? How long has someone been using opioids? Is there a tolerance present? Do they take care of themselves? Weight? Several factors are going to influence the outcome of heroin administration, but the safest method is prevention.

Heroin Overdose Death Rates

No one goes into addiction thinking the inevitable can happen to them. As humans, we always consider ourselves bulletproof. “That can’t happen to me!” You also think you’ll never get a bad batch of heroin. “My dealer cares about me.” Unfortunately, drug dealers care about one thing – that isn’t your health. The majority of heroin overdoses occur in long-term users, typically in their third decade of life. These rates are higher in those who use benzodiazepines, alcohol, cocaine, or other drugs in conjunction with heroin. Heroin overdose deaths are most commonly caused by respiratory failure or asphyxiation. 

The U.S. National Center for Health Statistics found that drug overdose deaths involving heroin more than tripled from 2011 to 2016. The figures are unconscionable, rising from 4,571 to 15,961. It went from accounting for 11 percent of all drug overdose deaths to 25 percent. From 2012 to 2015, heroin was ranked first in overdose deaths, only to be taken over by fentanyl in 2016. 

The number of heroin users in 2016 alone were higher than the percentages from 2002 to 2013 but was similar to the rates from 2014 to 2015. The number of people who used heroin in 2017 decreased from 886,000 to 808,000 in 2018, which is likely caused by the shift from heroin to fentanyl. In 2020, the number of drug overdose deaths ballooned to a record high of 93,331 people, which is 20,000 deaths more than the previous high in 2019. The increase is unprecedented and likely attributed to the global pandemic. It’s the largest single-year percentage increase since 1999. Opioids were responsible for 60 percent of all overdose deaths.

How to Determine if Someone Overdosed on Heroin

Fortunately, heroin overdose is easy to spot, and if someone you know has overdosed on heroin, you must look for these signs. If the user has displayed any of what is described below, you must immediately call 911 as it can be the difference between life and death. 

  • Pale face, or clammy skin
  • Drooped muscles
  • Slurred speech
  • Nodding head
  • Pinned pupils (contracted, small appearance)
  • Loss of consciousness
  • Inability to speak spite being awake
  • Unresponsive to outside stimulus
  • Choking or gurgling sounds
  • Vomiting
  • Limp body

Someone who has overdosed on straight heroin or a substance laced with fentanyl will fall asleep while standing up or in the middle of a sentence. If the individual is sitting down, their head “lolling” is a dangerous warning sign. Unless drug paraphernalia is present, it’s unlikely you’ll be able to determine if the individual has overdosed on heroin. However, based on the signs above, you’ll likely know it’s an opioid overdose of some sort. You should also look out for mental status changes, such as the individual not making any sense when they’re talking or if they’re stumbling around and slurring their words. If this takes place, you might wonder, what can I do?

What to Do If Someone Overdoses on Heroin

If you’re a spouse, family member, friend, or innocent bystander, understanding the signs of a heroin overdose can save someone’s life. If you know someone that’s abusing heroin, this is vital information. The odds of encountering a drug or heroin overdose are increasing, especially as more Americans transition from prescription opioids to heroin. 

The quicker you spring into the action, the more likely the individual has a chance of surviving and avoiding long-term consequences. In some cases, a person might survive the overdose, but they’ll be left brain dead because help wasn’t available immediately. For that reason, please, call 911 immediately, even if you’re not sure. You should also do the following:

  • Call 911.
  • Try to keep the person conscious by talking to them – report everything you know to the 911 operator.
  • Make sure to turn them on their side – if they’re on their back and vomit, it can cause them to choke. Moving them on their side will help.

If you have Naloxone available, an opioid reversal agent, administer it right away. However, you must expect severe withdrawal symptoms immediately after giving the drug. Even if the person comes out of the overdose, make sure to still get help. The person can slip back into an overdose once the Naloxone wears off, which can be fatal. 

Effects of Heroin


Once heroin enters the brain, it is immediately converted into morphine, which leads to a process of binding to opioid receptors. Those who use heroin report feeling an increase of pleasure – also known as the “rush.” The rush is accompanied by several other effects that are solely dependent on the dosage along with the purity. Some of these include warm flushing of the skin, often referred to as a “warm blanket,” dry mouth, and a feeling of weighing much more than they do. 

Someone high on heroin will experience drowsiness for several hours, and breathing will be affected significantly. In some cases, it can be of grave concern.

In the early stages of heroin use, it may be easier to mask from the outside world, but as the hook sinks deeper into the person, the symptoms will become much easier to spot.


Prolonged use of heroin will not just lead to a path of darkness, but it is going to cause physical and psychological changes in the brain. Long-term heroin use can create an imbalance in neuronal and hormonal systems that takes several years to reverse. Other studies have shown the deterioration of white matter in the brain, which can affect decision-making, rational behavior, and a response to stress.

Withdrawal can occur in a few hours after last use, but significant symptoms will peak around 24 to 48 hours, and dissipate in about a week.  No matter how the drug is used, it is highly addictive, and when someone reaches the point of a heroin use disorder (HUD), the drug will become their only purpose in life.

The changes in brain chemistry will require someone to attend treatment; this will be their best choice to overcoming heroin addiction and living their life as intended. Active heroin addiction steals away the best moments in life, and don’t let that happen another day.

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