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March 6, 2024

Heroin Overdose: Signs, Symptoms, & Treatment

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Rates of heroin overdose deaths have more than quadrupled in the United States within a decade, according to CDC (Centers for Disease Control and Prevention).

This guide explores how heroin overdose can occur and treatment methods used to counteract what should be treated as a medical emergency. You can also find out how to connect with effective and compassionate heroin addiction treatment.

Signs of Heroin Overdose

Heroin, classified as a Schedule I controlled substance, is responsible for about one-third of all opioid-related overdoses.

If you suspect that a heroin overdose is occurring, act swiftly by calling 911 for immediate assistance.

Early signs of a heroin overdose include:

  • Unusual sleepiness or unresponsiveness: Individuals may appear extremely drowsy or unable to wake up. This is often one of the first signs of overdose.
  • Disorientation or confusion: The person may seem lost, confused, or unable to comprehend basic questions or commands.
  • Pinpoint pupils: One of the hallmark signs of opioid overdose, including heroin, is constricted, pinpoint pupils.
  • Slowed or irregular breathing: Even before breathing becomes dangerously slow or shallow, noticeable changes in breathing patterns can be an early warning.
  • Weak pulse: A slow, weak, or irregular pulse can indicate that the overdose is affecting the heart’s ability to function properly.
  • Pale skin: The skin may look pale or feel cold and clammy to the touch, signaling circulatory problems.
  • Subdued movements: Movements may be sluggish or weak, indicating the body’s systems are slowing down.

Recognizing these early signs provides a crucial opportunity to seek immediate medical attention, potentially averting more severe symptoms and saving a life.


Heroin Overdose Symptoms

Consuming an excessive amount of heroin can critically impair breathing and heart functions, potentially leading to cessation of both within minutes of ingestion.

Symptoms of heroin overdose typically include:

  • Slow and shallow breathing 
  • Bluish tint to lips and fingernails
  • Cold, clammy skin
  • Seizures

These symptoms can escalate quickly, resulting in coma or even death. Those who use heroin face a higher risk of encountering these severe symptoms than people who use other opioids (except fentanyl, a deadly synthetic opioid 50 times stronger than heroin).

Overdoses involving drugs can lead to fatal outcomes. If you believe someone is undergoing an overdose, call 911 without hesitation. In situations where a phone is not available, Web Poison Control Services offers online support for emergency guidance right here.


Heroin Overdose Treatment

Treating a heroin overdose involves a series of interventions aimed at preserving life and preventing long-term damage. The approach to treatment is multi-pronged, focusing on immediate stabilization, counteracting the effects of the heroin, and addressing any complications arising from the overdose. 

  • Immediate stabilization: The first step in treating a heroin overdose is to ensure that the person’s airway is clear and that they are receiving sufficient oxygen. This may involve providing oxygen through a mask or implementing more advanced airway management techniques if the individual is unable to breathe on their own.
  • Administration of naloxone: Naloxone is an opioid antagonist that rapidly reverses the effects of heroin on the brain, restoring normal respiration. It can be administered via injection or as a nasal spray. Prompt administration of naloxone can prevent death or severe damage due to oxygen deprivation.
  • Supportive care: Once breathing is stabilized, ongoing supportive care is necessary to monitor vital signs, manage withdrawal symptoms, and treat any co-occurring medical issues. Intravenous fluids may be given to maintain hydration and blood pressure, and other medications may be used to address specific symptoms like nausea or agitation.
  • Observation and monitoring: After the immediate threat has passed, people are typically kept under observation to monitor for any recurrence of overdose symptoms, especially if the naloxone wears off and heroin effects return. Continuous monitoring allows for timely intervention if symptoms re-emerge.
  • Addressing withdrawal symptoms: For individuals who are dependent on opioids, withdrawal symptoms can begin rapidly after naloxone administration. Medical staff may provide medications and supportive care to ease these symptoms, which can include severe agitation, muscle aches, and anxiety.
  • Long-term treatment planning: Surviving a heroin overdose can be a wakeup call for individuals struggling with opioid use disorder. Healthcare professionals may use this opportunity to discuss long-term treatment options, including detoxification programs, MAT (medication-assisted treatment) like methadone or buprenorphine, counseling, and support groups. The goal is to support recovery and prevent future overdoses.
  • Emotional and psychological support: The aftermath of an overdose can be emotionally taxing for both the person and their loved ones. Access to mental health support and counseling services helps people address the psychological impact and to begin the journey toward recovery.

Heroin overdose treatment is not just about addressing the immediate effects of the drug but also involves comprehensive care and planning for the future. Effective treatment requires a coordinated effort from emergency medical providers, addiction specialists, and mental health professionals to ensure the best possible outcome for the individual.


What does a heroin overdose look like?

A heroin overdose typically presents as shallow, slow, or stopped breathing, blue lips and fingernails due to lack of oxygen, pinpoint pupils, convulsions, and unconsciousness. It may also involve disorientation, delirium, and an inability to wake up or respond to stimuli.

Can you overdose on heroin?

Yes, it is possible to overdose on heroin, as it’s a powerful opiate that depresses the central nervous system and respiratory function. The risk of overdose increases with higher doses, when combined with other substances, and in line with the person’s tolerance to opioids.

What happens when you overdose on heroin?

During a heroin overdose, breathing can slow down dramatically or stop altogether, leading to hypoxia – reduced oxygen supply to the brain – which can cause short-term and long-term neurological damage or death. Other critical bodily functions can also fail, making immediate medical treatment essential.

Get Treatment for Heroin Overdose at Gratitude Lodge

If you or someone that you care about requires compassionate and evidence-based heroin addiction treatment in Southern California, reach out to Gratitude Lodge.

We can treat heroin overdose, and we can also help you withdraw from opioids when you choose our medical detox program. Access FDA-approved medications and continuous care as you move beyond dependence on heroin and transition to ongoing inpatient treatment at one of our luxury facilities.

All Gratitude Lodge heroin addiction treatment programs deliver personalized treatments that may include:

Although heroin addiction is highly disruptive, it’s also treatable. Call 800-994-2184 for immediate assistance.

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Jenni Busse MS, LPCC

Jenni Busse MS, LPSS is the Clinical Director at Gratitude Lodge. Jenni oversees the clinical program and the clinical team at Gratitude Lodge as a whole. Jenni has worked in treatment for almost 14 years. Her background as a licensed therapist and her passion for helping others intersected with addiction recovery when she started working primarily in detox residential treatment.

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