Heroin

:For a female hero, see Heroine

Risks of non-medical abuse of heroin

• overdose, sometimes fatal
• for intravenous abusers (people who inject) of heroin, the use of non-sterile needles and syringes and other materials leads to the risk of contracting blood-borne pathogens such as HIV and/or hepatitis infections as well as the risk of contracting bacterial or fungal endocarditis
• poisoning from contaminants added to "cut" or dilute heroin

Many countries and local governments have instituted programs to supply sterile needles to people who inject illegal drugs in order to reduce some of these contingent risks. While needle exchanges have demonstrated an immediate public health benefit, some see such programs as tacit acceptance of illicit drug use. The United States does not support needle exchanges federally by law, though some of its state and local governments do.

Related Topics:
Sterile - Needle exchange - Public health - United States

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A heroin overdose is usually treated with an opioid antagonist, such as naloxone (Narcan) or naltrexone, which have a high affinity for opioid receptors but do not activate them. This blocks heroin and other opioid agonists and causes an immediate return of consciousness and start of withdrawal symptoms when administered intraveneously. The half-life of these antagonists is usually much shorter than that of the opiate drugs they are used to block, so the antagonist usually has to be re-administered multiple times until the opiate has been metabolized by the body.

Related Topics:
Overdose - Antagonist - Naloxone - Narcan - Naltrexone - Opioid receptors - Half-life

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Contrary to popular belief, a heroin overdose is not fast-acting. Stories about people who "OD with the needle still in their arm" and the like are not attributable to heroin overdoses, but rather they are very often the result of a fatal reaction with the adulterant. Quinine is notorious for causing such deaths. In the case of an actual heroin overdose, it very often takes many hours to die.

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Heroin overdoses are more rare than one might first expect. As noted above, an overdose is immediately reversible with an opioid antagonist injection. The overwhelmingly vast majority of reported heroin overdoses are actually adulterant poisonings or fatal interactions with alcohol or methadone. True overdoses are rare because the LD50 for a person already addicted is prohibitively high, to the point that there is no general medical concensus on where to place it. Several studies done in the 1920s gave addicts doses of 1600mg-1800mg of heroin in one sitting, and no adverse effects were reported. This is approximately 160-180 times a normal recreational dose. Even for a non-addict, the LD50 can be credibly placed above 350mg.

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