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Heroin Overdose Symptoms

picture of Joe Gilmore
Medically Reviewed By: Diana Vo, LMFT

May 21, 2024

Table of Contents

Heroin is a lethal and extremely addictive drug.

A semi-synthetic opioid that’s manufactured from the seeds of the opium poppy, opioid overdoses in general have increased in the United States due to the ongoing opioid epidemic. Some people addicted to opioid painkillers like hydrocodone or oxycodone and unable to refill their prescriptions use heroin instead.

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If you have a loved one abusing heroin, it pays to be fully aware of what happens when you overdose on heroin so you’re better placed to step in and help if required. Also, gaining an understanding of the warning signs of heroin use and addiction can help you intervene and get your loved one into a heroin treatment program long before heroin overdose becomes a reality.

Firstly, we’ll highlight some of the most common signs of a heroin overdose.

Signs of Heroin Overdose

When someone ingests too much heroin, there are many warning signs indicating a possible overdose.

Breathing that slows right down or stops completely is the primary red flag. All opioids depress your breathing rate, particularly in larger doses. Heroin is no different.

Look out for the following indicators of depressed breathing:

  • Gasping for air
  • Shallow breathing
  • Blue tinge to fingertips and lips
  • Pale blue hue to skin

There are also some other symptoms suggesting a possible heroin overdose:

  • Extreme drowsiness and inability to stay awake
  • Nausea or vomiting
  • Spasms or seizures
  • Constipation
  • Disorientation or delirium
  • Altered mental state
  • Low blood pressure
  • Weak pulse
  • Discolored tongue
  • Pinpoint pupils
  • Coma

Heroin overdose can be fatal, so it’s essential to seek immediate medical attention in the event of any of the above symptoms presenting.

If the person has injected heroin, signs of heroin overdose typically manifest around ten minutes after intravenous injection.

Heroin Overdose Symptoms

Becoming aware of the most common signs of a heroin overdose is the first thing you should do if a loved one is dependent on opioids. Beyond this, it’s vital to know what to do when these symptoms appear.

Although it might be challenging, do what you can to remain calm.

You should then call 911 and inform emergency responders that you suspect a heroin overdose.

Make sure the person has nothing obstructing their airways and then move them into the recovery position.

If you have naloxone – more on this heroin overdose antidote below – you should administer this as directed. Prenoxad is injected into the upper arm or upper thigh muscle, while Nyxoid is sprayed into the nose.

Wait with the person until emergency responders arrive. Hand over the used naloxone kit.

If you use naloxone, the medication starts taking effect in less than 5 minutes. The effects last for up to 40 minutes, but once they fade, the person begins overdosing again.

Heroin Overdose Death

While heroin overdose statistics make for sobering reading, heroin overdose death is by no means the only adverse outcome heroin abuse engenders.

Users develop a tolerance to opioids rapidly, and dependence soon follows. With heroin, few people manage to maintain a heroin habit at the same time as functioning fruitfully in society.

Long-term heroin abuse and addiction can trigger any or all of the following:

  • Lung complications (from smoking heroin)
  • Damaged nasal tissue (from snorting heroin)
  • Collapsed veins (from injecting heroin)
  • Heightened risk of HCV (hepatitis C)
  • Increased risk of HIV/AIDS
  • Stomach cramps
  • Jaundice
  • Sexual dysfunction (in males)
  • Heart disease
  • Infected heart lining
  • Pneumonia
  • Kidney disease
  • Liver disease
  • Insomnia
  • Constipation
  • Mental disorders

Increasingly, drug traffickers are adulterating heroin with fentanyl, a deadly synthetic opioid up to 100 times more potent than morphine.

Recent data shows that synthetic opioids were responsible for driving a 30% increase in drug overdose deaths in the USA in 2020.

Heroin Overdose Treatment

If heroin use is already out of control and you’re forced to deal with a heroin overdose, there is an effective antidote available in the form of naloxone.

Heroin Overdose Antidote

Naloxone is a heroin overdose antidote that’s been widely used for years

Binding to the same opioid receptors in your brain as heroin, Naloxone displaces substances like heroin, countering overdose. Naloxone has a shorter half-life than opioids like heroin, though. This means it won’t linger in your body for long, and it doesn’t act as an ongoing overdose antidote.

Naloxone is also available as a nasal spray (Narcan) and an automatic pen (Evzio).

Instead, naloxone acts as a band-aid and halts overdose for long enough to get the person emergency medical treatment. Never consider using naloxone in place of emergency medical assistance. It’s not an either/or situation when you’re dealing with opioid overdose.

As soon as the person is in the ER, naloxone is administered. Other methods such as using IV fluids or inducing vomiting may be used to stabilize the patient.

Prevention is better than cure, and if you have a loved one abusing heroin or you’re addicted to this lethal opioid yourself, current research shows that seeking pharmacological treatment can minimize some of the dangers of withdrawal while bringing about some benefits. Retention in treatment programs improves when medication-assisted treatment is utilized.

Given the notoriously harsh withdrawal symptoms associated with opioid withdrawal, medications are invaluable for streamlining this process.

Other medications used include:

  • Anti-vomiting medication
  • Anti-nausea medication
  • Sleep aids
  • Antidepressants

Also, lofexidine is an FDA-approved non-opioid that’s designed to mitigate opioid withdrawal symptoms.

Detox is not a cure for heroin addiction, but it’s the crucial first step down the road to recovery.

There are 3 main types of medication used in the treatment of heroin use disorder:

  • Partial opioid agonists: Partial agonists mildly activate opioid receptors
  • Opioid Agonists: Agonists fully activate opioid receptors
  • Opioid Antagonists: Antagonists block opioid receptors, interfering with the euphoric effects

From these groups, these are the most commonly administered and FDA-approved medications:

  • Buprenorphine: As a partial agonist, buprenorphine helps you to experience fewer cravings for heroin while detoxing without experiencing the euphoric high delivered by opioids. Suboxone is a combination medication including both buprenorphine and also naloxone, the heroin overdose antidote. First approved by the FDA back in 2002, buprenorphine was the first medication physicians were able to prescribe as a result of the Drug Addiction Treatment Act of 2000. This allowed the drug to be prescribed outside of specialized treatment centers, improving access. Generic versions came to market in 2013, further widening access to treatment. Monthly injections and implants lasting for up to 6 months have helped to remove the barriers of daily dosing.
  • Methadone: This slow-acting opioid agonist has been used since the 1960s to effectively treat heroin addiction. Methadone often works where other treatments have not yielded a response. Methadone is administered in a controlled setting in the form of an oral solution.
  • Naltrexone: Naltrexone is an opioid antagonist that blocks the action of opioids. Neither sedating nor addictive, naltrexone is also available in an injectable form (Vivitrol) that is FDA-approved and delivered once monthly.

Behavioral Therapy to Help with Heroin Addiction

The above medication-assisted treatment can be delivered in either an inpatient or outpatient setting, but to achieve the strongest chance of sustained abstinence, MAT should be combined with psychotherapy or contingency management.

CBT can help you explore the way your thoughts and feelings are linked to your behavior. You’ll learn that you are not compelled to follow the automatic thoughts that can lead you to use opioids. Once you’re aware of the people, places, and things that habitually lead you to use heroin, you’ll be better placed to avoid them. CBT will also help you to formulate healthy coping strategies.

Contingency management incentivizes and rewards healthy behaviors (passing a drug test or hitting sobriety milestones, for instance)

Other forms of therapy can also be usefully and successfully applied to treating heroin addiction, so all that counts is engaging with a personalized form of treatment tailored to your needs.

We can help you with that here at Renaissance Recovery Center…

Heroin Treatment at Renaissance Recovery

Attempting to stop using heroin at home using the traditional technique of cold turkey is not just unwise, but it’s also potentially dangerous.

While heroin is a highly addictive drug and quitting isn’t easy, there are several FDA-approved medications that can help soothe the intensity of the withdrawal symptoms you experience, while at the same time reducing the cravings you get for the drug.

Here at Renaissance Recovery Center, we’ll help you get back on track using an integrated approach of medication-assisted treatment and psychotherapy like DBT (dialectical behavior therapy) and CBT (cognitive behavioral therapy) and. MAT can minimize discomfort while psychotherapy helps you better understand your triggers for heroin use, replacing this destructive behavior with healthier coping strategies.

Taking the first step is often the hardest, so reach out to the friendly admissions team right now if you or a loved one needs help avoiding heroin overdose. Call us at 866.330.9449.



At Renaissance Recovery our goal is to provide evidence-based treatment to as many individuals as possible. Give us a call today to verify your insurance coverage or to learn more about paying for addiction treatment.

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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country. Connect with Joe on LinkedIn.

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