I had a relative die this way and my family said he literally still had needle in his arm, I have heard this in other overdose stories as well. What happens that causes them to die so instantly?
In: Biology
The effects from banging heroin are almost instant and hits hard. You would “nod off” as soon as it hits then you will stop breathing moments later if you do to much.
They don’t necessarily die instantly, it’s just that they feel good after the injection and don’t bother removing the needle sometime, then they start to overdose.
[fentanyl or carfentanil](https://gandaracenter.org/what-is-carfentanil-fentanyl-vs-carfentanil-synthetic-opioid/) that’s thousands of times more potent than heroin mixed in with filler and maybe a bit of real heroin in the baggie.
this is done because fentanyl and carfentanil are cheap and easy to transport because they are so incredibly potent, very little is needed to be smuggled in. a bit more than a two-thirds of an ounce (20g) of fentanyl is ”equivalent” to a kilogram of heroin, and a third of an ounce (10g) of carfentanil is ”equivalent” to a kilogram of *fentanyl*.
this works out to carfentanil being around 5000 times as strong as heroin, so a gram of carfentanil (about the size of a tylenol or apap pill) is ”equivalent” to just over 11 *pounds* (5kg) of pure heroin.
professional licenced and experienced labs have difficulty turning raw fentanyl into human-size doses, usually measured in *micrograms* (a millionth of a gram.. a grain of sand is around 50 micrograms). an illicit lab taking an ounce of fentanyl and mixing it out to a couple kilograms of i-can’t-believe-it’s-not-heroin is going to have a hell of a time getting the drug and the fluff thoroughly mixed so that there aren’t any ”hotspots”.
so some kid gets a bag of junk that’s supposed to be pure heroin, is expecting it to be heroin mixed with some filler, gets a bag of filler will a small hotspot of fentanyl, shoots up from the bag and gets only the fluff this round. the kid doesn’t feel anything, so shoots up again, gets maybe a little be high because the bag *was* mixed… just not well. kid goes to shoot up again, grabs the hotspot of nearly pure fentanyl (hey, you can’t tell one powder from another without a lab), shoots it up, and is in immediate od as he’s just put the equivalent of 50x as much opioid in his vein as he’s used to.
with carfentanil, it’s 100x worse. looks at the pictures in the link i left at the top.
these two drugs are so dangerous, if there’s even the remotest possibly either is involved, law enforcement or lab folks are *required* to have several doses of naloxone (opiate antidote) drawn up and ready to go, just in case. with carfentanil, a single dust-like grain of it in your eye can be a fatal dose, and fentanyl isn’t far behind.
complicating the matter is that because so little has such a large effect, even if the addict could get their drugs tested, it would be like trying to find 3 grains of salt in a spoonful of sugar: virtually impossible to do without destroying the drugs in the process.
it’s counterintuitive, but the vast majority of people get hooked on opiates for a reason… very few get hooked for the fuck of it. opiates dull grief, and even *loneliness*, in addition to physical pain. most addicts are self-medicating issues they don’t know how to fix, and their ”cure” causes more problems.
if we want to fix this, we need to treat the underlying problems and the *very* first thing necessary is to change the laws to avoid making addicts automatically criminals. hell, follow the lead of some more successful countries and provide a safe space, clean needles, some supervision, and clean, lab made opiates. eliminate most of the overdoses, halt the spread of the comorbidities such as hepatitis c, and start offering counseling and treatment.
until this us-of-a stops trying to sweep this into private prisons for the poor and betty ford for the rich, there’s going to be a black market for opiates, and people are going to die because those running the market have absolutely no interest in anything other than making money…. one might even say it’s the ultimate and worst expression of capitalism: no regulations, buyer beware, the cost of entry is the cost of your stock….
Addict’s who have stopped for some period of time but then resume using often go back to dosages they used when they were regular users and had built up a tolerance to the drug. They end up overdosing as a result of their tolerance no longer being what they were used to but failing to adjust for that with their initial dosage.
Two reasons:
1. Heroin feels really good and can cause the user to “nod off”.
2. Intravenous drug use is hard on the veins, and after a long period of using, it can become hard to find a good vein. Once you find a vein, you keep the needle there, only replacing the syringe, until you run out of heroin and have to get up and go find more.
An intravenous injection in the arm only takes a few seconds to reach the brain, which is where the drug works. This won’t kill someone instantly, but a large enough dose will make them lose consciousness rapidly, and at some point after that, they might stop breathing or aspirate vomit or something like that.
The way opiates like heroin and fentanyl kill people is through their ability to make you stop breathing. This is called “respiratory suppression.” These drugs bind receptors in your brain that make you want to breathe less. You breathing less first causes you to go unconscious then you ultimately die.
Now there are a few ways that this can happen.
1. You take too much.
2. You use the same amount you typically do but in a place that you don’t typically do it.
3. The potency is your drug is too much (I.e. you take a synthetic like others have mentioned)
Expanding on number 2. If you shoot up in your bathroom at home every day your brain associates that location with shooting up, so it does essentially prime your body for breaking down the drug faster. Say now you go home for the holidays. You go into your parent’s bathroom and shoot up the same amount that you do at home but because you aren’t in that same environnement, your body isn’t ready for all of that heroin/fentanyl and you’ve now overdosed on your usual dose.
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