Heroin overdose
Heroin is a hard opiate drug. Its use leads to the rapid development of addiction and is often accompanied by overdose phenomena. The release of heroin as an antitussive drug was launched in 1898 by the pharmaceutical company Bayer AG. In 1913, the company discontinued the drug, as it was found that heroin is metabolized in the liver to morphine, causing the development of severe mental and physical dependence.
Currently, no country in the world produces or sells heroin as a medicine.
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How Much Heroin Do You Need to Overdose?
In most cases, drug addicts inject heroin intravenously. To achieve an intoxicating effect at the very beginning of use, 1 mg of the drug is enough, but rapidly developing addiction causes the injecting drug user to constantly increase the dose. Quite quickly, a single dose increases to 10-50 mg, and the daily dose reaches 2-2.5 g. It is difficult to say how much heroin can lead to an overdose, for some the toxic dose is 60-70 mg, and for others 200 mg, it depends from a number of factors:
- the introduction of the next dose of the drug until the moment the effect of the previous one ends;
- decreased tolerance to heroin - increased susceptibility to its action after a period of quitting;
- the use of well-purified heroin after a substance with a lot of impurities;
- the use of "dirty" heroin, containing many impurities, since in this case it is difficult to calculate the dose;
- the presence of severe concomitant diseases of the liver, lungs and other organs;
- the combined use of heroin and benzodiazepines (Seduxen, Valium) or other psychoactive substances, including alcohol;
- low socioeconomic status or the presence of mental disorders.
Signs of overdose
Signs of heroin overdose appear within 2-3 minutes from the moment of its intravenous administration. These include;
- disorientation in space;
- confusion of consciousness;
- lowering blood pressure;
- severe drowsiness;
- dry mouth;
- weakness of the muscles of the limbs;
- slowness of movements;
- shallow breathing;
- cyanosis of the skin and mucous membranes;
- a sharp narrowing of the pupils.
In case of a severe overdose, the drug addict quickly loses consciousness, while his respiratory failure increases, blood pressure drops sharply, and the pulse becomes rare and weak. Death occurs as a result of pulmonary edema or cardiac arrest.
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First aid for heroin overdose
If the victim maintains spontaneous breathing and pulse, you should:
- Lay the victim on a hard, flat surface on their side.
- Clean the oral surface from accumulated saliva and / or vomit.
- Provide fresh air by loosening tight clothing (open collar, remove belt) and open window.
- Try to bring the victim to his senses: pat on the cheeks, rub the auricles with your hands, sprinkle with cool water.
- After recovering consciousness, talk loudly with the victim, preventing him from falling asleep again or fainting.
- Constantly remind the victim to take deep and slow breaths in and out.
If, against the background of an overdose of heroin, a person has lost consciousness, he has no breathing and the pulse is not determined, and the pupils begin to dilate, you should immediately start cardiopulmonary resuscitation (indirect heart massage and artificial ventilation of the lungs) and carry it out until spontaneous breathing is restored or an ambulance arrives. help.
Antidote
Naloxone is a specific antidote to opiates, including heroin. Its mechanism of action is the ability to displace opiates from opioid receptors, due to which the phenomena of intoxication are quickly eliminated.
When is medical attention needed?
In case of an overdose of heroin, in all cases, without exception, it is necessary to urgently call an ambulance.
Naloxone is administered intravenously or intramuscularly, the dose being determined individually. If after the introduction of the initial dose the victim's condition has not improved, after 2-3 minutes Naloxone is re-administered. The indicators of the effectiveness of antidote therapy are the normalization of blood pressure, pulse rate and respiratory movements. It should be borne in mind that after the introduction of Naloxone, drug addicts quickly develop withdrawal symptoms (withdrawal syndrome, "withdrawal").
When administered intramuscularly, the effect of Naloxone lasts no more than three hours, and when administered intravenously - 45 minutes, after which the signs of heroin overdose appear again, since it takes much longer to remove it from the body. Therefore, after the introduction of the antidote, patients with heroin overdose are hospitalized in the toxicology department, where all the necessary measures are taken (life support, detoxification, etc.).
Possible consequences
The prognosis for a heroin overdose is always difficult. Against the background of respiratory depression, the brain experiences severe oxygen starvation. Hypoxia of the brain can cause the development of a deep coma, and often death. Even if a lethal outcome can be avoided, after a coma experienced, patients often have persistent neurological and mental disorders that lead to disability.
Severe heroin overdose leads to a sharp drop in blood pressure, renal blood flow stops. If the necessary measures are not taken urgently, acute renal failure develops.
Another common complication is pneumonia.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
