Heroin What causes a heroin overdose ?

[effie]

It is, my grandfather was prescribed it when he was terminally ill. Heroin is just as useful medically as any other strong opioid, it's just pure propaganda and doublethink that causes it to be schedule I in the US. If you don't believe me, check this out:
http://www.netdoctor.co.uk/medicines/100000751.html
(i particularly enjoy "Warning! This medicine may cause drowsiness").

It used to be prescribed all the time, then there was a shortage and everyone switched to morphine. However, it is still used a lot in terminal care, as there is a smaller volume of the drug to inject so it causes less distress, and you can fit larger amounts into a syringe driver (a device to deliver a constant supply of the drug subcutaneously).

 

[Tchort]

This article is excellent in examining the evidence that the 'Overdose' label regarding street heroin is overused and misunderstood:

http://www.druglibrary.org/schaffer/Library/studies/cu/cu12.htm

The main thrust of the argument being that 'Sudden Death' following intravenous diamorphine (caused by pulmonary edema) is a new phenomenon from the epidemic of post-WWII heroin use in the US (especially NYC). That a non-opioid cause of death is what isreally killing addicts shortly after injecting.

I highly recommend this article to everyone. Here's a sample from it:

Virtually all of the victims whose deaths are falsely labeled as due to heroin overdose, moreover, are addicts who have already developed a tolerance for opiates--- and even enormous amounts of morphine or heroin do not kill addicts. In the Philadelphia study of the 1920s, for example, some addicts reported using 28 grains (1,680 milligrams) of morphine or heroin per day. 19 This is forty times the usual New York City daily dose. In one Philadelphia experiment, 1,800 milligrams of morphine were injected into an addict over a two-and-a-half-hour period. This vast dose didn't even make him sick. 20

Nor does a sudden increase in dosage produce significant side effects, much less death, among addicts. In the Philadelphia study, three addicts were given six, seven, and nine times their customary doses--- "mainlined." Far from causing death, the drug "resulted in insignificant changes in the pulse and respiration rates, electrocardiogram, chemical studies of the blood, and the behavior of the addict." 21 The addicts didn't even become drowsy. 22

Recent studies at the Rockefeller Hospital in New York City, under the direction of Dr. Vincent P. Dole, have confirmed the remarkable resistance of addicts to overdose. Addicts receiving daily maintenance doses of 40 milligrams to 80 milligrams of methadone, a synthetic narcotic (see Chapter 14), were given as much as 200 milligrams of unadulterated heroin in a single intravenous injection. They "bad no change in respiratory center or any other vital organs." 23

. . .

At some point in the history of heroin addiction, probably in the early 1940s, the custom arose among coroners and medical examiners of labeling as "heroin overdose" all deaths among heroin addicts the true cause of which could not be determined. These "overdose" determinations rested on only two findings: (1) that the victim was a heroin addict who "shot up" prior to his death; and (2) that there was no evidence of suicide, violence, infection, or other natural cause. 24 No evidence that the victim had taken a large dose was required to warrant a finding of death from overdose. This curious custom continues today. Thus, in common coroner and medical examiner parlance, "death from heroin overdose" is synonymous with "death from unknown causes after injecting heroin."

During the 1940s, this custom of convenience did little apparent harm. Most deaths among heroin addicts were due to tetanus, bacterial endocarditis, tuberculosis, and other infections, to violence, or to suicide, and they were properly labeled as such by coroners and medical examiners. It was only an occasional death which baffled the medical examiner, and which was therefore signed out as due to "overdose." But, beginning about 1943, a strange new kind of death began to make its appearance among heroin addicts. 25 The cause of this new kind of death was not known, and remains unknown today--- though it is now quite common.

A striking feature of this mysterious new mode of death is its suddenness. Instead of occurring after one or more hours of lethargy, stupor, and coma, as in true overdose cases, death occurs within a few minutes or less--- perhaps only a few seconds after the drug is injected. Indeed, "collapse and death are so rapid," one authority reports, "that the syringe was found in the vein of the victim or on the floor after having dropped out of the vein, and the tourniquet was still in place on the arm." 26 This explains in part why nalorphine and other narcotic antagonists, highly effective antidotes in true opiate overdose cases, are useless in the cases falsely labeled overdose.

An even more striking feature of these mysterious deaths is a sudden and massive flooding of the lungs with fluid: pulmonary edema. In many cases it is not even necessary to open the lungs or X-ray them to find the edema; "an abundance of partly dried frothy white edema fluid [is seen] oozing from the nostrils or mouth" 27 when the body is first found. Neither of these features suggests overdose--- but since "overdose" has come to be a synonym for "cause unknown," and since the cause of these sudden deaths characterized by lung edema is unknown, they are lumped under the "overdose" rubric.

Not all of the deaths attributed to heroin overdose are necessarily characterized by suddenness and by massive pulmonary edema, but several studies have shown that a high proportion of all "overdose" deaths share these two characteristics. 28

 

[burn out]

To me that article sounds wrong and dangerous.

Nor does a sudden increase in dosage produce significant side effects, much less death, among addicts. In the Philadelphia study, three addicts were given six, seven, and nine times their customary doses--- "mainlined." Far from causing death, the drug "resulted in insignificant changes in the pulse and respiration rates, electrocardiogram, chemical studies of the blood, and the behavior of the addict." 21 The addicts didn't even become drowsy. 22

This can't be right. If I took 6-9 times my normal dose of heroin, I would probably die. I would DEFINITELY became drowsy. Sometimes I get drowsy on my normal dose.

 

[Captain.Heroin]

To me that article sounds wrong and dangerous.



This can't be right. If I took 6-9 times my normal dose of heroin, I would probably die. I would DEFINITELY became drowsy. Sometimes I get drowsy on my normal dose.

There's a huge difference between someone who is using < 0.5g per day, and someone who's using multiple grams, every day (assuming similar purity).

 

[Tchort]

To me that article sounds wrong and dangerous.



This can't be right. If I took 6-9 times my normal dose of heroin, I would probably die. I would DEFINITELY became drowsy. Sometimes I get drowsy on my normal dose.

The article was written in the early '70s, trying to document that something changed in street dope between the beginning of the street dope scene up to the 1940's, when the modern day heroin rackets were first established. The studies cited that you mention were from the 1920's, where opioids were far cheaper, far more available, and street dope was generally not from the French Connection type rackets known today or diverted pharmaceutical morphine and heroin (Heroin was only banned in the US in 1924 with the Heroin Act), back when the Jewish organized crime groups were the primary pushers of dope coming out of Chinese heroin factories. Plus this is the time period of the short-lived morphine & heroin IV maintenance clinics. Similar doses are used by addicts in the Swiss IV diamorphine program - (i.e. three 500mg shots of rx diamorphine a day).

Compare this to the street Heroin of the 1950's-1970's, which was generally only of a potency of 10mg morphine give or take per cap/bag. In a matter of a couple decades the average amount of opioids injected by addicts drops by a factor of 20. Sudden deaths among addicts rise dramatically into the archetypal 'Heroin OD' we are all familiar with today. The argument being that something else in street dope is what kills addicts in this manner.

Here's another article which references the 1972 article I posted earlier:

People rarely die from heroin overdoses — meaning pure concentrations of the drug which simply overwhelm the body's responses. What, then, are we to make of frequent reports of heroin overdoses from Plano, Texas and Strathclyde, Scotland? People do die while consuming heroin — but the overdose myth may actually make such deaths more, rather than less, likely.

The first popular source to tell us about the myth of heroin overdose was the classic 1972 Consumer Union Report, Licit & Illicit Drugs, written by Edward M. Brecher. Brecher pointed out that, when street doses of heroin were far purer than they are today (China Cat and black-tar heroin scares notwithstanding), drug overdoses were practically unknown.

Brecher noted that heroin overdoses began to be reported in New York City after World War II, and accelerated into the 1970s. Yet the average purity of a street dosage prior to the War was 40 times the concentration of a 1960s dose.

http://www.peele.net/lib/heroinoverdose.html

The above article written in 1998.

 

[burn out]

I understand the argument but it doesn't make sense to me. When I use heroin, I am pretty sure it is the heroin affecting me and not something else in it. But I guess there's a simple way to test it.

For people who use pharmaceutical opioids, do you think you could tolerate 6-9 times your normal dose without ODing? Obviously, whatever causes heroin ODs if it's not heroin, then it should not apply for pharmy opioids.

 

[Tommyboy]

It is, my grandfather was prescribed it when he was terminally ill. Heroin is just as useful medically as any other strong opioid, it's just pure propaganda and doublethink that causes it to be schedule I in the US. If you don't believe me, check this out:
http://www.netdoctor.co.uk/medicines/100000751.html
(i particularly enjoy "Warning! This medicine may cause drowsiness").

I believe you mate. Is it only prescribed in a hospice settings, or is it available for take home? They usually treat terminally ill patients with morphine and fentanly in the US.

they make morphine patches...

edit: just found out that these "morphine" patches that I've been hearing of for years is actually fentanyl...I feel dumb

I think it is just a sales tactic by street dealers, since a lot more people have heard of morphine than fentanyl. The fentanly lolli pops were called morphine lolli pops by me.

 

[uno22]

I understand the argument but it doesn't make sense to me. When I use heroin, I am pretty sure it is the heroin affecting me and not something else in it. But I guess there's a simple way to test it.

For people who use pharmaceutical opioids, do you think you could tolerate 6-9 times your normal dose without ODing? Obviously, whatever causes heroin ODs if it's not heroin, then it should not apply for pharmy opioids.

interested in what people have to say about this