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The true cause of "Heroin overdoses"

chugs

chugs

Bluelighter
Joined
Feb 23, 2004
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I just found a really really informative article about the real cause of heroin overdoses.

mods, stop me if i'm wrong or its already in another thread.

Chapter 12. The "heroin overdose" mystery and other occupational hazards of addiction


Chapter 4 of this Report reviewed in detail the effects of heroin and other opiates on addicts, including deleterious physiological effects traceable to the drugs themselves. Narcotics addicts today face other physiological hazards that are traceable to the narcotics laws, to the adulteration, contamination, and exorbitant black-market prices that those laws foster, and to other legal and social (as distinct from pharmacological) factors. Dr. Jerome H. Jaffe has described some of these risks in Goodman and Gilman's textbook (1970): "Undoubtedly, the high cost and impurities of illicit drugs in the United States exact their toll. The high incidence of venereal disease reflects the occupational hazard of the many females who earn their drug money through prostitution. The average annual death rate among young, adult heroin addicts is several times higher than that for nonaddicts of similar age and ethnic backgrounds. . . . The suicide rate among adult addicts is likewise considerably higher than that of the general population." 1

Because "the preferred route of administration is intravenous," Dr. Jaffe continues, "there is sharing of implements of injection and a failure to employ hygienic technics, with a resultant high incidence of endocarditis, and hepatitis, and other infections." 2

The exorbitant price of black-market heroin, Dr. Jaffe might have added, is one of the factors that makes intravenous injection "the preferred route of administration," for "mainlining" is the cheapest way to forestall withdrawal symptoms. And the laws restricting possession of injection equipment, under penalty of imprisonment, increase the risk of needleborne infections by encouraging the sharing of implements.
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Infections from sharing needles isn't at all related to overdoses. Paramedics don't rush straight to you because you just realised you've been diagnosed with hepatitis. As for suicide, well they never said heroin was their method of suicide - I think they're just stating that Heroin addiction leads to an emotionally terrible life for some, and so they kick the bucket.

EDIT: Sorry, I didn't read that entire article; but no doubt that quote is irrelevant.
 
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seriously tl;dr ??

ok - its in the middle of the article that it gets to the gold:

There are two theories

Theory 1:

Quinine in heroin causes a reaction in the individuals that results in the death of the individual. This is on the basis that

a) that under medical supervision/clinical trials they have given users up to 7 times their usual dose, but with pure medical grade heroin. Not only in those cases have the users continued to be fine in many of the cases they weren't even drowsy. Case in point it has been proven across the medical establishment that it is quite impossible to die from even large doses of heroin. The LD50 is about 7-8mg per kg in primate trials. That's a lot of smack for a newbie say a female at 60kg that's 480mg, or with today's street heroin at least 1 gram would be required to create an overdose.

b) where overdoses have been found quite often they find the needle still in the person arms. Clinical trials involving overdosing on heroin find that it takes quite a period of time for the OD to occur. The article notes that there is usually more then enough time to admister the antidote for opiates (nalxone)

c) Quinine caused deaths however can happen very quickly and even at below the theruaputic range for quinine (which can be IV'd for maleria treatment). They find hitting a nerve is particular dangerous within quinine and that there seems to be a relationship with lesions on the lungs of users.

Theory 2:

Alcholol is a factor in many overdoses. Considering that many people drink its quite reasonable to find people with a blood acholol reading of 0.20, a lot but enough when mixed with heroin to cause death.

Summary

The point of the article is that what is killing people is not heroin. Heroin is a factor but is not the deciding cause. The media and the medical establishment have been lazy and denied the medically proven fact that its extraordinarily difficult to kill yourself using heroin alone. Instead of researching those "junkies" deaths its all put under the "heroin overdose" label and promptly forgotten.

So yeah I though the HR value of this would be fucking huge. Wish you people would read this. Especially you Bronson. I know you like trolling but even you seem to like facts.
 
chugs said:
Alcholol is a factor in many overdoses. Considering that many people drink its quite reasonable to find people with a blood acholol reading of 0.20, a lot but enough when mixed with heroin to cause death.
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Good point. Alcohol along with other prescription drugs are involved with many heroin overdoses (especially these days) benzos and/or methadone would be the main ones. With heroin purity generally lower ATM, and with it being more expensive (AFAIK) it's less likely people would die from straight up heroin OD. Would have to check the stats but after the drought in Australia in 2000 I'm almost certain you'd see a corresponding drop in OD's.


I think the title of your thread was a bit off...it's not that you don't have some interesting and valid points.

True cause of heroin overdose is heroin. If they have alcohol or other depressants in their blood I'm sure the coroner would note that in the cause of death.

Heroin by itself, at the correct dosage, administered correctly isn't all that dangerous...it's not damaging your brain like a meth addiction would, it's not messing up your lungs like smoking cigarettes. As you said the problem is purity (cuts like quinine), potency (which makes overdose always a possible risk) and the lifestyle that goes along with an illegal drug addiction (not looking after yourself, not having sterile/safe injection practices, having to commit crimes to fund drugs)

Can you give us a link regarding this bit -

a) that under medical supervision/clinical trials they have given users up to 7 times their usual dose, but with pure medical grade heroin. Not only in those cases have the users continued to be fine in many of the cases they weren't even drowsy. Case in point it has been proven across the medical establishment that it is quite impossible to die from even large doses of heroin. The LD50 is about 7-8mg per kg in primate trials. That's a lot of smack for a newbie say a female at 60kg that's 480mg, or with today's street heroin at least 1 gram would be required to create an overdose
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Heroin on the street varies in potency. Normally it falls within a certain range, but if you're using it everyday, hundreds and hundreds of times a year, there's a risk you'll get your hands on something that's significantly more potent (could be double what you're used to, if not more) If it's true what you're saying about 700% increase over what they're tolerant to isn't even causing them to be drowsy..I'd find that pretty interesting. But I'm a bit sceptical about it.
 
Christ! said:
Good point. Alcohol along with other prescription drugs are involved with many heroin overdoses (especially these days) benzos and/or methadone would be the main ones.
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Is the reason methadone would be a main reason people OD on heroin because of potentiation, or because they need to shoot a lot more in order to feel the effects of the smack? Alcohol and benzos I've always known to be a terrible risk, but I can't remember reading anything about methadone being a major factor.
 
Thanks for posting Flex.

Looks like I was wrong about methadone being one of the main presciption drugs involved in ODs.

Treatment

Overdoses among heroin users receiving treatment (such as maintenance pharmacotherapies and drug-free therapeutic communities) appear to be relatively rare.

For example, only 2 per cent of heroin-related deaths in New South Wales in 1992 were in methadone maintenance (the dominant treatment modality) at the time of death, while 75 per cent of fatalities had never been in methadone treatment. Enrolment in methadone maintenance has been found to be protective against overdose in spite of continued use of heroin, probably reflecting a combination of reduced heroin use while in treatment and/or a higher tolerance to opioids while being maintained on methadone
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many synthetic opiates like fentanyl or etonitazen and benzimidazole which is used to cut heroin can be a main problem of overdose related deaths. fentanyl can cause fatal suppression of breathing easily. you cant say for sure that it was heroin overdose or in fact it was fentanyl overdose.
 
i wonder if there any statistics on fentanyl cut heroin.

I've read that its the case but has anyone here got any first hand experience on fentanyl in their smack?
 
^ I've never actually heard of it happening in Australia, that doesn't mean it hasn't though.

The article was a good read, thanks.
 
i went to an "education" class for a drug diversion once, and there was some discussion about the fact that heroin overdoses tended to happen in unfamiliar surroundings more often than in users' normal using environments. they seemed to suggest that there was some medical uncertainty about what even caused heroin "overdose".
has anybody heard of this, and can anyone confirm it? or is this state propaganda? :)
it reminds me of the idea of 'set and setting' which is typically referring to psychedelic experiences.
any thoughts?
 
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I have read recently that using opiates in an unfamiliar setting can cause more of an effect. There was a name for this but I've forgotten it, I also remember seeing it referenced on Wikipedia.

Here is one thing I found:
http://www.intropsych.com/ch05_conditioning/conditioning_and_drug_tolerance.html

Often the fatal overdose occurred in unfamiliar environments. Drawing an analogy to their rat studies, the researchers proposed that addicts who took the drug in an unfamiliar setting, or took it after a period of time not using the drug were in special danger of overdosing.
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Another: http://people.whitman.edu/~herbrawt/classes/390/Siegel.pdf

I think I found the scientific name for this: Situational-Specifity of Tolerance.

786 Results in Google Scholar:
http://scholar.google.com/scholar?q...a=X&ei=fq9VT6bDDIGhiQfa-eTyCA&ved=0CB8QgQMwAA
 
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^ If I remember correctly, there is a paper that is available on/linked to on Erowid perhaps that talks about this. Interesting topic, I remember it being brought up on BL a few times before in discussions.
 
spacejunk said:
i went to an "education" class for a drug diversion once, and there was some discussion about the fact that heroin overdoses tended to happen in unfamiliar surroundings more often than in users' normal using environments. they seemed to suggest that there was some medical uncertainty about what even caused heroin "overdose".
has anybody heard of this, and can anyone confirm it? or is this state propaganda? :)
it reminds me of the idea of 'set and setting' which is typically referring to psychedelic experiences.
any thoughts?
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This is definitely in the literature - I'll see if I can track down a journal article to back it.. The "drug, set, setting" idea is actually firmly linked to heroin use through the seminal text "Drug, set, setting" by Norman Zinberg (1984) in which he explores non-dependent heroin use. You can read the first chapter online here

So I think the stats are that you are more likely to OD in public, but more likely to die at home (because no-one finds you until it is too late). The same person can take the same dose at different times/places and get different effects - there is no simple formula to say "OK I can take this much and not die"

Certainly benzos and alcohol are involved in most fatal ods in Australia (check coroner's stats or ABS) - particularly benzos. That said - when the gear was stronger (late 90s) the number of people who dies each year was shitloads higher (but still mostly people mixing with benzos and/or acohol). Remeber when the herald scum printed the heroin toll next to the road toll - it was like a competition! These days the annual death toll from heroin od is about a quarter what it was back then. Of course the slaughter on the roads continues....
 
Thanks again for that link Ajay... was an interesting read about Carl's story.. I;m diggin the The New Perspective on Control
 
other than stronger than normal batches of heroin i would say most overdoses happen because of xanax

this is based on nothing statistcally but every erson i know who has overdosed has done so because of xanax
 
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