Editing Heroin (section)

==Overdose==
{{further|US drug overdose death rates and totals over time}}
[[File:NIDA overdose heroin.png|thumb|US yearly opioid overdose deaths involving heroin]]

[[Heroin overdose]] is usually treated with the [[opioid antagonist]] [[naloxone]]. This reverses the effects of heroin and causes an immediate return of consciousness but may result in [[drug withdrawal|withdrawal]] symptoms. The [[half-life]] of naloxone is shorter than some opioids, such that it may need to be given multiple times until the opioid has been metabolized by the body.

Between 2012 and 2015, heroin was the leading cause of drug-related deaths in the United States.<ref name="CDC2018Death">{{cite web |title=Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2011–2016 |url=https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_09-508.pdf |website=U.S. [[Centers for Disease Control and Prevention]] (CDC) |access-date=21 December 2018 |date=12 December 2018 |archive-url=https://web.archive.org/web/20181213221854/https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_09-508.pdf |archive-date=13 December 2018 |url-status=live }}</ref> Since then, [[fentanyl]] has been a more common cause of drug-related deaths.<ref name=CDC2018Death/>

Depending on drug interactions and numerous other factors, death from overdose can take anywhere from several minutes to several hours. Death usually occurs due to [[hypoxia (medical)|lack of oxygen]] resulting from the lack of breathing caused by the opioid. Heroin overdoses can occur because of an unexpected increase in the dose or purity or because of diminished opioid tolerance. However, many fatalities reported as overdoses are probably caused by interactions with other [[depressant]] drugs such as alcohol or [[benzodiazepine]]s.<ref>{{cite journal | vauthors = Darke S, Zador D | title = Fatal heroin 'overdose': a review | journal = Addiction | volume = 91 | issue = 12 | pages = 1765–72 | date = December 1996 | pmid = 8997759 | doi = 10.1046/j.1360-0443.1996.911217652.x }}</ref> Since heroin can cause nausea and vomiting, a significant number of deaths attributed to heroin overdose are caused by aspiration of vomit by an unconscious person. Some sources quote the [[median lethal dose]] (for an average 75&nbsp;kg opiate-naive individual) as being between 75 and 600&nbsp;mg.<ref>{{cite web |url=http://lincoln.pps.k12.or.us/lscheffler/ToxicSubstances%20in%20water.htm |title=Toxic Substances in water |publisher=Lincoln.pps.k12.or.us |access-date=20 October 2010 |url-status=dead |archive-url=https://web.archive.org/web/20110430180739/http://lincoln.pps.k12.or.us/lscheffler/ToxicSubstances%20in%20water.htm |archive-date=30 April 2011}}</ref><ref>{{cite web| vauthors = Breecher E |title=The Consumers Union Report on Licit and Illicit Drugs|url=http://www.druglibrary.org/schaffer/Library/studies/cu/cu12.htm|url-status=live|archive-url=https://web.archive.org/web/20070208092708/http://www.druglibrary.org/Schaffer/Library/studies/cu/cu12.htm|archive-date=8 February 2007}}</ref> Illicit heroin is of widely varying and unpredictable purity. This means that the user may prepare what they consider to be a moderate dose while actually taking far more than intended. Also, tolerance typically decreases after a period of abstinence. If this occurs and the user takes a dose comparable to their previous use, the user may experience drug effects that are much greater than expected, potentially resulting in an overdose. It has been speculated that an unknown portion of heroin-related deaths are the result of an overdose or allergic reaction to [[quinine]], which may sometimes be used as a cutting agent.<ref>{{cite book | vauthors = Brecher EM | collaboration = Editors of Consumer Reports Magazine | date = 1972 | chapter-url = http://www.druglibrary.org/schaffer/Library/studies/cu/cu12.htm | chapter = Chapter 12. The "heroin overdose" mystery and other occupational hazards of addiction | title = The Consumers Union Report on Licit and Illicit Drugs | archive-url = https://web.archive.org/web/20070208092708/http://www.druglibrary.org/Schaffer/Library/studies/cu/cu12.htm | archive-date=8 February 2007 | publisher = Schaffer Library of Drug Policy }}</ref>