“More than 46,000 people were killed by drugs in 2013. Most of these deaths were caused by prescription drugs, but for an increasing proportion heroin was the culprit — 8,200, to be exact. Most of these heroin deaths are chalked up to overdose in the media, but there are reasons to be suspicious of this characterization. Is it really simple overdose killing people?
For the most part, no. It turns out that most heroin deaths are probably not simple overdoses, but polydrug interactions, particularly between heroin and other nervous system depressants like benzodiazapines, tricyclic antidepressants, or alcohol. It’s an important distinction both for addicts themselves and for crafting a drug policy focused on harm reduction.
What do we mean by overdose? This is when a drug user takes more than he or she can tolerate, and dies as a result. Heroin depresses the nervous system, so if you take too much, then you’ll stop breathing and die. Simple.
The trouble with this story is that it is actually rather hard to overdose on simple heroin, particularly for experienced users. In fact, addicts are known to be capable of tolerating staggering quantities of pure heroin, dozens of times the average street dose in some experiments. It also usually takes several hours to die of a pure overdose, and treatment (with an opioid antagonist) is extremely simple — meaning that it ought to be pretty easy to save someone who has taken too much.
And complicating factors, the typical “overdose” fatality is typically not a naive heroin user — it’s an older, long-term addict. (Though addicts who relapse after a period of sobriety — thus having lost their tolerance — are a significant minority.)”
Source: TheWeek.com – September 30, 2015