Heroin Dosage Guide

Opioid overdose is a medical emergency that kills within minutes without intervention. Knowing how to recognize and respond is a survival skill for anyone around opioid use. **How Overdose Kills** Mu-opioid agonism suppresses the brainstem's breathing reflex, causing respirations to slow and stop. Without oxygen, irreversible brain damage begins within 4-6 minutes. Most fatal overdoses involve co-use of other depressants (benzodiazepines are present in ~30% of cases) or fentanyl-contaminated products. **Recognizing Overdose** Distinguish a "nod" from an overdose — this saves lives: - **Nodding:** Responds to stimulation (shaking, sternal rub). Still breathing, even if slowly. - **Overdosing:** Unresponsive. Breathing extremely slow (fewer than 10/minute), shallow, or stopped. Blue/gray lips and fingertips (cyanosis). Pinpoint pupils. Gurgling sounds. Limp body. Do not give naloxone to someone who is simply sedated but breathing adequately — unnecessary naloxone causes precipitated withdrawal without medical benefit. **Emergency Response** 1. **Call 911.** Good Samaritan laws in most US states protect you from drug-related prosecution. 2. **Administer naloxone.** Nasal spray into one nostril, or inject into outer thigh. Repeat every 2-3 minutes if no response. Fentanyl may require 3+ doses. 3. **Rescue breathe** if the person is not breathing: one breath every 5 seconds. 4. **Recovery position** (on their side) to prevent aspiration. 5. **Stay with them.** Naloxone wears off in 30-90 minutes — they can stop breathing again. **After an Overdose** Overdose is not evidence of recklessness — unpredictable potency means it happens even with cautious dosing. Seek medical evaluation even if you feel recovered. Do not use from the same batch for at least 24 hours. Consider this a critical moment to explore medication-assisted treatment — buprenorphine, methadone, and naltrexone save lives.