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  #1  
Old 01-12-2010, 01:32
kailey_elise Gold member kailey_elise is offline
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Heroin overdose - is it ever too late?

So, last month I lost 2 friends, one to a presumed drug overdose and the other to a known drug overdose.

I heard the story of the known overdose from someone who was actually with him at the time. Apparently, J had been clean for a bit of time, decided to get some heroin (there's also an assumption that benzodiazepines were taken earlier, which would both make the idea of taking heroin after clean time sound like a "good idea" as well as making the heroin more dangerous) and overdosed.

It would seem that the other person who was with J (who says he tried to talk him out of it, since they'd been clean for a while & he was worried about J dying) knew immediately that J was dead and that there was nothing he could do for him. The exact quote was "His lips were blue, his eyes were empty and he smelled like shit." Someone else (?!) stopped by the house, saw that J was out cold, emptied his pockets & said "oh, he'll be fine, he'll snap out of it" as that person walked out the door, even as the other person allegedly tried to assert that he was NOT fine and was, in fact, dead.

The person who was there said his goodbyes and left, calling 911 to report the OD anonymously when he left so that someone would find him. *sigh*

My question is, is there a time where it's just too late? Admittedly, I probably don't have the WHOLE story - the other person could have done heroin with J & nodded out for a few hours himself, finding J dead upon coming to and assuming it must be too late due to the hours that passed - I don't know and will never know. However, this happened in an area that has a Narcan Pilot Program...I guess I want to know, if by the time someone "shits themselves", is it too late? Say that happened right away, within 5-10 minutes; if the person was hit with Narcan, even after apparently being so out of it that they defecated in their pants, could it still work (even though there might be brain damage from a lack of oxygen for more than 4 minutes)?

There are stories of people being underwater & passed out for up to an hour, without oxygen to their brains, who "come back from the dead" sometimes even with minimal to no brain damage.

I realize the potential mixture of benzos complicates matters. But is there a point where you just have to cut your losses, or is it always worth it to try Rescue Breathing & such?

~Kailey

ps. If this isn't a good place for this question, MODS feel free to move it - it seemed like the most appropriate option to me at the time.
  #2  
Old 01-12-2010, 03:34
SlightlyBitter SlightlyBitter is offline
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Re: Heroin overdose - is it ever too late?

........

Last edited by SlightlyBitter; 15-08-2012 at 23:58.
  #3  
Old 01-12-2010, 03:46
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Re: Heroin overdose - is it ever too late?

I would say its never too late to try, however I know how delicate of a situation this can be, as heroin use is illegal and with paramedics comes cops, its sad we actually have to worry about this, saving a life should come first.

the above poster is correct though that naloxone, naltrexone will only work if blood is pumping through the body, It would be my guess (only a guess not medical advice,) that a combination of the antagonist and CPR to get blood pumping, even if its only pumping because you are pumping it, would be the best bet at recessitation.
  #4  
Old 04-12-2010, 22:38
NeuroChi NeuroChi is offline
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Re: Heroin overdose - is it ever too late?

I'd say it's only too late if the paramedic has arrived and pronounced the individual dead. Within reason, of course.

My point is that you may not be able to feel a pulse at all, they may look dead, but the heart may still be beating. Especially during the first onset of effects as time passes more and more of the drug binds available receptors and further depresses the central nervous system - it can still be reversed.
  #5  
Old 04-12-2010, 23:27
C.D.rose C.D.rose is offline
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Re: Heroin overdose - is it ever too late?

Quote:
Originally Posted by kailey_elise View Post
There are stories of people being underwater & passed out for up to an hour, without oxygen to their brains, who "come back from the dead" sometimes even with minimal to no brain damage.
I have no idea about heroin overdoses, chances of survival, etc., but I just wanted to comment on the paragraph I quoted above.

Cases like those, especially when there's no brain damage, are usually (I would actually say always) due to circonstances in which the body temperature (and particularly the "brain temperature") of the individual have been significantly lowered during the time he was cut off from oxygen (such as being underwater in cold water). Colder temperatures slow down the body's metabolism, so the cells use up oxygen at a lower than usual rate, postponing the point at which cells die due to lack of oxygen. Which is why, if I was ever with a person who had respiratory arrest (or cardiac arrest, or a stroke, ...), I would do my best to cool that person's head by whatever means possible. Even if that means taking stuff from the freezer and putting it below or around the person's head. The time until an ambulance arrives would not be enough to induce severe hypothermia that would in itself be a risk, but it's just a matter of minutes until brain cells die when they are cut off of oxygen, so even minimally slowing down metabolism can make a significant difference.

Post Quality Evaluations:
fantastically sensible advice re cooling the head area of a person in resp/cardiac arrest etc - great idea that could make alot of difference. Superb!
Great info, I did not know that.
  #6  
Old 05-12-2010, 03:49
Holly021255 Holly021255 is offline
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Re: Heroin overdose - is it ever too late?

Quote:
Originally Posted by kailey_elise View Post
So, last month I lost 2 friends, one to a presumed drug overdose and the other to a known drug overdose.

I heard the story of the known overdose from someone who was actually with him at the time. Apparently, J had been clean for a bit of time, decided to get some heroin (there's also an assumption that benzodiazepines were taken earlier, which would both make the idea of taking heroin after clean time sound like a "good idea" as well as making the heroin more dangerous) and overdosed.

It would seem that the other person who was with J (who says he tried to talk him out of it, since they'd been clean for a while & he was worried about J dying) knew immediately that J was dead and that there was nothing he could do for him. The exact quote was "His lips were blue, his eyes were empty and he smelled like shit." Someone else (?!) stopped by the house, saw that J was out cold, emptied his pockets & said "oh, he'll be fine, he'll snap out of it" as that person walked out the door, even as the other person allegedly tried to assert that he was NOT fine and was, in fact, dead.

The person who was there said his goodbyes and left, calling 911 to report the OD anonymously when he left so that someone would find him. *sigh*

My question is, is there a time where it's just too late? Admittedly, I probably don't have the WHOLE story - the other person could have done heroin with J & nodded out for a few hours himself, finding J dead upon coming to and assuming it must be too late due to the hours that passed - I don't know and will never know. However, this happened in an area that has a Narcan Pilot Program...I guess I want to know, if by the time someone "shits themselves", is it too late? Say that happened right away, within 5-10 minutes; if the person was hit with Narcan, even after apparently being so out of it that they defecated in their pants, could it still work (even though there might be brain damage from a lack of oxygen for more than 4 minutes)?

There are stories of people being underwater & passed out for up to an hour, without oxygen to their brains, who "come back from the dead" sometimes even with minimal to no brain damage.

I realize the potential mixture of benzos complicates matters. But is there a point where you just have to cut your losses, or is it always worth it to try Rescue Breathing & such?

~Kailey

ps. If this isn't a good place for this question, MODS feel free to move it - it seemed like the most appropriate option to me at the time.
I'm so sorry about the loss of J and your other friend, Kailey. You've probably heard this a million times already, but they were both really lucky to have you as a friend during their lives.

I don't know a whole lot about naloxone/Narcan, and what the exact success rate is, but my city has something similar to a Narcan Pilot Program (the community-run NE that I volunteer at hands out injectable naloxone), and I've seen it used a few times. Also, my friend Miss H has OD'ed and was revived with it.

Personally, I would always encourage someone who suspects an overdose has occured to err on the side of caution when using Narcan, and even if the OD victim seems dead/fine without it, use it if there's any question at all. It seems as though people are reticent to use Narcan in certain situations, and even though the instant withdrawal symptoms are really fucking awful, it's better safe than sorry, and the person will probably thank you later. Also, CPR/rescue breathing are worth trying until paramedics arrive or medical attention can be given to the person.


Narcan seems to have a pretty high success rate, and I've seen people who turned blue be revived instantly, but like SlightlyBitter stated, it only works if you're ODing, not on someone that's been dead. I've heard of Narcan not working, but other methods revived the person (I'm not sure how reliable my source is for this, though, and whether overdose was caused primarily by opiates or by something else), or the individual was already beyond the point of being revived, and died. Also, I'm not sure when a person is clinically dead, but the people I know that have OD'ed on heroin and were given Narcan didn't experience a loss of bowel control prior to being revived, so if this is observed in a suspected heroin overdose, there's a good chance the person is already dead, but naloxone is worth a try anyway. This probably isn't medically accurate, but it seems like heroin overdose usually causes bad constipation, along with dry mouth, very pinned pupils, respiratory depression, etc. (all the signs of heroin use, only on an extreme scale of course), and a loss of bowel control would occur only after death.

Holly021255 added 33 Minutes and 43 Seconds later...

Quote:
Originally Posted by kailey_elise View Post
Admittedly, I probably don't have the WHOLE story - the other person could have done heroin with J & nodded out for a few hours himself, finding J dead upon coming to and assuming it must be too late due to the hours that passed - I don't know and will never know.
Also, there's a pretty good chance that this is what happened. Miss H OD'ed once while she was shooting up with her friend, and another time when she was with two other people that were doing dope and one who wasn't. When she OD'ed the first time, Miss H's friend had nodded out so hard himself that he didn't notice her blue lips and nail beds until she was unconscious, and a good amount of time had already passed. And H was really lucky her clean friend had been with her in the other instance, as the other two were nodding too hard to notice. Similar to J, Miss H had been doing benzos (clonazepam/lorazepam/diazepam) with her friends when she OD'ed. Likewise, Miss H has overdosed on heroin alone a couple of times, and she thinks the combination OD's are a lot worse and have a higher fatality rate. Whenever Miss H OD'ed from a heroin shot and was with others, she would always collapse and lose consciousness within seconds, and she'd barely have time to pull her needle out and say a word or two before she was on the ground, turning blue. With her OD's caused by mixing benzos with dope, it was more like Miss H would slowly fade away, and she'd just kind of curl up alone in the corner without anyone noticing a thing, as they were equally detached (and it was totally the benzos that were responsible). If she was alone when she did either, Miss H would be fucked anyway, but obviously, a dramatic, Casino-esque OD is more likely to be noticed by someone (even a nodding junkie), than an individual who OD's quietly by falling asleep and not waking up, as with benzos or other downers. Also, additional tranquilizers definitely made Miss H less aware of the danger she was in, where with dope alone she'd know instantly if she'd overdosed. Anyone else notice this?

Last edited by Holly021255; 05-12-2010 at 04:46. Reason: Automerged Doublepost
  #7  
Old 05-12-2010, 04:29
phenythylamine phenythylamine is offline
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Re: Heroin overdose - is it ever too late?

Let this serve as a reminder not to mix opiates with other depressants. benzos are remarkably safe alone but very very dangerous when combined with other depressants (including heroin,) as it worsens the resperatory depression.

I personally dont believe it is ever too late to administer opiod antagonists, even if the person has already shit themselves, its at least worth a shot.
  #8  
Old 05-12-2010, 05:04
Titus Titus is offline
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Re: Heroin overdose - is it ever too late?

A little bit off topic, but are narcan shots available without a prescription? How does one acquire one? Are they available via internet from overseas?
  #9  
Old 05-12-2010, 05:18
bcubed Gold member bcubed is offline
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Re: Heroin overdose - is it ever too late?

Where Lizard is from, Narcan (naloxone) is prescription, but can be acquired via needle-exchange programs after a 2-hour instructional course.

In fact, the Rx was a bit of a joke, as the naloxone was given upon completion of the instruction, and the script was retroactively signed by an MD. All of which probably means it's technically illegal, but hey--had the blessing of the county gov't.
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Old 03-01-2011, 02:47
Yid Army Yid Army is offline
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Re: Heroin overdose - is it ever too late?

A few weeks after swim came home from rehab swim had a one bag iv hit administrated by swims g/f. Just befoe she left the house she put her head round the door to say good bye and found swim blue lipped and chocking on his tounge. The paramedics and police arrrived but got no response from swim. No vein could be located so a nasal spray was used a total of 11 times, still no responce so a fast trip to the hospital while a policeman was posted on the taped of door due to their preservation of a scene of death. At the hospital a neck injection was disscussed but refused as after 5 hours i'd shown signs of life, the first thing swim knew about any of this was 10 hours later waking up in a hospital bed asking the nurse why am i here? Swim had been using for 15 years and couldnt believe one little hit could do this to him, i guess swim had built up a I'm bigger than the drug type of attitude. Any heroin user can go over at any time, just be careful !!!
  #11  
Old 12-01-2011, 18:46
Tantalus4200 Tantalus4200 is offline
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Re: Heroin overdose - is it ever too late?

Just recently swim decided to take some xanax, 5 of the 1mgs, swim was withdrawing so he thought it would help and it did a little bit, Later on that night swim copped 3 bags of H, the usual dosage, went to a drug store for points then woke up at a restaurant with the cops knocking on his window, swim luckily got outta of it but the point i think swim is trying to make is, by itself the dope woulda done the same but mixed with the xanax put em over the limit.

Swim takes xanax often and much more then the 5mg, and it was in his system for at least 4 hours, so yes swim does believe that it is never too late.

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