Heroin Overdose: Signs, Symptoms, and Treatment

Heroin is an illicit opioid that is highly addictive and has a high risk of overdose.1 While heroin use contributed to a surge in overdose deaths across the country during the second phase of the opioid epidemic, it has declined in recent years.2

Despite this decline, heroin addiction is still a serious issue that results in a large number of overdose deaths. In 2023, there were 79,358 opioid-related overdose deaths, with nearly 4,000 involving heroin.3 Read on to learn more about heroin overdose signs and symptoms, and how to get started on your recovery journey at our Kansas City drug rehab center.

What Is a Heroin Overdose?

A heroin overdose can happen when someone takes more of the drug than their body can handle.4 Opioids, like heroin, affect the areas in the brain that control breathing.4 When someone takes too high a dose of heroin, it can slow breathing to potentially fatal levels.4 This can result in coma or possibly death.1

Signs & Symptoms of a Heroin Overdose

There are several distinctive heroin overdose symptoms and signs. Recognizing them quickly can be lifesaving. Some of these include:

• Difficulty breathing4
• Slow or shallow breathing1
• Unresponsiveness or the inability to wake up4
• Small, constricted pupils4
• Discolored or purplish skin, particularly the lips or fingernails1
• Cold, clammy skin1
• Convulsions1
• Coma1

How to Help Someone Overdosing on Heroin

A heroin overdose is a medical emergency that should be addressed immediately.5 Heroin overdose effects can quickly become life-threatening without prompt intervention.5 If you witness someone experiencing a heroin overdose, you should4:

• Call 911 immediately.
• Administer Narcan (naloxone) if available.
• Try to keep the person awake and breathing.
• Stay with the person until first responders arrive.

Narcan (Naloxone) for Opioid Overdoses

Narcan (naloxone) is a lifesaving medication. It can reverse the effects of an opioid overdose before it’s too late. Within two to three minutes, Narcan can help restore breathing to normal rates in someone whose breathing has slowed or stopped due to a heroin overdose.6

Narcan is available over-the-counter in all 50 states.6 It comes as a prefilled nasal spray, as well as in injectable forms.6 Narcan is generally effective for about 30-90 minutes after administration.7 Here’s how to administer Narcan nasal spray8:

1. Check if you suspect an overdose (i.e., shake the person gently, try to wake them up)
2. Hold the nasal spray device with your thumb on the bottom of the plunger.
3. Insert the nozzle into either nostril.
4. Press the plunger firmly to give the 1st dose (one spray equals one dose).
5. Wait two to three minutes to see if the person wakes up.
6. Continue administering doses every two to three minutes if the person doesn’t respond.
7. Stay with the person until medical assistance arrives and give another dose if the person becomes sleepy again.

Heroin Overdose Causes and Risk Factors

There are many ways heroin overdoses can occur, beyond taking too much of the drug on its own.9 Mixing heroin with respiratory depressants, like benzodiazepines or alcohol, is a significant risk factor.9 Because both substances can suppress breathing and cause sedation, using them together can result in extreme drowsiness and respiratory depression and increase the risk of overdose death.¹⁰

Here are some other heroin overdose risks9:

• Changes in tolerance after stopping or reducing use
• Unpredictable drug contents
• Mixing heroin with stimulants, such as methamphetamine or cocaine.
• Having a history of past overdoses
• Having chronic health conditions, such as lung disease, heart disease, Hepatitis C, or HIV

Risk of Fentanyl Laced Heroin

Since heroin is an illicit drug, its purity and contents are generally unpredictable.1 A growing trend of lacing heroin with fentanyl has become increasingly common in the illegal drug market.1 Fentanyl is a highly potent synthetic opioid that is 50 times more potent than heroin.11 Because it’s so powerful, mixing it with heroin or any other drug greatly raises the risk of overdose.4

Fentanyl-laced heroin has been responsible for several overdoses in the current opioid epidemic.3 In 2022, the rate of heroin overdose deaths involving fentanyl increased to 80% and remained stable through 2023.3 While recent findings show a general decrease in fentanyl-related overdose deaths, they remain high.12

How to Prevent a Heroin Overdose

Taking harm reduction steps can reduce the chances of experiencing a heroin overdose. Harm reduction focuses on reducing the harmful effects of substance use by providing stigma-free, person-centered services.13

Some common harm reduction strategies include fentanyl testing services, naloxone distribution, and safer drug use education. By creating a space where people who use drugs can access judgment-free assistance, harm reduction programs lessen the risks of adverse effects, including heroin overdose dangers.13

The following steps can prevent overdose and reduce potentially life-threatening effects9:

• Always carry Narcan.
• If possible, use it when someone else is present.
• Test drugs for fentanyl and other contaminants.
• Start with low doses and pace yourself.
• Avoid mixing heroin with other substances, such as benzos, alcohol, and cocaine.

Heroin Addiction Treatment in Kansas City

Overcoming heroin addiction can be challenging, but help is available at Empowered Recovery Kansas City. We offer several levels of addiction treatment to meet your unique needs. You can access medical detox, partial hospitalization programs (PHPs), intensive outpatient treatment, and standard outpatient care. We provide a personalized approach that prioritizes your recovery goals.

Our admissions team can answer any questions you may have about starting rehab in Kansas City. From finding the best program for you to rehab insurance coverage, we provide ongoing guidance to simplify the process. Even if you don’t have insurance, we can help you explore other ways to cover the cost of rehab, such as private payment.

If you or a loved one is struggling with addiction, seeking treatment can open the doors to a brighter, healthier future. Contact Empowered Recovery Kansas City to verify your insurance coverage and get started on your journey.

References

1. U.S. Drug Enforcement Administration. (2024). Heroin. Retrieved on January 8, 2026, fromhttps://www.dea.gov/sites/default/files/2025-01/Heroin-Drug-Fact-Sheet.pdf
2. U.S. Centers for Disease Control. (2025). Understanding the Opioid Overdose Epidemic. Retrieved on January 8, 2026, fromhttps://www.cdc.gov/overdose-prevention/about/understanding-the-opioid-overdose-epidemic.html
3. National Institute on Drug Abuse. (2024). Drug Overdose Deaths: Facts and Figures. Retrieved on January 8, 2026, from https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates#Fig3
4. National Institute on Drug Abuse. (2024). Opioids. Retrieved on January 8, 2026, from https://nida.nih.gov/research-topics/opioids#overdose-crisis
5. Substance Abuse and Mental Health Services Administration. (2025). Opioid Overdose Prevention and Reversal. Retrieved on January 8, 2026, from https://www.samhsa.gov/substance-use/treatment/overdose-prevention
6. U.S. Centers for Disease Control. (2025). Lifesaving Naloxone. Retrieved on January 8, 2026, from https://www.cdc.gov/stop-overdose/caring/naloxone.html
7. National Institute on Drug Abuse. (2022). Naloxone DrugFacts. Retrieved on January 8, 2026, from https://nida.nih.gov/publications/drugfacts/naloxone
8. Narcan.com. (n.d.). FAQs. Retrieved on January 8, 2026, from https://narcan.com/en/frequently-asked-questions
9. Commonwealth of Massachusetts. (n.d). Opioid Overdose Risk Factors. Retrieved on January 8, 2026, from https://www.mass.gov/info-details/opioid-overdose-risk-factors
10. National Institute on Drug Abuse. (2022). Benzodiazepines and Opioids. Retrieved on January 8, 2026, from https://nida.nih.gov/research-topics/opioids/benzodiazepines-opioids
11. U.S. Drug Enforcement Administration. (2024). Fentanyl. Retrieved on January 8, 2026, fromhttps://www.dea.gov/sites/default/files/2025-01/Fentanyl-Drug-Fact-Sheet.pdf
12. Tanz, L., Stewart, A., Gladden, M., Ko, K., et al. (2024). Detection of Illegally Manufactured Fentanyls and Carfentanil in Drug Overdose Deaths — United States, 2021–2024. Retrieved on January 8, 2026, fromhttps://www.cdc.gov/mmwr/volumes/73/wr/pdfs/mm7348a2-H.pdf
13. U.S. Centers for Disease Control. (2025). OD2A Case Study: Harm Reduction. Retrieved on January 8, 2026, from https://www.cdc.gov/overdose-prevention/php/od2a/harm-reduction.html