Here sits Inigo.
He’s all cooked up and ready to go.
Spike. Flash. Rush…here comes the horsie!!!
Woops. Too much! What’s Inigo feeling? Assuming a lethal OD, how long’s that gonna take?
Off to the ER for a drop & drive (what a swell bunch of friends Inigo has!) The ER nurse reads the note taped to Inigo’s forhead, “Too much smack.”
Ms. Hello Nurse administers the Narco-no-no gravy stripping Inigo’s receptors of the drugs. Heh heh…NOW how does Inigo feel? Relative to feeling nothing but groovy, I’m sure he’s doing poorly, but is it safe to say he’d be feeling much worse than someone who has chosen life and has just said “NO” all along?
And then I assume he’ll have to fight the withdrawal meanies, depending on the intensity of his addiction previous to this episode?
How long will this take? Depends on a lot of things. The dose of H, your weight, any tolerance you may have, etc. And, if you really plan on doing this, having someone sober around with some syringes of nalaxone is HIGHLY recommended.
One: Respiratory depression. The drive to breath goes waaaay down. The individual dies of oxygen starvation.
two: Stupor, vomiting and aspiration. The individual dies of oxygen starvation.
As has been pointed out, the dosage needed depends on size, potency of the opiate, and pre-existing tolerance. And both the respiratory depression and stupor may be reversed in seconds with a shot of IV naloxone. However, if oxygen starvation causes tissue damage, this is less easily reversed.
If the person getting the shot of naloxone is physically dependent on opiates, they may wake up with a mean case of the jones’. If they were just dabbling in opiates, they won’t experience that.
However, withdrawl symptoms are less permanent than death. Note that if someone has no tolerance to opiates, it is very easy for the things Qadgop mentions to happen. In this case having a sober person around, even if they don’t have nalaxone handy and know how to administer it, is a very good idea.
Less permanent, for sure! And not even risky for 99.99% of the addicts. But to many withdrawing opiate addicts who are hooked thru the bag, death will seem eminently preferable. I’d rather have two weeks of influenza than 2 days of hardcore opiate withdrawal. (And I’ve had both, so I can talk!)
So Inigo, a 180 pound male in his late 30s in pretty good health, never did the opiates before. Shoots up with a sufficient dose to induce respiratory depression. What? He’s not breathing and presumably doesn’t care? What’s his state of mind during all this. Any fear or pain? Capacity for fear or pain?
And after he gets his shot of naloxone, what? Back to feeling as spunky as the day befor he shot up? Or is he feeling rather put out what with having his receptors stripped?
For the first part, what likely would happen is the H OD would first result in unconsciousness, and then asphyxiation leading to death. You’d never know what hit you. As for the second part, since you had no tolerance, there would be no nasty withdrawal. Soon you’d be back to normal.
When I had my gallbladder removed, I experienced being revived with naloxone. I had never had morphine before, so did not know that my body was unable to process the morphine. It worked great as a pain killer, but as described, suppressed respiratory ablity.
All I can remember is a strange sensation, not unlike screaming through a tunnel, or having a dream like you are falling, then startling awake. When I opened my eyes, there was a room full of people staring at me. I have since become friends with the nurse on duty, and he said my respirations were 2-4 per minute (I don’t know if this is an exaggeration, so someone else may be able to clarify)—SCARY :eek: . Since I was post-surgical, the down-side was excruciating pain ALL AT ONCE. I don’t remember any other problems other than the surgical pain, though…
Typically, the person getting Narcan is pretty pissed when they wake up. Although, most of my experience is with habitual users in the field. Also, if you get some yahoo medic/doc who pushes a full 2 mg really fast- the patient almost always vomits. Not just normal vomiting, either, projectile vomiting onto the ceiling of the ambulance vomiting…
On the other hand, the one time we used it on a medical, not recreational OD, the patient woke right back up in about 2 minutes and was acting normally.
You know, that used to piss me off back when I worked at the rehab clinic - these pious teetotalers who’d never had so much as a hangover pontificating that opiate withdrawal was “about as bad as a bad case of the flu”. Huh. Well, if you’ve ever had really bad flu, you know that’s a sort of hell, and all the addicts were pretty adamant about how withdrawal didn’t usually kill you, you just wish it did… never added up in my mind. If you’re not the one suffering it’s awful easy to look at the junkie, whose pain you’re not feeling, as say “aw… it’s not so bad… he’s just a whiner”. Nope, to me it always looked like the guy was really suffering.
It’s the mental state that makes opiate withdrawal so difficult. Take the worst case of shakes, chills, myalgias, arthralgias, headaches, nausea, diarrhea, anorexia, and sleeplessness that you can imagine. Then add severe anxiety, depression, hopelessness, guilt, shame, and an alteration of time sense where each minute seems to last for hours. Throw in the knowledge that all you have to do is get a dose of opiates, and all these symptoms will vanish in moments!
doesn’t naloxone wear off quicker than the heroin ?. When we were doing toxicology I’m sure we were told that they had to be carefull because patients might discharge themselves and then drop dead a few hours later.
Yeah, that’s always amusing to see. Back in my residency days, I saw that more than once. An addict would come in stuporous, wake up with IV naloxone, with a real bad craving for more heroin, jump up, and try to leave. Sometimes we delayed them long enough that the naloxone wore off, and they nodded off again. Other times they’d make it as far as the parking lot, and down they’d go!
Users who OD generally drift off into unconsciousness before they are aware of what’s happening to them; they last thing they remember is fixing and waiting for the rush, and suddenly awaken a short time later to a medical emergency and the general confusion associated with one. This is a pretty goddamn scary experience.
I’ve made it no secret that I’ve been in recovery from alcohol and drug addiction for over 14 years now. And legitimate opiate pharmaceuticals pack as much of a punch as heroin. Or so I’m told. I’ve never used heroin.
Thank you for the explanation. I have dabbled with heroin. I will never do so again. I have a problem now with alcohol. It is something I hope I can overcome.
Note that if someone has no tolerance to opiates, it is very easy for the things Qadgop mentions to happen. In this case having a sober person around, even if they don’t have nalaxone handy and know how to administer it, is a very good idea.