Mistaking one narcotic for another, fatal?

Factual Questions
1

Let’s say that I snort cocaine. A lot of cocaine. I love cocaine. Maybe enough that I am looking up drug rehabs for the fun of it. Let’s say I was with my scuzzy drug friends and I saw another guy passed out with a baggie of white stuff on a table. I don’t know the guy, so I steal his baggie and off I go.

I am at home lining up my white powder, anticipating the rush that it will give me. Do a line and then find out that it is not cocaine but something else…

Let’s say the drug on the table is heroin. I (the user) has never done heroin. Heroin is basically the opposite end of cocaine. Would my brain be confused between what it thought it was getting as a reward versus what it receives?

Everyone who has gotten drunk or high did it for the first time and did not have a frame of reference to what it was going to do, or what it was going to feel like. Would taking a dangerous drug thinking it was another kind of dangerous drug be more dangerous than taking a dangerous drug for the first time?

I as a druggie would hate to do crystal meth instead of a “downer” drug and then be up bouncing the walls for 12 hours trying to come down and sleep. Or on the end of the spectrum, do a drug like heroin, oxycotin, or another downer that will “put me away” for several hours when I have to get out and drive the schoolbus.

I am familiar with most drugs and what they do. It is more difficult to inspect, smell and even taste powder drugs like marijuana. Good cocaine will numb the tounge. Does heroin have a scent to it? I hear it tastes (or smells) like bitter almonds.

Lastly, (a little bit off my question), why does Kieth Richards live to be an old man while many people, even movie/musical stars seemingly perish from heroin addiction in their 20’s? Is Richards manageable? Under a doctor’s care? Richards doesn’t have to go to the bad part of town to score, so that leaves off the danger element. But other celebrities could get their shit delivered to and died from it.

2

Just to be nitpicky, cocaine isn’t a narcotic. Neither is crystal meth. “Narcotic” isn’t a synonym for “illegal drug”. Heroin, morphine, codeine, etc. are narcotics.

3

Sounds like Pulp Fiction to me.

If a chronic drug user is opiate-naive, and takes a massive dose of heroin or other opiate, they may well die, as their tolerance won’t be to opiates.

Now, their liver may metabolize the heroin a bit better, for being revved up to metabolize cocaine, but it won’t help much during the acute respiratory arrest.

4

And they’re probably going to scratch their own skin off. Opiate-naive patients often experience terrible itching even at the low doses we start them on. It passes, for some reason I don’t fully understand, but someone who takes a large dose of heroin (a dose as visually large as the cocaine they’ve become accustomed to) is going to wish for a bathtub of calamine lotion.

And then stop breathing.

5

Is snorting heroin, as opposed to injecting or smoking, automatically dangerous/fatal?

6

Any route of ingestion that gets a lot into the bloodstream quickly can be fatal quickly.

But it’s not the route, but rather the amount that is most acutely dangerous. Take too much orally, and one will die (if they don’t vomit it up.)

The nasal route is pretty quick: Nasal mucosa to capillaries to to veins to heart to arteries to brain. At least when taken orally the drug goes through the liver first, for some initial metabolizing. Not so with IV or nasal or intra-thecal dosing.