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How Many People Die From Heroin? Dangers & Risks

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Aug 21, 2023 • 10 cited sources

Heroin overdose deaths have been up and down over the past few years. Impacted by the availability of other opioid substances, heroin overdose deaths have continued to be high even in years when they experienced a small decline.

For example, in 2020, overdose deaths caused by heroin dropped 7% when compared to 2019, but 13,000 people still fell victim to the drug. This number, though lower than 2019, was still seven times higher than it was in 1999. It is estimated that about one-fifth of all overdose deaths that occur involve the use of heroin. [1]

The risks of heroin alone are bad enough. The drug can slow down and even stop the central nervous system, causing breathing to stop. But today’s heroin is mixed with even more potent substances like fentanyl, an opioid that is 50 times stronger than heroin, to make it stronger and cut costs.[2] This makes it even more deadly for long-time users as well as those who experiment with the drug, since it’s impossible to know exactly how potent any given batch will be. 

There are medications that can be effective in helping people to stop taking heroin while managing the accompanying withdrawal symptoms. Contact Bicycle Health today to learn more about your options. 

How & Why Is Heroin So Deadly? 

Heroin is a highly addictive opioid drug derived from morphine, which is a natural substance extracted from the seed pod of the opium poppy plant. Easily available on the street, heroin is known as a deadly substance due to the following characteristics:

  • High risk of overdose: Heroin use can lead to overdose, which can be fatal if not treated in time. It can happen to new users as well as those who are “used to” the drug.

    An overdose occurs when someone takes too much heroin, resulting in respiratory depression (slowed or stopped breathing), which reduces oxygen supply to the brain and can cause stroke or brain death.
  • High rate of addiction: Heroin is highly addictive and can cause physical and/or psychological dependence with just a few uses of the drug. With regular use, it’s normal to  develop a physical tolerance to heroin, which means they need to take increasingly higher doses in order to achieve the same effects.

    This phenomenon can lead to opioid use disorder (OUD), which is characterized by physical and mental symptoms, including compulsive drug-seeking and use despite negative consequences.[3]
  • Associated health risks: Heroin use can lead to several health problems, many of which are life-threatening. These include infectious diseases like HIV and hepatitis C, collapsed veins, and infections in the heart lining and valves. In addition, heroin users are at higher risk of developing respiratory illnesses, liver disease, and other serious health problems.
  • Unknown additives: Street heroin is almost always cut with other substances. In some cases, they are benign like baking soda or talcum powder, but in many cases, the additives are even more deadly than the heroin, such as in the case of fentanyl.

    Many dealers will cut their batch of heroin with fentanyl specifically because it is so potent in the hopes of attracting more buyers. But they don’t know what the batch has been cut with before it got to them, so they may inadvertently add far too much, making it immediately deadly to users. 
  • Easy access: Heroin is available on the street. While it may seem like it should be harder to find a substance that is illegal, it is actually easier and less expensive to buy heroin than it is to get prescription painkillers, which are legal for medical use. 
  • Risky behavior: Heroin use can lead to unsafe behaviors that put the person at risk. These can include behaviors like sharing needles, which can increase the risk of infectious diseases and other health problems; having unprotected sex; driving; and being unaware of their surroundings, which can put them in harm’s way while under the influence. 

How Does Heroin Cause Death? 

Heroin can cause death in many ways, but the most common cause of death due to heroin use is overdose. 

An overdose occurs when an individual takes a high dose of heroin, which overwhelms the body’s ability to metabolize the drug. This can result in respiratory depression, which is the slowing or stopping of breathing.[4] When breathing slows down or stops completely, the body does not receive enough oxygen, leading to hypoxia (oxygen deprivation). This damages vital organs like the brain, heart, and lungs.

Heroin works by binding to opioid receptors in the brain and activating the brain’s reward system, causing a rush of “feel-good” chemicals and a decrease in pain. However, when taken in large amounts, heroin can cause the body’s respiratory centers to become depressed, leading to slowed breathing or respiratory arrest, which can be deadly. 

Additionally, the risk of overdose is higher when heroin is mixed with other substances, such as alcohol or benzodiazepines, or when the heroin itself is mixed with other drugs like fentanyl. Since this often occurs without the user’s knowledge, it can be incredibly difficult to know the dose that will not lead to life-threatening overdose.

In addition to overdose, heroin can cause death in other ways over time. For example, infections, collapsed veins, and damage to vital organs like the heart and lungs can occur with ongoing use that can lead to deadly disorders or breakdown of the body. 

Heroin Use & Overdose Statistics 

  • Though some people have died due to a heroin overdose as new users of the drug, most of the time, deaths occur among long-time heroin users. The causative factor may not be the dose of heroin in long-time user overdose deaths, but the dose of heroin on top of the long-term damage caused by ongoing heroin use. 

Which Populations of People Are More at Risk of Dying From Heroin? 

Heroin use and overdose can affect anyone of any age, culture, gender, or class who uses the drug, whether they are using it only occasionally or using it multiple times per day. However, there are some populations that are at higher risk of dying from heroin use, if for no other reason than their population has high rates of using heroin. For example, non-Hispanic white men between the age of 18 and 25 year old making less than $20,000 per year and living in the northeast U.S. are more at risk.[9] 

Other populations that are more at risk include the following:

  • Men: Men are more likely to use heroin and have higher rates of overdose death than women, though the gap between the number of women who use heroin and men who use the drug has decreased over the years. 
  • People who have experienced overdoses in the past: People who have experienced non-lethal overdose in the past are more likely to experience a deadly heroin overdose. Their past experience may make them feel like the threat of overdose isn’t that severe.
  • Long-time users of heroin: People who have been using heroin for decades and exposing their body to the ongoing wear and tear may be more likely to die due to heroin overdose than new users. 
  • Poly-drug users: People who use heroin in combination with other drugs, such as alcohol or benzodiazepines, are at a higher risk of overdose and death.
  • People living with mental health disorders: People who use heroin to manage symptoms related to mental health symptoms, such as depression and anxiety, may be more likely to misuse the drug and overdose.
  • People who relapse after a period of abstinence: When long-time users stop using heroin for a period of time either due to lack of access, incarceration, or attempting to quit using the drug entirely and then go back to heroin use, they may not realize that their tolerance levels have dropped and take too much of the drug and inadvertently overdose. 

It’s important to note that while these populations may be at higher risk of heroin overdose, anyone who uses the drug could potentially die due to overdose.

What Factors Impact Heroin Overdose Death Rates?

Heroin overdose death rates are influenced by a variety of factors, including individual characteristics, environmental issues, and mental health as well as whether or not someone is on standby with the right medication to help the person survive should the worst occur. 

Some of the key factors related to heroin overdose death rates include the following:

  • Age: People tend to be younger when they use drugs, therefore rates of overdose are higher among young people. 
  • Sex: More men use heroin than women, thus men are more likely to die due to heroin overdose. 
  • History of OUD: Long-term opioid use disorder contributes to wear and tear in the body, which in turn makes it more susceptible to overdose. 
  • Poly-drug use: Using multiple drugs in combination with heroin can cause a synergistic effect, meaning that the impact on the body is far greater than simply adding the effects together.
  • Route of administration: Injecting the drug can come with deadly risks outside of overdose when compared to snorting and smoking the drug. 
  • Quality and purity of heroin: Most heroin is cut with substances that are deadly in and of themselves, so when combined with heroin, the result is deadly. 
  • Geographic location: Heroin use is more common in urban centers, the Northeast, and the Northwest though it can be found in every part of the country.
  • Socioeconomic factors: Heroin users are more likely to have an income that is below the poverty line.
  • Policy and law: There are laws that can make being high or possessing heroin a crime, which means that calling for help when concerned about someone else’s well-being or their own doesn’t feel like an option. While Good Samaritan laws protect people who get help for someone who is overdosing, many heroin users and bystanders aren’t aware of these laws. 

It should be noted that many people who struggle with heroin use and OUD do not fit the mold of what people think a heroin user should look like or act like based on TV and movies. One does not need to fit this description in order to have an OUD related to heroin and be at risk of overdose. 

Avoid Heroin Overdose: Connect With Treatment Now 

Heroin is an opioid, which means that it works by binding to opioid receptors in the brain. When the body becomes accustomed to a certain level of opioids in the body, it responds with significant withdrawal symptoms when those levels drop.

Opioid withdrawal symptoms are often a huge deterrent when it comes to getting and staying in treatment for OUD related to heroin use. The good news is that there are medications that can bind to the opioid receptors in the place of heroin and mimic its effect in the body, staving off withdrawal symptoms, and making the detox process much more comfortable.

At Bicycle Health, we can connect you with these medications and help you to get the treatment you or your loved one needs to stop using heroin and block the risk of overdose. Call now to find out more about the different medications available and discuss the right path forward for your needs. Don’t wait to get started. The right treatment can save your life.

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

  1. Heroin Overdose Data. Centers for Disease Control and Prevention. 2021. Accessed March 2023.
  2. Fentanyl Facts. Centers for Disease Control and Prevention. February 2022. Accessed March 2023.
  3. What Are the Medical Complications of Chronic Heroin Use? National Institute on Drug Abuse. June 2018. Accessed March 2023.
  4. Understanding Heroin Overdose: A Study of the Acute Respiratory Depressant Effects of Injected Pharmaceutical Heroin. PLOS ONE. October 2015. Accessed March 2023.
  5. Heroin: Fast Facts. National Drug Intelligence Center. Accessed March 2023.
  6. Heroin. Centers for Disease Control and Prevention. May 2022. Accessed March 2023.
  7. Infective Endocarditis in Persons Who Use Drugs: Epidemiology, Current Management, and Emerging Treatments. Infectious Disease Clinics of North America September 2021. Accessed March 2023.
  8. Heroin-related deaths in New South Wales, 1992: toxicological findings and circumstances. Medical Journal of Australia February 1996. Accessed March 2023.
  9. Vital Signs: Demographic and Substance Use Trends Among Heroin Users — United States, 2002–2013. Centers for Disease Control and Prevention. July 2015. Accessed March 2023.
  10. Addressing the Stigma That Surrounds Addiction. National Institute on Drug Abuse. April 2020. Accessed March 2023.

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