Sudden Death 2:
Types of Sudden Death I
When people talk about sudden death with heroin, they usually call it "overdose". The reason this is not a good idea, is that heroin overdose is one of the least common forms of sudden death. This causes many experienced users to be very cocky about sudden death. A young addict once told me, "There's no way I could get enough heroin in a syringe to OD". This was probably true (there are, however, some wrinkles that might upset her logic which we will discuss later). But a very small amount of heroin might kill her for other reasons. This is why I always make a clear distinction between "sudden death" and "overdose".
An overdose is exactly what the two words that make up the word mean: "over dose"--having too high a dose of the drug. The primary effect of heroin is respiratory depression. If too much heroin is ingested, breathing will stop all together and the user will suffocate.
As a user does heroin more and more, his body becomes used to it, and it takes more of the drug to produce the same effect. This is called tolerance. Tolerance is not a function of a drug, however; it is a function of a drug effect. People become tolerant to heroin's euphoria much faster than they do to its respiratory depression. As a result of this, a person may overdose because they have become very tolerant of the euphoria caused by heroin, but not nearly as tolerant to it respiratory depression.
Tolerance is also a function of the user's mental state. In particular, the environment in which heroin is used can have a large effect on a person's tolerance. Because of this, using heroin in an unfamiliar location can cause your tolerance to decrease greatly, and a dose that would normally be no problem for you causes you to OD. This is what happened to me the only time I ever overdosed. I used almost exclusively in a particular room in my house. The day I ODed, I used at the house of a friend who I hadn't seen in a long time. Although I survived, obviously, this overdose resulted in my first felony--there are many reasons you want to avoid sudden death.