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A Junkie Dies

It is harder to deal with the sudden death of a loved one than a death that gives warning. It may seem odd or even cruel to say that prolonged deaths like those from certain kinds of cancer are a "good" way to die. For the survivor, however, it is true, and there is one very obvious reason why it is so: prolonged deaths allow everyone involved to say all those things that we rarely say on ordinary days--things like, "I love you", "I forgive you", "I'm sorry". In other words, it is possible (even likely) that you will reach some kind of closure in your relationship with the dying loved one.

Unpredictable Death

When a heroin user dies as a result of his use (1), much is left un-said, because there is nothing that can predict the death (other than the obvious fact that one who doesn't use heroin will not die as a result of using it). To make matters worse, surviving loved ones fall into one of two categories, both bad:

  1. They were unaware that their loved one used heroin. This situation inevitably leads to thoughts such as, "I should have been more involved with his life".
  2. They were aware. This situation is even worse with thoughts such as, "I should have done whatever was necessary to get him to stop using--not just wait for this to happen."

Keep Perspective

There is nothing that I, or anyone else, can say that will do much to ease the sorrow of a heroin-related sudden death. The one thing I think I can do is put the death into perspective. Such a death is kind of a combination of a suicide death and an accidental death, even though in all cases it is solely one of the two. Some heroin users choose to end their lives and they use heroin to do it. Based upon my own experience, however, most heroin related sudden deaths are accidents: mis-judging the purity of drugs being used, carelessly combining heroin with other drugs such as alcohol, or any number of other things that can go wrong.

As I have written many, many times, using heroin is a dangerous hobby. I have never met a user who was not aware of that fact--for many, it is part of the thrill of doing the drug. But leaving how dangerous a hobby heroin use is, it is still just that: a hobby. Heroin use is a recreational choice that some people make. You have no control over such choices made by other people.

You Can't Make Decisions for Others

When a person dies for a reason related to his heroin use, you must stop all thoughts that you could have gotten him to stop using. Doing so would have been as effective as trying to stop a hang-gliding enthusiast to "ground" himself. He made his decision, and although the results were tragic, you are not to blame in any way.

Ways to Keep Perspective

Below is a list of things to keep in mind when you are thinking of a deceased heroin user who you cared about.

Those Using Heroin Know What They Are Doing
There are a lot of people who could be blamed for a heroin related sudden death: the dealer, the government, the user's parents. All of this is bunk. The user knew that what he was doing could kill him. He made the choice anyway, because he thought the good things (the way the drug made him feel) out-weighed the bad things (jail, death). When a heroin user dies in this way, it is his fault. This doesn't mean we can't still feel sorry for him. A lot of things conspired against him; he would have led a very different life in the 19th century, for example.
Heroin Use Does Not Imply an Unhappy Life
Contrary to popular belief, heroin users use their drug of choice because it makes them feel good. I've met plenty of junkies who had near-perfect childhoods. They weren't using heroin to rid themselves of painful childhood memories. Doing heroin (at least at first) was fun. No one questions the motivations of people who ride rollercoasters; no one should question the motivations of heroin users.
Heroin Use Has a Positive Impact on Society
Most heroin users are rebellious. We should revoice that our heroin using loved one pushed the limits of our social conventions--in a manner that didn't harm others. They may have also done bad things, but their form of social protest was strong and noble and certainly out-weighed those "wrongs".
Great Joy is Experience by Heroin Users
Most heroin users have experienced the greatest joy of which their bodies were capable. They might also have lived through some difficult times, but before they left this world they got to experience the best life has to offer.
Sudden Death is Painless
Sudden death comes to heroin users in many forms. Some simply drift off into sleep while others foam at the mouth and have seizures. Regardless of how it looks on the outside, the heroin user feels no pain. My one experience with this caused my body to go into grand mal seizures--scaring all those around me terribly. But all I felt was the warm flush of heroin followed by no feeling at all. If I got to choose how I would die, that would be it. (2)

Things to do Before a Death Occurs

If the heroin user you love is still alive, there are a number of things that will make sudden death easier to handle (I would give the same advice to the loved ones of anyone who has a dangerous hobby.)

Be honest
Don't let important things go un-stated, because there may not be a tomorrow to do so. This is similar to some of the advice I gave in Encouraging Junkies to "Clean Up", but it is even more important here. If you want, think of your heroin-using loved one as having cancer which may cause him to die any day.
Keep the danger in perspective
Heroin use is not as dangerous as driving a taxicab for a living.
Remind him of tolerance
Many heroin related sudden deaths are the result of brief withdrawal periods (usually due to a day or two in jail) followed by the user doing his usual amount which is now much too high a dose for him. Remind him of the tolerance problem.
Remind him of drug mixing
The easiest way to kill yourself with heroin is to get really drunk and then do a moderate amount of heroin. (3) There are many bad drug combinations, but heroin and alcohol are the most common and the most deadly.
Don't isolate him
In most cases, a heroin user's death could have been prevented if someone had been around to call for help when the event took place. The less you isolate a heroin user, the less likely he will be to use alone.

Relationships with Heroin Users

It is hard to be the loved one of a heroin user in today's political climate. Nowhere is this seen so clearly as when a heroin user dies suddenly. If you know that a loved one is a heroin user, remember that he has a greater risk of death than other people in your life. Use this information: keep your relationship up to date; say the things there may not be time to say later.

If the loved one is already gone, keep the loss in perspective. Hopefully, you were on good and open terms with him. If not, you have information to use in your next relationship with a heroin user.


Notes

1 You will note that I do not use the term "overdose". This is because the term is misused; and it is almost never the case that a heroin user dies of an overdose (defined here as simply using too much heroin in too short a period of time). In almost all cases, the true cause was the mixing of heroin with some other drug (either deliberately, as when a user does a speedball--a combination of heroin and cocaine, or accidentally, as when the heroin itself is cut with some drug such as quinine). "Overdose" is a convenient shorthand for "heroin related death", but it gives users and non-users alike, the wrong idea. The misuse of the term "overdose" perpetuates ignorance of the danger of mixing heroin and alcohol, for example. This is responsible for the deaths of untold numbers of heroin users each year.

2 Clearly, I didn't stay dead. Paramedics were called who injected me with narcan. But I was, by the common (but not technical) definition, dead: my heart had stopped beating and I was not breathing. What I was experiencing was not actually a heroin overdose. At that time and place, much of what was being sold as heroin was really morphine. Large doses of morphine can cause histamine reactions which in turn, can cause seizures and death. This is another case of a drug's illegality making an accidental death far more likely. No pharmacist would given morphine to a person asking for heroin. Morphine (and much more so) codeine are more toxic than heroin

3 Note how the media almost always attributes such deaths heroin overdose. The fact that the deceased had near toxic levels of alcohol in his blood is rarely mentioned and never blamed.

by Dr. H © 2002
Last Modified: 8 January 2004


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