"They usually are somnolent, or sleepy, when overdosing," said Dr. Marvin Seppala, Chief Medical Officer at Hazelden, a preeminent treatment center for alcohol and other drug addiction.
"This is something they are used to from regular use of heroin, eliminating the ability to monitor or notice the decrease in respiratory rate. This also undermines any other way for the individual to recognize their own overdose. It is much easier for others to recognize, but, unfortunately, the people surrounding the individual who is overdosing are also using heroin. The fear of being arrested prevents them from calling for help."
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There is a drug that can reverse the effects of heroin, if administered at the right time: naloxone binds to the opiate receptor, knocking off the heroin and preventing the activity of the receptor, Kampman said.
Hoffman, who had been in drug treatment recently, may have been particularly vulnerable to an overdose. If a user has a relapse, they usually return to the level of drug they used before they quit, Knott said. But after detox, the body no longer has any tolerance to a drug. When Hoffman went to rehab last year, he admitted he'd relapsed after not using for 23 years.