Explain the lethality of heroin abuse.

Question

What will be an ideal response?

Answer 1

From a long-term perspective with regard to one's physical health, heroin is considered relatively nontoxic, particularly when compared to several other drugs of abuse. As one expert has put it: Unlike alcohol, the amphetamines, and the barbiturates, which are toxic to the body over the long run with relatively heavy use, the narcotics are relatively safe. The organs are not damaged, destroyed, or even threatened by even a lifetime of narcotic addiction. There are no major malformations of the body, no tissue damage, no physical deterioration directly traceable to the use of any narcotic, including heroin.
Smoked heroin has been linked to leukoencephalopathy, an incurable neurological disease in which a progressive loss of muscle coordination can lead to paralysis and death, as well as kidney degeneration.
The practice of heroin abuse is highly dangerous and potentially lethal. The reasons have to do with situations resulting from the acute effects of the drug. Heroin has a relatively small ratio of LD (lethal dose) to ED (effective dose). Increase a dose that produces a high in a heroin abuser by ten or fifteen times and you will be in the dosage range that is potentially fatal. 
As a result, death by overdose is an ever-present risk. If we take into account the virtually unknown potency of street heroin in any given fix, we can appreciate the hazards of a drug overdose. The "bag" sold to a heroin abuser may look like the same amount each time, but the actual heroin content could be anywhere from none at all to 90 percent. Therefore, it is basic to underestimate the amount of heroin being taken in. The user risks possible adverse effects from any toxic substance that has been "cut" with the heroin. 
Deaths from heroin overdose are frequently consequences of synergistic combinations of heroin with other abused drugs such as stimulants like cocaine or depressants like alcohol, Valium, or barbiturates. In some cases, individuals have smoked crack as their primary drug of abuse and snorted heroin to ease the agitation associated with crack. In other cases, lines of cocaine and heroin are alternately inhaled in a single session, a practice referred to as "criss-crossing." 
Some heroin abusers develop unstable levels of tolerance that are tied to the environmental setting in which the heroin is administered. As a result of conditioned tolerance, a heroin dose experienced in an environment that has not been previously associated with drug taking may have a significantly greater effect on the abuser than the same dose taken in more familiar surroundings.
The specific effect on the abuser is highly unpredictable. Although the overriding danger of excessive amounts of heroin is the potentially lethal effects of respiratory depression, abusers can die from other physiological reactions. In some instances, death can come so quickly that the victims are found with a needle still in their veins; such deaths are usually due to a massive release of histamine or to an allergic reaction to some filler in the heroin to which the abuser was hypersensitive. Intravenous injections of heroin increase the risks of hepatitis or HIV infections, and unsterile water used in the mixing of heroin for these injections can be contaminated with bacteria.
Beginning around 2013, the synthetic opioid, fentanyl, approximately 50 times more potent than heroin, was being reported by drug-control authorities in dramatically increasing numbers of confiscations, either mixed with heroin or sold as heroin. The potency of fentanyl was so much greater than heroin that a mere two-milligram dose of fentanyl would now be potentially lethal to humans. This has been one of the primary contributors to opioid overdoses.