Heroin overdose after using cocaine

Source: NSW Health
Drug sold as: Cocaine

Reason for concern: Contains heroin

Warning: One death and two hospitalisations have recently been associated with heroin overdose after use of substances thought to be cocaine across Sydney.

Know the risks

  • Heroin can cause life-threatening overdose, even in a single line of powder.
  • People who have never or rarely used heroin or other opioids are at highest risk of overdose.
  • You are at increased risk of overdose if you:
    • Re-dose when you are not getting the desired effect.
    • Use a high dose.
    • Use with other drugs e.g. alcohol, benzodiazepines, ketamine, GHB, opioids.
    • Use drugs when you are alone.

Effects to look out for

  • Use of heroin may result in pinpoint pupils, drowsiness, loss of consciousness, slow breathing/snoring and skin turning blue/grey.
  • Be on the lookout for unexpected symptoms, such as drowsiness following use of a stimulant (e.g. cocaine).

Getting help

If you or your friends see the warning signs of overdose:

  • Seek help immediately from your nearest emergency department or call Triple Zero (000). You won’t get into trouble for seeking medical care.
  • Start CPR if someone is not breathing.
  • Use naloxone if you have it. Call ‘000’ even if naloxone has been given.

Support and advice

  • Call Alcohol and Drug Information Service (ADIS) on 1800 250 015 at any time 24/7. Start a Web Chat with an ADIS counsellor Mon-Fri, 8.30am-5pm.
  • Call NUAA & DanceWize NSW’s PeerLine on 1800 644 413 (Mon-Fri 9am-5pm) to speak to a peer or visit NUAA for a range of resources on opioids and naloxone.
  • Call the NSW Poisons Information Centre on 13 11 26 for information on adverse effects from drugs.
  • Visit Your Room for fact sheets and other resources.

Take Home Naloxone program

  • If you use cocaine and/or opioids you should carry naloxone. Drugs sold as cocaine have been found to contain opioids.
  • Naloxone is an easy to use, life-saving medicine that can temporarily reverse an opioid overdoses. People at risk of experiencing an opioid overdose or who may witness an overdose can get naloxone for free without a prescription from some NSW community pharmacies, NSW Health needle and syringe programs, opioid treatment services and NUAA.
  • Visit Your Room – Naloxone for participating sites and more information on take-home naloxone.
  • NUAA can mail you naloxone for free in a discreet package. Order via their online shop or call (02) 8354 7343.

Reproduced by permission, NSW Health © 2023