What Does Nodding Out From Heroin Mean?

Nodding out sounds a lot like dozing off. But when heroin is involved, nodding can be a sign of a serious problem. It can also be a precursor to a variety of life-threating effects.

What is Nodding Out?

Nodding out is sometimes also called nodding off, having the nods, or being on the nod. Regardless of which term you use, nodding out refers to a state of being barely awake and deeply drowsy after using heroin or another opioid.

The term “nodding” alludes to how a person’s head will begin to droop as they start to slip into unconsciousness, then pop back up as they suddenly awaken. As this is repeated, it can look like the person is nodding their head. 

If you have ever been subjected to a boring lecture in a warm classroom right after lunch, you are likely familiar with what the nods look like. However, unlike this relatively harmless example, nodding out on heroin can be extremely dangerous and possibly fatal.

The Dangers of Nodding Off on Heroin

Nodding out is not simply falling asleep. Someone who is on the nod may be at risk of considerable harm. For example:

• If their breathing is too slow or shallow, the diminished flow of oxygen could lead to two life-threatening conditions, hypoxia (insufficient oxygen levels in tissues) and hypoxemia (dangerously low oxygen in the blood). These conditions can cause substantial harm, including irreversible damage to the brain and other organs.
• Diminished awareness and impaired motor skills can put them in danger of unintentional physical injuries due to slips, falls, or even burns (particularly if they have been smoking).  They will also be unable to defend themselves if assaulted or attacked.
• Individuals who frequently nod off on heroin may also be at elevated risk of anxiety, depression, and other mental health concerns. Their heroin abuse may worsen their mental health, which in turn could push them to use the drug more frequently, leading to a potentially devastating downward spiral.

The greatest danger of nodding off on heroin is that it can be a sign of overdose, which could be fatal:

• According to the National Institute on Drug Abuse (NIDA), heroin was a factor in 5,871 overdose deaths in the United States in 2022. 
• The good news about this statistic is that it marks the sixth consecutive year of declining heroin-involved overdose deaths following the peak year of 2016, when the drug contributed to 15,469 fatalities. 
• The bad news is that it still represents an average of 16 deaths every single day.

What To Do When Someone Gets the Nods

If you are with someone who has nodded out after using heroin, it is vital to be able to recognize the warning signs of overdose:

• Extreme drowsiness (nodding off)
• Constricted (pinpoint) pupils
• Profound confusion or disorientation
• Diminished ability to respond
• Slow, shallow, or labored (difficult) breathing
• Gurgling or choking sounds
• Faint heartbeat or pulse
• Loss of consciousness
• Inability to be awakened
• Cool, clammy skin
• Bluish or purplish coloration near their lips and/or fingertips

If someone with the nods has overdosed, they are at risk of death if they don’t get immediate medical assistance. Here’s how you can help:

• Call 911. Before you do anything else, summon an emergency first responder.
• If you have naloxone (Narcan), administer it as soon as you have called 911. When given in a timely manner, naloxone can reverse the effects of an opioid overdose. However, even if a person is revived with naloxone, they still need to be seen by a medical professional.
• If the person is conscious, have them sit in a comfortable chair. If they cannot be awakened, position them so they are lying on their side. This can prevent them from choking if they vomit while still unconscious.
• Place a pillow under their head and a blanket or jacket over them to keep them warm.
• Stay with them until the emergency responders arrive.
• While you are waiting, do not try to revive the person by putting them into a bath or shower, slapping them, or taking any other actions. Just stay with them, monitor their breathing, and wait for help.
• When the emergency responders arrive, tell them as much as you know about how much heroin the person used. You will also want to tell them if they also used any other drugs and what symptoms they displayed.

The best way to avoid overdose and the other dangers of nodding off is to not use heroin. If you have become addicted to heroin, this can be extremely difficult to accomplish on your own. But when you get effective professional heroin addiction treatment, you can end your heroin use and build a foundation for a healthier and more hopeful future in recovery.

Contact Phoenix Rising Recovery to Help Someone Overcome Heroin Addiction

Phoenix Rising Recovery offers customized programming for adults who have become dependent on heroin, other opioids, or other addictive drugs. We also offer dual diagnosis programming for patients who have also been living with co-occurring mental health concerns.

Your treatment options at our rehab center in Palm Springs, California, include detoxification, residential care, a partial hospitalization program (PHP), an intensive outpatient program (IOP), and an outpatient program. In each of these programs, you can expect to receive personalized services and compassionate support from a team of highly skilled professionals.

To learn more or to schedule a free assessment, please visit our Contact page or call us today.