“Nodding Out” is a common term for a heroin or opioid induced state that causes overdose related deaths more often than any other drug euphoria or high.

When heroin enters the brain, users feel a strong euphoria, or “rush”. However, this is inevitably followed by a period when the person experiences a trans-like state that shifts between being drowsy and wide awake for many hours. It is referred to as “nodding out.”

“Nodding Out” is not a exactly medical term. It can be comparable to a student that is bored in class who is trying keep his head up and stay awake — his head will “nod” and drop as he gets more and more sleepy, and then his head will inevitably jerk awake… Until it doesn’t.

“Nodding out” occurs because heroin and painkillers are opioid sedatives which make a user to go from feeling alert but sleepy into such a deep sleep that he or she cannot be forced to wake up. This may seem like a perfect state of well-being for a heroin user, but it is commonly the first step on the road toward falling asleep and never waking up again.

“Nodding out” is especially dangerous if a user is sedated to the extent where they lose consciousness – Even more so in people who simultaneously mix heroin or painkillers with alcohol or benzodiazepines such as Valium or Xanax. People often helplessly slip into a comatose state, immediately followed by overdose, where only the heart and lungs are left functioning. When breathing becomes slowed to the point that the brain gets deprived of oxygen, it sometimes stops all bodily function, resulting in death.

Despite law enforcement efforts to fight the opiate epidemic, deaths from heroin overdoses reached an all-time high in 2015, according to Centers for Disease Control and Prevention. Heroin and Opioid related overdoses continue to be the leading cause of unintentional death for Americans, rising 17% from 2014 to 2015.

Last year, 77,055 people died from drug overdoses — 1.5times greater than the number killed in car crashes. Opioids are involved in 82% of all drug overdose deaths. Each year, Drug and alcohol addiction treatment centers are seeing a record number attempting to recover from heroin and other opioid related addictions.