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From:  http://www.pantless.com/~pdxnorml/CU_12_Heroin_OD_Mystery_1972.html
"The Heroin Overdose Mystery And Other Hazards Of Addiction",
Chapter 12 from The Consumers Union Report on Licit & Illicit Drugs,
by Edward M. Brecher and the editors of Consumer Reports,
Little, Brown and Company, Boston, 1972.
Nothing has changed since 1972 - the government, media and medical
profession are still incapable of informing the public about the most
basic factual information.
From:  http://www.druglibrary.org/schaffer/library/studies/cu/cumenu.htm
"The Consumers Union Report on Licit & Illicit Drugs," pp. 101-114,
by Edward M. Brecher and the editors of Consumer Reports
(Little, Brown and Company, Boston, 1972), ISBN 0-316-10717-4,
available for $14.95 plus $1.75 postage from New Morning Books in
Mt. Morris, IL (800) 851-7039. (Stock # HB/44)
Chapter 12.
The "Heroin Overdose" Mystery And Other Hazards Of Addiction
Chapter 4 of this Report reviewed in detail the effects of heroin and
other opiates on addicts, including deleterious physiological effects
traceable to the drugs themselves. Narcotics addicts today face other
physiological hazards that are traceable to the narcotics laws, to the
adulteration, contamination, and exorbitant black-market prices that
those laws foster, and to other legal and social (as distinct from
pharmacological) factors. Dr. Jerome H. Jaffe has described some of
these risks in Goodman and Gilman's textbook (1970): "Undoubtedly,
the high cost and impurities of illicit drugs in the United States
exact their toll. The high incidence of venereal disease reflects the
occupational hazard of the many females who earn their drug money
through prostitution. The average annual death rate among young,
adult heroin addicts is several times higher than that for nonaddicts
of similar age and ethnic backgrounds. . . . The suicide rate among
adult addicts is likewise considerably higher than that of the general
population." [1]
Because "the preferred route of administration is intravenous," Dr.
Jaffe continues, "there is sharing of implements of injection and a
failure to employ hygienic technics, with a resultant high incidence
of endocarditis, and hepatitis, and other infections." [2]
The exorbitant price of black-market heroin, Dr. Jaffe might have
added, is one of the factors that makes intravenous injection "the
preferred route of administration," for "mainlining" is the cheapest
way to forestall withdrawal symptoms. And the laws restricting
possession of injection equipment, under penalty of imprisonment,
increase the risk of needle-borne infections by encouraging the sharing
of implements.
There remains to be considered yet another risk of heroin addiction,
the most publicized hazard of all - death from "heroin overdose."
Because these deaths are a source of such widespread concern, and
also because they are so widely misunderstood, even by authorities on
heroin addiction and by addicts themselves, we shall examine the data
in detail. Much of the discussion that follows is focused on New York
City, since the deaths attributed to heroin overdose are most numerous
there and since the New York City data are published in convenient form.
"Prior to 1943, there were relatively few deaths among addicts from
overdosage." [3]  By the 1950s, however, nearly half of all deaths among
New York City addicts were being attributed to "acute reaction to dosage
or overdosage." [4]  In 1969, about 70 percent of all New York addict
deaths were assigned the "overdose" label [5] - and in 1970, the
proportion was about 80 percent. [6] The number of deaths so designated
by New York City's Office of the Chief Medical Examiner increased from
very few or none at all before 1943 to about 800 in 1969 and 1970. [7]
During this same twenty-eight-year span, addict deaths from all other
causes - infections, violence, suicide, and so on - increased very
little. The enormous increase in number of deaths among addicts shown
in Figure 2 was attributed almost entirely to "overdose" deaths.
The number of deaths throughout the United States attributed to heroin
overdose from 1943 to date must total many thousands. In New York City
it was reported that narcotics, chiefly heroin, were the leading cause
of death in 1969 and 1970 in all males aged fifteen to thirty-five, [8]
including nonaddicts. This can properly be characterized as an epidemic;
the general alarm over these deaths is thoroughly warranted.
There are two relatively simple ways, however, to prevent deaths from
heroin overdose.
*First*, addicts can be warned to take only their usual dose of heroin
rather than risking death by taking too much.
*Second*, even in cases where an addict takes a vastly excessive dose
despite the warning, death usually can be readily prevented, for death
from an overdose of opiates is ordinarily a slow process. "In cases of
fatal poisoning with morphine, the time of death may vary roughly from
one to twelve hours." [9]  The first signs are lethargy and stupor,
followed by prolonged coma. If, after a period of hours, death does
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