Did you ever stop to notice that a lot of celebrities’ so-called drug-overdose deaths occurred in a hotel room or someplace other than their own home? And did you ever wonder why that is?
First, let me just say that I mention celebrities because, well, there have been many who have struggled with drug addiction and died due to their disease. It’s just easier to look to these cases when discussing this topic because their struggles and deaths were made (very) public.
Now, we’re not talking some kind of conspiracy theory stuff, here. There’s actually science behind this idea: that a drug user’s physical environment at the time of their drug use can influence whether they overdose and die.
When we look at the idea of tolerance and consider that there might be more to it than physical tolerance; there is also psychological tolerance, if you will, for lack of a better term. Think of this idea in terms of the placebo effect of a medication – a perceived or actual improvement or result.
Can all of these heroin overdoses chalked up to simply taking too much?
When we hear of an addict or otherwise long-term drug user fatally overdosing, especially from heroin, the general consensus is that they even though they have a certain level of tolerance to the drug, they eventually take more than their body can handle. But there are some holes in this theory. Again, in this scenario, the overdose victim is a long-term user (not just a “novice”) and so it can be assumed that they would have an extensive history with heroin, which would have resulted in developing quite a significant tolerance to the drug, and (looking specifically at heroin) this means that the user would need high levels of the drug to induce a fatal respiratory depression. Even 30 years ago, the problems with the standard overdose story were concisely summarized by the author Brecher (source below), who said:
1.the deaths cannot be due to overdose,
2. there has never been any evidence that they are due to overdose,
3. there has long been a plethora of evidence demonstrating they are not due to overdose.
Tolerance and Environment
Tolerance is usually defined as the decreasing effects of a drug through repeated administrations.
For chronic drug users, such as addicts, tolerance is not only a product of the drug, itself, and its effects on the body but, it is also partly a function of their surroundings: the “context cues” that they associate with the drug use through ritual or habit. Simply put, if a heroin addict only injects heroin in the same environment, (such as their bedroom), then the cues associated with their bedroom will take on the ability to cause a biological response that prepares the addict’s body for the drug, therefore producing the level of tolerance.
The overdose problem occurs when the heroin addict does heroin somewhere else, a new environment, like in a park or at a friend’s house. Now, the additional context cues that would normally produce the tolerance response, the addict unknowingly “overdoses” even by doing the same amount of heroin as they normally do.
The tolerance that they developed over the years has suddenly disappeared and therefore taking the same amount of the drug that they are used to will now be too much.
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Brecher, E. M., (1972). Licit and Illicit Drugs. Boston: Little, Brown.