In the 1960s, New York City Medical Examiners Drs. Milton Helpern and Michael Baden studied heroin addict deaths. Heroin found near dead addicts was not unusually pure and their body tissues did not show especially high concentrations of the drug. Although the addicts typically shot up in groups, only one addict at a time died. Furthermore, the dead addicts were experienced rather than novice users and therefore should have built up tolerance to large doses of heroin.
The best guess as to what was killing these addicts (aside from general infection, illness, and malnutrition) were the impurities in the drug, such as quinine, which produced adverse reactions in some injectors. A related likelihood which is more evident today is the mixture of drugs, or of drugs and alcohol.
Street lore among heroin addicts typically eschewed drinking alcohol with heroin as a potentially deadly combination. Today, drug cocktails as well as drinking while shooting up are common. The majority of drug deaths in an Australian study, conducted by the National Alcohol and Drug Research Centre, involved heroin in combination with either alcohol (40 percent) or tranquilizers (30 percent).
If it is not pure drugs that kill, but impure drugs and the mixture of drugs, then the myth of the heroin overdose can be dangerous. If users had a guaranteed pure supply of heroin which they relied on, there would be little more likelihood of toxic doses than occur with narcotics administered in a hospital.
