The Silent Struggle Between Awareness And Altered States

In addiction, the nod refers to the uncontrollable, drowsy state that individuals may experience after using certain drugs, particularly opioids. This behaviour is characterised by the user drifting in and out of consciousness, sometimes even while engaged in conversation or activities. The nod is a classic indication of the sedative effect that drugs have on the central nervous system. Nodding is not limited to any specific drug but it is most commonly associated with opioid use, including prescription painkillers and illicit drugs like heroin.

During the nod, you might notice someone’s eyes closing and their head dropping forward, only to quickly jerk back up as they try to stay awake. This repetitive motion is typical of the nod and is caused by the alternating state of sedation and alertness triggered by the drugs’ effects.

Nodding Out

“Nodding Out,” is a term commonly associated with heroin or opioid use, leading to a state that often results in overdose and death. This state begins with a euphoric rush after heroin enters the brain, followed by a trance-like phase where the user alternates between drowsiness and wakefulness. “Nodding out” is likened to a sleepy student in class whose head nods off as they struggle to stay awake. It’s caused by the sedative effects of heroin and painkillers, leading users into a deep sleep from which they cannot be awakened. This can appear as a blissful state but often leads to falling asleep and not waking up again.

The danger of “nodding out” increases when heroin or painkillers are mixed with substances like alcohol or benzodiazepines. Users may enter a comatose state, leading to an overdose where only the heart and lungs function. This can slow breathing to the point of depriving the brain of oxygen, resulting in death.

Despite efforts to combat the opiate epidemic, heroin and opioid-related overdoses have been rising, becoming the leading cause of unintentional death in Americans. In 2015, the CDC reported a record high in heroin overdose deaths with opioids involved in 82% of all drug overdose fatalities. Treatment centers are witnessing an increasing number of people seeking recovery from heroin and opioid addictions.

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