The group arrived at the house and were let in by a man who had anticipated their arrival. Perhaps he was the one who had phoned emergency notifying a death by overdose, a heroin overdose, as I was to learn from street talk the following morning.

Two hours later the ambulance officer and the police departed; so did a body. There was no fuss, no sirens, no flashing lights. Almost immediately, though, a sweating Sydney night heard the chilling cries of people squared up by sudden loss.

Death by heroin overdose is not common. About 400 such deaths will occur in Australia this year. About 150 will be in Sydney, mostly in the south west and in south Sydney, the places where heroin injection is most common.

Like my neighbour, the person who dies will more than likely be a young man, about 30 years old. He will suffer depression. He may have recently tried to quit or he will have been greedy, or needy, and gone for a bigger hit. Or he will have mixed his hit with other drugs and booze.

Critically he will have been on his own, in his room or alone in his house. No one will have noticed the slowness of his breathing, his lapse into unconsciousness, a quiet gurgling, his lips and fingernails turning blue, his skin going cold and clammy. For if these are observed and an ambulance called promptly then he will probably survive. The injection of the drug Narcan saves a victim of overdose nearly all the time.

The numbers of deaths by heroin overdose have been halved in the last decade. It’s a public health success story unmatched in any other category of death. Yet any young life lost is deeply sad, a waste, an emptiness ‘permanent, blank and true.’

Be alert to a victim of overdose, whether a house mate, a neighbour, or a stranger. A quick call for help will be probably be a life giving gesture.

*Phillip O'Neill is Professor and Director of the Urban Research Centre for the University of Western Sydney. He contributes regular comments on the issues facing the Sydney metropolitan area.