Our investigation of a cluster of three fatal overdoses casts doubt on the conventional wisdom that overdoses result from unregulated changes in the purity of street heroin. Use of alcohol or other sedatives can make an otherwise safe dose of heroin (or other opioids) lethal. In addition users can knowingly increase their dose, usually as an indulgence. Some media reporting of this cluster of deaths was accurate, but there was also sensationalization, perpetuating stereotypes about the drug market that may be untrue. Information flow within the using community was relatively accurate, but slow, possibly because it was the holiday season. Larger studies to substantiate our findings are needed. In addition, introduction of a user-organization-based epidemiological monitoring system for overdoses would be a valuable public health measure.