I've only (fucking "only", that's how bad this shit is) known four people who died of heroin-related causes. Same as everyone else stated, pills lead to smack leads to death.
A good friend of mine was on the wagon for a while and doing well, but fell off after I moved away, and ended up trying to steal some copper pipes for money, got caught, and hung himself in jail. He called me maybe a year or so before he passed and I screened it, knowing he was just strung out, looking for a ride. That would have been the last time I talked to him, and I still regret it.
Another gnarly story was this local ripper hurt his knee, got hooked on pain pills, and, again, rotated between on and off the wagon, until some "friends" supposedly shot him up with heroin for the first time one day. He started overdosing, and this was before the good samaritan law was in place, so no one called an ambulance for him. Instead, they put him in the backseat of a car, drove to the mall, drove to another friend's house to ask for advice, and ended up leaving him on his parent's doorstep. He died later in the hospital, due to a lack of oxygen to the brain, but he literally would have lived had someone just gotten him medical assistance immediately.