DEADLY PAINKILLER-DRUG COMBINATION LIKELY TO COME HERE, AUTHORITIES SAY

The Saginaw County arrival of narcotics laced with the painkiller
dubbed "China White" -- responsible for dozens of fatal Detroit-area
overdoses in recent weeks -- is all but imminent, experts say.

The drug, fentanyl, whose mixture with heroin or cocaine is growing
in deadly popularity, is 80 times more potent than morphine, the
National Institute for Drug Abuse reports.

"It may be the scare was big enough that people just aren't mixing
it" with the other drugs, said Dr. Cheryl Plettenberg, director of
the Saginaw County Health Department's substance abuse treatment and
prevention. "But I would think if they are a true user, and they want
it, they are going to take it.

"It gives them a really good high."

Though Saginaw hospitals haven't yet handled overdoses of heroin or
cocaine mixed with fentanyl, doctors in emergency rooms in Oakland
and Genesee counties are treating such cases, making its arrival
appear unavoidable, officials said.

"It is probably a matter of time," said Shane Hunt, a registered
nurse and manager of St. Mary's of Michigan Emergency Department.

He said many hospitals became aware of the mixture's deadly effects in mid-May.

"It is logical that we will see some in Saginaw County," Hunt said.
"I don't think we should be naive to think we don't have people who
use (heroin)."

Combining fentanyl with heroin or cocaine has killed nearly 50 people
in the Detroit metro area in the past two weeks, authorities said.

The painkiller, widely used legally as an anesthetic, kills by
causing the equivalent of a heart attack and coma in victims, Plettenberg said.

Heroin use remains significant in Saginaw County, but it is neither
on a clear upswing nor among the most widely abused drugs. Use of
forms of cocaine and marijuana far outpace heroin use, said hospital,
county and police officials.

Since 2000, Covenant Medical Center has seen 288 cases of accidental
overdoses of heroin or, in rarer cases, straight fentanyl. The annual
figures fluctuate from 33 to 49 cases but do not follow any trend.
There have been no overdoses of the mixture of the two drugs.

However, the data already show 34 heroin or fentanyl overdoses just
five months into 2006. The six-year high is 49 cases in 2004.

St. Mary's of Michigan hospital in Saginaw did not have such
statistics immediately available, spokesman Ken Santa said.

Abuse of fentanyl arose in the 1970s among medical professionals and
has kept a grip ever since on addicts nationwide, the U.S. Drug
Enforcement Agency reports.

The agency said at least 12 variations of fentanyl exist in illegal
drug markets, many of them homemade. Its effect on addicts is
identical to heroin -- with one exception.

"The fentanyls may be hundreds of times more potent" than heroin. The
painkiller is usually injected intravenously but also is snorted or
smoked, the government agency reports.

Fentanyl, also known as "Murder 8" and "TNT," has not shown up in any
drug busts in Saginaw, Bay, Midland, Isabella, Clare or Gladwin
counties, state police said.

The Bay Area Narcotics Enforcement Team has prosecuted heroin cases
in Isabella, Clare and Saginaw counties this year, "but nothing was
cut with fentanyl," said Detective 1st Lt. Mel Mathews, BAYANET commander.

The narcotic used in Detroit was a homemade, not prescription, form,
Mathews said.

"There is a possibility it could spread from down that way," Mathews added.

But authorities caution that having no reports of overdoses doesn't
mean there is no use here.

"We haven't seen anything yet, but that doesn't mean it's not out
there," Plettenberg said.