HEROIN MIX LEAVES TRAIL OF DEATHS

Painkiller Cited in Rash of Overdoses

Unusually potent heroin laced with a powerful painkiller has killed
more than two dozen people and sent more than 300 to hospitals across
the eastern USA during the past three weeks, local and federal officials say.

Federal agents from the Drug Enforcement Administration have joined
police in cities from the East Coast to Chicago in scrambling to find
the source of the deadly concoction. It surfaced in Chicago on April
13 and has been linked to 11 deaths there since then, police
spokeswoman Monique Bond says. Chicago paramedics treated 144
overdoses from April 13 to April 27, says Donald Walsh, assistant
deputy fire commissioner for emergency medical services.

Just as Chicago officials began reporting a surge in heroin-related
deaths and overdoses, authorities in Camden, N.J.; Wilmington, Del.;
Salisbury, Md.; Harrisburg, Pa.; and several other communities did, too.

The culprit in many of the cases appears to be heroin mixed with
fentanyl, a potent form of synthetic morphine that is used to treat
extreme pain. Veterinarians use one formulation of it to immobilize
large animals. The mixing of such a powerful, costly drug with heroin
for street sales is very unusual, says Mary Cooper, chief of
congressional and public affairs for the DEA.

Heroin sold illegally in the USA typically is diluted, or "cut," with
common household substances such as sugar, flour, quinine or starch.
Such fillers help drug traffickers boost profits.

The recent deaths and overdoses have dramatically illustrated
addicts' vulnerability to distributors who mix illegal drugs, as well
as the broad reach of the drug rings that move heroin from Mexico and
Colombia to cities across the USA, Cooper says. She notes that a
distributor with 1 kilogram of heroin -- about 2.2 pounds -- can
produce 25,000 doses that typically sell on the street for $10 each.

"It can go everywhere and anywhere," she says.

Less than 1% of the U.S. population used heroin in 2004, according to
the National Survey on Drug Use and Health. Heroin accounts for about
8% of drug-related emergency room visits, according to the Drug Abuse
Warning Network, which collects data from hospitals for the U.S. government.

Heroin generally is diluted by midlevel distributors in the USA, says
Douglas Collier, a senior agent for the DEA's New Jersey division.
Distributors may dilute a kilogram of heroin once or twice before
packaging it for street-level dealers, he says, and a local dealer
may cut it again before packing it into individual doses.

Dealers are careful not to dilute the heroin too much for fear of
losing sales, Collier says. "Customers will go where the purity is."

It's unclear why dealers might have mixed fentanyl with heroin.
Cooper says it might have been part of a marketing ploy to create a
powerful batch of heroin that would attract addicts.

In Chicago last week, police got a hint of many addicts' desperation
when officers began passing out handbills in communities where
overdoses had occurred. The handbills were intended to steer addicts
away from those locations. Instead, scores of addicts showed up,
looking for a dose of the ultra-powerful mix, Bond says. "We were
basically providing free advertising for the dealers."

Among the areas hit by the recent wave of heroin-related deaths and overdoses:

. Camden has had seven deaths since April 14, an usual surge in a
city that had 40 heroin-related deaths in all of 2005.

"The local hospitals have been getting a steady stream of people,
well above the norm," says Bill Shralow, spokesman for the Camden
County Prosecutor's Office. "Some samples have had fentanyl. We're
continuing to investigate."

Doctors at Cooper University Hospital have been treating about nine
overdoses a day, says spokeswoman Linda Michael. From April 20 to
April 28, they tallied 51 cases.

Steven Marcus, executive director of the New Jersey Poison
Information and Education System, says state officials counted 75
non-fatal overdoses from April 13 to April 27, far above normal.

"Our addicts are dropping like flies," he says. "This shows how
dangerous this stuff is."

. In the Harrisburg area, there have been two deaths and about three
dozen non-fatal overdoses, city spokesman Randy King says. In a
24-hour period beginning April 18, the city had 10 overdoses.

The city put out an alert that day, King says. "We told people you're
playing Russian roulette with your life if you use this stuff. It
made no difference."

Harrisburg usually has no more than one heroin overdose a month, King says.

. In Rockford, Ill., a city of 151,000 people 80 miles west of
Chicago, two people died of heroin overdoses last month, and nearly a
dozen people had non-fatal overdoses, says Dominic Iasparro, deputy
chief of detectives for Rockford police. Authorities are awaiting
toxicology results to see whether the heroin contains fentanyl, but
they have noticed a spike in overdoses, he says.

. Delaware has had five deaths and 18 non-fatal overdoses in the last
month, says Delaware State Police Sgt. Melissa Zebley.

Nearby, one person has died and eight others have overdosed in the
Salisbury, Md., area since April 20 on what was believed to be
fentanyl-laced heroin or straight fentanyl, says Judith Sensenbrenner
of the Wicomico County Health Department.

"Certainly we have heroin use here," she says, "but we don't tend to
see that number of overdoses."