ADDICTS CLOSER TO GETTING DRUG TO STOP OVERDOSES

Portland officials are moving forward with a program to provide the
anti-overdose drug naloxone to heroin addicts in an effort to reduce the
number of drug-related deaths.

They also plan to begin stocking the drug on Portland firetrucks as well as
ambulances, and to train intermediate emergency medical technicians to
administer the drug along with paramedics.

Portland police, fire and public health officials met Wednesday to begin
developing a strategy to deal with the growing number of overdose deaths.
Portland has tallied more than 200 overdoses and 20 overdose deaths since
January, up from 16 overdose deaths in all of 2001.

The program is being modeled after efforts in Chicago, San Francisco,
Providence, R.I., New Mexico, Germany and Australia, where the use of
naloxone has been credited with saving lives. Portland officials expect to
have a plan in place by September.

"We're focusing on the problem as a public health issue rather than a
criminal issue," said Gerald Cayer, Portland's director of health and human
services. "Our short-term goal is to reduce mortality. Our long-term goal
is to reduce opiate use."

Despite potential controversy over the naloxone program, Cayer said he
expects it to be implemented without formal City Council review.
Wednesday's meeting included Mayor Karen Geraghty and Councilor Peter
O'Donnell, chairman of the council's health and human services committee.

"Clearly the state and Portland are experiencing a huge surge in the use of
opiates," Geraghty said. "We have the added problem that a large number of
people have ended up dead. In some of these cases, it's possible that
naloxone could have saved a life."

The Portland program would provide addicts with a kit that includes a dose
of naloxone, commonly known by the brand name Narcan, latex gloves and
alcohol wipes. The kits would be distributed by prescription through the
India Street Clinic, which is where the city operates a needle-exchange
program started in 1999. The cost of the program has not been calculated.

Addicts would be required to go through a training program to learn when
and how to administer naloxone. They also would be encouraged to call 911
as soon as they suspect someone has overdosed.

During an overdose, a drug user stops breathing and loses consciousness. If
naloxone is injected in time, the heroin, methadone or other opiate will
stop working in the body for 45 to 90 minutes, allowing breathing to resume.

In many cases, it may be just enough time for paramedics to arrive and get
the overdose victim to the hospital for further treatment. "We want people
to stay alive long enough for EMS to get there," Cayer said.

Cayer said that naloxone is not addictive and that federal officials may
make it an over-the-counter drug. Still, some people question whether
naloxone will promote drug use. Others wonder whether it's a good idea to
entrust addicts with medical care in the event of an overdose.

One of those people is Deputy Fire Chief Terence Walsh, who oversees the
city's paramedics and emergency medical technicians. But Walsh isn't
jumping to conclusions.

"We're taking a real hard look at the whole issue," he said. "We're not
dismissing it. I'm keeping an open mind."

Until now, naloxone has been kept on Portland ambulances in locked boxes
only accessible to 30 of the city's 52 paramedics. By Friday, Walsh hopes
to get state permission to stock the drug on firetrucks, too, making it
accessible to another 22 paramedics.

Walsh also hopes to get state approval to begin training Portland's 16
intermediate EMTs to administer the drug. So when the city's ambulances are
busy, emergency medical personnel on firetrucks won't have to wait to
provide naloxone. "So far, it hasn't been a problem," he said. "It just
hasn't been thought of."

Naloxone alone won't save a life, which is why Portland officials also plan
to encourage addicts to call 911 as the first step in dealing with an
overdose. Often addicts are reluctant to call because the emergency medical
services' response typically includes police, and they fear being arrested
for drug-related crimes.

Police Chief Michael Chitwood said he would never subvert a criminal
investigation, but he believes the primary concern at the scene of an
overdose should be saving a life.

"If somebody calls to save somebody's life, we'd have to take that into
consideration," Chitwood said. "I support this program, just as I supported
the needle exchange. The goal is to save lives."