PAINKILLER-LACED HEROIN A FATAL ATTRACTION

Schuylkill May Have 9 Deaths From Mix. Other Counties Gird For Cases

A blend of potent painkiller and heroin that has killed hundreds of
people in cities across the country -- including at least 70 in
Philadelphia -- has hit the tiny towns of the coal region.

Authorities say the mix of fentanyl, a fast-acting painkiller
commonly used for cancer patients, and heroin, is suspected of
causing the deaths of at least nine people in Schuylkill County, five
of them in the small town of Tamaqua, in the past few months.

That five people may have died from the fentanyl/heroin mix in
Tamaqua is unusual, Schuylkill County Coroner David Dutcavich said.
He typically sees about 25 overdose deaths a year in the entire
county of 150,000 people.

"Overdose deaths are not uncommon here, but ...to have that many
indicates that there's a change in what's happening," he said.
"Either everybody is getting more careless or there's a change in
what they are doing."

The four other deaths include one person in the western end of the
county and three in the central part.

Dutcavich would not disclose the victims' names or any other
identifying information. He said that the nine Schuylkill deaths are
still in the "suspected" category pending final toxicology tests that
can take several weeks.

State police Capt. David Young, director of the Drug Law Enforcement
division of the Pennsylvania State Police, said the number of deaths
in Philadelphia is not surprising because it is a "source city" for
heroin. Monroe County also is a heroin hot spot, said Stroud Area
Regional Police Department Lt. Brian Kimmins.

"Yeah, we've got it. We've noticed an increase in heroin, and the
[fentanyl-heroin mix] is now on the radar," he said.

That juxtaposition of sources is helping authorities as they try to
make sense of the five deaths in the sleepy little town of Tamaqua,
whose population is about 7,000.

Schuylkill County Drug and Alcohol Commission Administrator Daniel
McGrory said he's seen a "very steady increase in the use of heroin"
in the county.

"Tamaqua overlaps two heroin distribution points: coming down from
the Poconos and up from the Allentown/Philadelphia area," he said.
"That's why there is a concentration in that in the area. It is a hub
of the distribution points."

Tamaqua Mayor Christian Morrison is frustrated with the illegal drug
use in his town.

"We've had a heroin problem in town for some time," he said. "Every
now and again they get bored with their good old stand-by drug and
they try something with it. This time it's fentanyl."

A potent mix

"The high is instantaneous -- that's why people people have been
found dead with the needle in the arms," said Young. "When you're an
addict and you want it now and you need it now, fentanyl is a good
thing to have with your heroin."

People ingest the mix in a number of ways, said Kevin Harley,
spokesman for state Attorney General Tom Corbett.

"We're seeing several different things -- heroin addicts are getting
fentanyl patches and crystallizing [the drug] and putting it in the
heroin," he said. "We've also heard reports that fentanyl is coming
in from Mexico and being put in heroin."

Some addicts, he said, shoot heroin while chewing a fentanyl patch.

But the immediate high followed by the numbing effect of the heroin
is all too often ending in death.

"Even an experienced user can get himself or herself into trouble
very quickly," Dutcavich said. "They go into this zone, and the zone
is so effective they forget to breathe. They probably don't even
notice the respiratory arrest and subsequent cardiac arrest."

Substance abuse counselors have
known for a while that the combination was becoming more common.
Heroin users may not even know the drug they are about to take
contains fentanyl.

"We knew anecdotally from clients that it was out there and it was
dangerous," McGrory said. "There is no telling on the addicts' part,
what level of medication is in [the heroin]. You're not going to know
until its too late."

While people have died in several regional counties, including Berks
and Luzerne, Lehigh County Coroner Scott Grim said he hasn't seen any
confirmed deaths. Neither has Northampton County Coroner Zachary Lysek.

"We do have some cases pending toxicology tests," Grim said. "I'm
sure we will see some -- it's just spreading like wildfire."

Why the combination?

State police drug experts are trying to figure out why the lethal mix
is showing up more.

Mixing fentanyl with heroin might be a way for dealers to get more
people to buy heroin, Young said.

"Is it a marketing ploy? Possibly," he said. "Fentanyl is 50 to 100
times more potent than heroin."

Or, dealers might be trying to get more addicts to use the painkiller.

"It could be to get people moving toward fentanyl," Young said. "It
can be made like methamphetamine -- you don't need to grow plants.
With a little bit of sophistication, fentanyl can be made."

Whatever the reason for mixing the drugs, it's risky business.

"It's extremely hard to cut fentanyl into heroin," Young said. "You
really have to know what you're doing to get an even mixture so
somebody doesn't die."

Young said he has been seeing more deaths related to the mix. "There
is basically an outbreak of this going nationwide," he said.

The uptick nationally began around April, he said.

According to the U.S. Department of Justice National Drug
Intelligence Center, Mexico is the likely source of fentanyl
associated with recent overdoses. In May, Mexican law enforcement
authorities seized a fentanyl laboratory in Toluca, Mexico.

In February, U.S. Customs and Border Protection agents seized a
wholesale shipment of fentanyl powder just north of the U.S.-Mexico border.

The primary markets have been Chicago, Detroit and
Philadelphia/Camden, N.J., according to the drug intelligence center.

There also are clandestine fentanyl producers within U.S. borders,
the center said. In December 2003, agents seized an illegal fentanyl
lab in Newtown Square, Delaware County.

Stemming the flow

Law enforcement agencies are tackling the problem from the top.

"State police are focusing on larger-scale organizations to disrupt
flow of drugs," Young said.

Harley said the state attorney general's office has several ongoing
investigations involving fentanyl-laced heroin.

"We've made some progress, but we're not prepared to announce the
results of the investigations because they are ongoing," Harley said.

Morrison said Tamaqua police are hitting the problem as hard as they can.

McGrory said prevention is crucial ammunition in the battle,
especially given what he described as a dramatic increase in the
number of people injecting drugs.

"Over last couple of years, we have targeted fentanyl abuse with our
outreach programs," he said. "This is street-level contact. We go to
where the addicts are, distributing information -- clinics, bars,
soup kitchens, emergency rooms. We try to tell them to be aware that
it's out there and know what it is that you are ingesting."

But Harley said that in many cases, the more attention the deadly mix
gets, the more attractive it is.

Some addicts have told agents that they believe those who died "just
didn't know what they were doing," he said.