PROGRAMS GIVING HEROIN ADDICTS PRESCRIPTIONS IN CASE OF OVERDOSE

Some Say It Will Slow Rise In Deaths; Critics Say It Condones Use

PHILADELPHIA -- In the wake of more than 400 deaths nationwide from
heroin laced with the painkiller fentanyl, some needle-exchange
programs are giving addicts prescriptions for a drug to keep on hand
to stop an overdose.

The antidote - naloxone, which is sold under the brand name Narcan -
can save the life of someone who might not call 911 for fear of
prosecution, treatment providers say. Even if a user does call, help
can arrive too late.

"If people have to rely on paramedics, more often than not, the
overdose is going to be fatal, just because of the amount of time for
people to get there," said Casey Cook, the executive director of
Prevention Point Philadelphia, a nonprofit group that runs the city's
needle-exchange program. It recently began distributing naloxone
prescriptions through a doctor.

But others say that naloxone is best administered by trained
paramedics and that the prescription approach might appear to condone drug use.

"We don't want to send the message out that there is a safe way to
use heroin," said Jennifer DeVallance, a spokeswoman for the White
House Office of National Drug Control Policy.

Fentanyl - an opiate used legally in anesthesia and for cancer
patients - is cheaper than heroin and 80 times more potent than
morphine. That makes it an appealing additive for heroin distributors.

At least 150 fentanyl deaths have been recorded in the Philadelphia
area, 130 in Chicago and 130 in Detroit.

John P. Walters, the director of the White House drug policy office,
said that investigators hope to learn whether a laboratory raided in
Mexico last month was a main source of illegal fentanyl reaching the
United States.

"We think and we hope that the production site taken down in Mexico
was the (main) site," Walters said.

Fentanyl can lead to respiratory failure so quickly that one addict
in Philadelphia apparently died even before he finished shooting up.
A syringe with some heroin still in it was in his arm when paramedics
found his body, said Capt. Richard Bossert of Philadelphia's
Emergency Medical Services Administration.

The case underscores the difficulty that medical workers have faced
in responding to the fentanyl crisis. Bossert said that his unit has
answered many calls but has saved only two people.