AMID HEROIN DEATHS, AUTHORITIES DEBATE DRUG THAT STOPS OVERDOSE

While Fentanyl-laced heroin has killed several hundred drug-users
nationwide over the past few months, people who work in the field
believe the extent of the overdoses is not fully known because so
many nonfatal overdoses go unreported.

PHILADELPHIA -- In the wake of more than 400 overdose deaths
nationwide from heroin laced with the painkiller fentanyl, some
needle exchange programs are starting to give addicts prescriptions
for a drug to keep on hand to halt 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 they do 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, executive director of
Prevention Point Philadelphia, a nonprofit that runs the city's
needle exchange program. The group recently began distributing
naloxone prescriptions through a physician.

But others say 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, which sponsored a
symposium on the fentanyl problem Friday in Philadelphia.

Fentanyl -- an opiate used legally in anesthesia and for some cancer
patients -- is cheaper than heroin and 40 to 100 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
region, 130 in the Chicago area and 130 in the Detroit area.

John P. Walters, the director of the White House drug policy office,
said investigators hope to learn whether a clandestine laboratory
raided in Mexico last month was the source of much of the illegal
fentanyl reaching the U.S.

"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, according to Capt. Richard Bossert of Philadelphia's
Emergency Medical Services Administration.

The case underscores the difficulty the medical community has faced
in responding to the fentanyl crisis. Bossert said his unit has
answered dozens of calls but has saved only two people.

"In other years, we were getting them (non-fentanyl heroin overdoses)
to the hospital and they survived," Bossert said.