FENTANYL-LACED HEROIN DRAWS PENN POWWOW

Substance-Abuse Experts Eye Ways To Cut Drug's Lure

With a recent explosion of deaths and overdoses from fentanyl-laced
heroin nationally, local and federal substance-abuse experts huddled
in Philadelphia yesterday to plot ways to reduce demand for the deadly drug.

The doable: Law-enforcement authorities and health-care providers
should share information to track the drug's sources, so police can
snag the suppliers, experts urged.

The difficult: Victims should be automatically screened for fentanyl,
despite the prohibitive costs and detection difficulties that have
discouraged many coroners and doctors from routine screening, they exhorted.

The seemingly impossible: Pharmacologists must develop drugs for
medical use that can't be abused by addicts, they appealed.

Those calls to action were oft-repeated yesterday at the
"Fentanyl-Laced Heroin Demand Reduction Forum," sponsored by the
White House Office of National Drug Control Policy.

The daylong forum drew about 200 local and national experts to the
University of Pennsylvania Medical School's campus, one month after a
similar gathering in Chicago focused on supply of the lethal drug cocktail.

"It's going to take all of us working together to fight this
problem," said Patrick L. Meehan, U.S. Attorney for the Eastern
District of Pennsylvania. "People are dying - they're black and
white, from the cities and the suburbs - while drug dealers are
turning a profit."

Nationally, there have been 502 confirmed deaths from fentanyl
overdoses since April 2005, mostly in Chicago, Detroit, Camden and
Philadelphia, according to the Office of National Drug Control
Policy. The tally so far in the Philadelphia tristate region is 170
deaths and another 300 nonfatal overdoses, Meehan said.

"Heroin users are always looking for a bigger bang," Meehan said.
"The bang fentanyl creates is killing people. Fentanyl is turning
heroin and the syringe that's being used into a loaded gun."

In its legally prescribed form, fentanyl is a painkiller that is 50
to 100 times more potent than morphine and much stronger than
OxyContin, another legal, frequently abused painkiller, said Dr. Nora
Volkow, director of the National Institute on Drug Abuse. It's
typically prescribed to alleviate cancer pain but can also be used to
anesthetize patients or to control chronic coughing and diarrhea, Volkow said.

Taken improperly, it can cause an irregular heartbeat, an inability
to breathe and death.

The fentanyl mixed with heroin probably is being manufactured in
illegal, clandestine labs, like one busted in Mexico several weeks
ago, said Dr. Bertha Madras, deputy director of Demand Reduction of
the Office of National Drug Control Policy. Still, fentanyl is a more
complicated drug than other illegal substances thugs can concoct in
their kitchens, like methamphetamine, Meehan said.

To pinpoint its source, coroners and emergency-room physicians must
share information about overdose victims, Madras and Meehan agreed.

"The second someone collapses from an overdose, vital information is
being generated," Meehan said. "We need to look at new ways to
expedite this information-sharing. We need to understand how these
drugs are getting into the market."

Detectives, hospitals, public health agencies, drug treatment centers
and medical examiners should submit their findings to a central
information-collection center, like the federal High Intensity Drug
Trafficking Area program, Meehan said.

Investigators who discover where addicts get the tainted heroin can
then collar the suppliers and slow the flow of tainted drugs, he
said. Investigators already have pegged Kensington as a principal
distribution point in Philadelphia, he added.

"We want to reduce the supply and demand," said John P. Walters,
director of the White House Office of National Drug Control Policy.
"If we do that, we can also help people who have started taking
[tainted heroin] from becoming addicted."

Fentanyl screening is a pricey test and not conclusive, as fentanyl
"appears in tissues in vanishingly low quantities," Madras said.

Still, Philadelphia authorities now automatically test for fentanyl
in drug deaths, Meehan said. Cities, counties and states elsewhere
must do the same to reverse the growing epidemic, he added.

Jeff Moran, spokesman for the city medical examiner's office, said
all overdose cases and drug deaths between ages of 12 and 70 are
tested for fentanyl.

Counselors in Philadelphia also now tell addicts who seek treatment
or participate in needle-sharing programs about the risks of
fentanyl-laced heroin, said Dr. Charles O'Brien, a Penn professor who
helped organize yesterday's forum.

Madras also challenged the audience full of researchers "to develop
drugs that promote therapeutic benefits but have no abuse liability.

"There is much we can do collectively," he said, "to improve the
public health of our nation."