BIG HURDLES IN BID TO CURB A POTENT HEROIN

Use of fentanyl-laced heroin is rising, as law officers work to ID
the origin of the painkiller.

CHICAGO - Jimbo tries to be cautious these days. The middle-age
heroin user says he buys only from dealers he knows - a hedge against
getting heroin mixed with the pain-reliever fentanyl, a concoction
that has killed at least 150 people in recent months.

Many of his friends, though, seek out fentanyl-laced heroin for its
potent high, swapping information about where the latest overdose
victim got his dope.

"They always say, 'It's gonna be different with me, 'cause I'm not
going to use so much,' but it's still too much," says Jimbo, as he
exchanged used needles for clean ones at a mobile van run by the
Chicago Recovery Alliance. "It's a whole new ballgame."

Demand for the potent heroin-fentanyl mixture is just one factor
complicating officials' efforts to contain, if not eliminate, a
street drug that is raising alarms in cities in the upper Midwest and
the Northeast. So far this year, the drug combo has been responsible
for between 150 and 300 deaths in a handful of cities.

Last week, Chicago police and the US Drug Enforcement Administration
(DEA) arrested 29 members of a southside street gang suspected of
trafficking in the specialty heroin. Over the weekend, police in
Detroit arrested a local man suspected of being a major provider of
the drug in that city, which has counted the largest number of
fentanyl-related deaths.

Also impeding efforts to crack down on the drug is the fact that it
remains something of a mystery. Officials acknowledge they have much
to learn, including where the fentanyl is made. They also are
concerned because, as a synthetic drug made in sophisticated labs,
fentanyl may point to a new territorial opening in the war on illegal drugs.

"Even if this episode subsides, what it represents is a very serious
and emerging problem. The rise of synthetic drugs manufactured in
labs in the developed world is a very different phenomenon than
Afghan warlords or coca crops being smuggled in," says David Murray,
a senior policy analyst with the White House Office of National Drug
Control Policy in Washington. The good news, he says, is that federal
and local law-enforcement and public-health officials have been able
to test a new system of coordination and data-sharing. "We think
we're seeing progress on this, but this is the kind of agility we'll
require in the future for multiple synthetic threats."

Fentanyl, used as an anesthetic and pain reliever when prescribed,
can be 100 times more potent than heroin - one reason addicts seek it
out, but also the reason it's so deadly if the minutest error occurs
when it's cut into heroin. Health officials measure its doses in
micrograms rather than milligrams.

Reports about the drug began circulating in Chicago last winter, when
a rash of overdoses occurred in the same place. Toxicologists
discovered fentanyl in the bodies of those who died, though they
still don't know if the drug may have been present earlier. At the
beginning of June, the Norwegian-American Hospital on Chicago's west
side was seeing an average of 10 overdose victims a day, instead of
the usual one or two, says Chuck Thomas, the hospital's director of
emergency medicine.

The blended drug has played a role in at least 60 deaths in Chicago
this spring, including the teenage son of a suburban police official,
and in many more nonfatal overdoses. Detroit, Philadelphia, and
Camden, N.J., have also seen significant numbers of deaths, and the
drug is beginning to spread to other cities.

The DEA and Chicago police got accolades for the raid at a public
housing project last week, where they arrested 29 alleged members of
the Mickey Cobras gang and seized more than 100 kilograms of heroin.

"It lets people know there's a concentrated effort [to crack down] in
areas that have been known for overdoses or deaths due to fentanyl,"
says Christopher Hoyt, a special agent with the DEA in Chicago. The
arrests, he says, are part of a larger investigation.

Some public-health officials have tried to use the deaths to get out
more information to addicts about all overdose issues, but their
advice can be at odds with the instincts of drug users. The Mickey
Cobras, for instance, had been using the recent deaths as a marketing
ploy, calling their product names like "Reaper," "Drop Dead," and
"Lethal Injection." Elsewhere, the mix has been sold under the name
"Get High or Die Tryin'."

"The typical addict in Chicago is spending $25 to $30 a day on
heroin, not actually getting high but just keeping them from going
into withdrawal," says Greg Scott, a sociologist at DePaul University
who studies drugs and gangs in the city. "If for that same $30 you
can get high the way you used to, it makes sense."

Of the five drug crews Professor Scott has spent time with in
Chicago, four are dealing at least 50-percent fentanyl-laced drugs,
he says. They tell him they're willing to accept a certain number of
deaths among their customers because the profits increase so much in
the days immediately after the overdoses. Some gangs have even given
out free samples as a marketing ploy.

The overdose rate has not necessarily been worse than the numerous
fatal overdoses Chicago has routinely had - about one or two a day,
Scott says. But he's glad to see the increased attention on the
issue. "It's really opening discussion for how marginalized injection
drug users are from healthcare services," he says.