'MAKING A DENT' IN DEATH

On a typically busy Friday morning at Una Ala methadone clinic in
Espanola, men and women pour into the tiny building and wait in line.
Many clench money in their fists to pay for their daily dose of the
synthetic opiate they drink as a substitute for the heroin they crave.

Jeanne Block, a nurse and health educator for the New Mexico Health
Department, waits by the front door so people looking for free doses
of Narcan can find her.

Narcan is a prescription drug that reverses the effect of heroin.
Given to a person who has overdosed, the lifesaving drug "knocks the
heroin off the brain receptors," Block says. It acts almost
instantly, and those who've seen it take effect say it's like
watching a dead person come back to life.

Paramedics have used Narcan on overdose victims for years. But many
drug users are reluctant to call 911, fearing it will lead to their
arrest. In Espanola, where police are often the first to answer a 911
call, some people are more likely to leave an overdose victim at the
hospital door. Or they'll try reviving the user with cold water or an
injection of milk or salt water. Such folk remedies are ineffective
and lengthen the time a victim's brain is starved for oxygen.

In 2001, New Mexico became the first state to legalize the
distribution of Narcan to addicts and their relatives. The law was
part of the Health Department's attempt to lower the state's
fatal-overdose rate, which is the country's highest and six times
higher than the national rate.

Block designed training materials to teach people how to help
overdose victims, first by restoring breathing and, if that fails, by
injecting Narcan.

Her approach is straightforward and realistic -- she knows that if
friends or family call 911, they might leave the overdose scene
before the ambulance comes. She tells people to leave overdose
victims in an obvious spot so paramedics will find them quickly and
to lay them on their sides, so they don't choke.

Narcan distribution, like the Health Department's needle-exchange
program, was unpopular at first. After agreeing to carry Narcan and
being trained in its use, Espanola police backed off, saying the use
of syringes raised safety concerns. But Block says the New Mexico
State Police have agreed to carry Narcan in a nasal-spray form.

In the past eight months, Block and her team have trained more than
250 people -- addicts and their families -- in the Espanola area in
harm-reduction techniques.

She goes where she's invited, including the Rock Christian Fellowship
in Espanola, El Duende Bar in Hernandez and Ayudantes and Una Ala
methadone clinics.

Her classroom at Una Ala is a narrow storage space piled high with
boxes. Before a typical class, she arranges her pink CPR training
dummies and waits near the clinic entrance.

All her students this day are return customers -- people who used
their Narcan on someone who was suffering an overdose. One woman
tells of coming upon a man lying in the street. "A girl nearby was
screaming, 'He's overdosed, do something.' "

The woman had a dose of Narcan in her car, and she used it to revive
the man. She used another dose on an addict friend, who "went in the
bathroom and never came out."

"You did good. You saved two lives," Block says as she sends the
woman off with a red-plastic container holding two more doses of
Narcan, a breathing mask, rubber gloves and alcohol swabs.

The woman has an abscess scar on her arm. She used to shoot heroin,
but she's not using now, she says. She seems proud of having saved two lives.

In the next two hours, Block learns of three more rescues by her
trainees. She adds them to more than 60 cases documented by the
Health Department.

A man tells of injecting Narcan into a woman who had "just come out
of rehab and slammed a giant speedball" -- a mixture of heroin and
cocaine. He recalls the time he stumbled across an unconscious man
lying on the ground. "That guy was gone. He was blue, blue, blue,"
the man says. "Then, after I saved his life, he starts telling me off
because he was feeling withdrawals."

Saving the lives of people who aren't grateful or are likely to
overdose again can be thankless, but Block says it's "pretty
thrilling" nevertheless.

"We have no way of knowing with certainty that these people would
have died without Narcan, but it's likely," she says. "I have to
believe we're making a dent."