OVERDOSES MAY BE UNDER-REPORTED

There may have been even more heroin overdoses in the Pittsburgh area
than estimated at first, according to Dr. Fred Harchelroad, chairman
of the emergency medical department at Allegheny General Hospital, Pittsburgh.

Harchelroad on Tuesday said the number of deaths would be reduced
because paramedics use Narcan, also known by the generic name
naloxone, to routinely help revive those who overdose on heroin and
other opiates before they are taken to emergency rooms.

Emergency room doctors also use the medicine so much that they may
not have started to order certain toxicology screenings until the
fentanyl-heroin mix gained public attention, he said.

Also, naloxone, is "sold on the black market and some addicts
administer it to people who overdose," Harchelroad said.

Police reports in the Alle-Kiski Valley show that addicts sometimes
get naloxone by stealing it from ambulances.

Experts aren't sure how long the heroin-fentanyl outbreak will last.

"It all depends on the supplier," said Dr. Cameron Bobbett, an
emergency room physician at the Alle-Kiski Medical Center in Harrison.

"We don't know how much is on the street," said Dr. Daniel Brooks,
UPMC director of toxicology. "Is there more out there?" Harchelrode
isn't sure. Usually, he said, a heroin shipment is used up within one
to two weeks.

"A number of addicts may cut back because of the scare, but the
thrill seekers might be attracted," Harchelrode said.

Fentanyl-laced heroin has killed more than 200 people in
Philadelphia, Detroit and other major cities in recent weeks and
comes in stamp bags with the name "Get high or die trying" -- such as
the ones confiscated in Pittsburgh.

Fifteen people took heroin-fentanyl and died in Philadelphia
hospitals during one 24-hour period in April.

The National Drug Intelligence Center estimates there are 800,000 to
1 million heroin users in the country who potentially could be impacted.

Last month, Mexican authorities seized a black-market fentanyl lab
and the NDIC said some of the new heroin-fentanyl likely has been
shipped from that country.

Last month the FBI and Philadelphia police arrested eight Hispanic
drug distributors and seized 25,000 bags of fentanyl-tainted heroin,
the NDIC said.

Brooks said one of the Pittsburgh overdose survivors is Hazelwood man
in his late 20s or early 30s who said he didn't know the heroin,
which he got from Philadelphia, he used contained fentanyl, too.

"This is troubling because the users aren't being told the drug is
significantly different," Brooks said.

Fentanyl is a potent synthetic opiate that is expensive to make.

"Why wouldn't they say what it is and sell it for more?" Brooks asked.

Brooks said the drug taken by the Hazelwood man was fentanyl and not
3-methyl fentanyl -- better known as China White -- that killed 16
Allegheny County residents in 1988. This is the second confirmation
is as many weeks that China White is not likely causing the deaths.

Two weeks ago, Philadelphia police chemist Ed Dugan told the Valley
News Dispatch that heroin-fentanyl found there contained fentanyl and
not China White.

Brooks said fentanyl is a valuable painkiller that is strong but it
starts to wear off in 20 to 30 minutes.

"There aren't a lot of adverse effects" when fentanyl is used
correctly, he said.