HEROIN-PAINKILLER MIX PROVES DEADLY

DETROIT - Larry, a 53-year-old heroin addict, has two cardinal rules:
Never shoot up alone, and shoot up only one person at a time. If one
overdoses, "you need someone there to bring you back," he said.

Larry, who asked that his last name not be used, recited his rules
after hearing that a mixture of heroin and a powerful painkiller has
been killing users who believe they are taking heroin alone.

Officials from Philadelphia to Chicago have reported deaths from
fentanyl, which is considered 80 times more powerful than morphine.
The Detroit area seems to be the hub of the problem, with more than
100 confirmed cases since last fall and as many as 41 possible deaths
in the past eight days. Officials from the national Centers for
Disease Control and Prevention are investigating, and Detroit
community organizations are scrambling to get the word out to users.

The CDC says it has no national statistics on fentanyl deaths. But
reports from a several states indicate the mixture is widespread.

Philadelphia has had 20 confirmed deaths from heroin mixed with
fentanyl since April 17, and test results are pending in eight
suspected cases, the city health department said.

In New Jersey, where officials first raised the alarm about the drug
in April, there have been about 10 confirmed fentanyl deaths and 10
to 20 suspected cases since last month, according to the state's
poison control center.

In Chicago, 30 people died from fentanyl or fentanyl-laced heroin
from September 2005 to March 2006, said Christopher Hoyt, a spokesman
for the U.S. Drug Enforcement Administration in that city. In
addition, 23 suspected cases were reported in April and May.

In Wayne County, which includes Detroit, Medical Examiner Carl
Schmidt said he began noticing a rise in fentanyl-related deaths in
September. Medical examiners found 63 people who died in Wayne County
with fentanyl in their blood last year. From the beginning of 2006 to
mid-April, there were 70 such cases.

County officials did not begin treating fentanyl as a crisis until
last week, when the number of overdoses began to soar.

There have been 41 drug-related deaths since May 18, said Teresa
Blossom, a spokeswoman for the Detroit-Wayne County Community Mental
Health Agency. The county of 2 million typically sees two to three
drug deaths a day.

The drug kills by inhibiting respiration, Schmidt said. "It literally
suppresses your natural impulse to breathe," he said.

Organizations that run needle exchanges and other programs for drug
users are trying to spread the word. But to some drug users, the
warnings are an advertisement.

"When they hear about people OD'ing somewhere, they want to go there"
to get the more potent drugs, said Larry, the Detroit heroin user.

Latonja, 37, said she would do her best to stay away from the tainted
heroin. But she said it may be difficult, because users can never
know for sure what they're buying.

"We're not analyzers when we're trying to shoot our dope," said
Latonja, of Detroit, who also asked that her last name not be used.
"We're like, 'OK, it's time to get happy.'"