AN OCCUPATIONAL HAZARD

OVERDOSE IS the heroin addict's occupational hazard. Last year, 324 died in
Baltimore after excessive heroin use so numbed their central nervous
systems they couldn't breathe.

Many of these addicts might have been saved if they had received a timely
antidote and resuscitation. That's why Baltimore's health department has
embarked on a radical experiment: training 50 addicts to inject naloxone,
an opiate blocker. As of May, if those so trained find fellow addicts
overdosing, they are directed to intervene and attempt resuscitation.

This approach has achieved some success in Chicago, where a private
activist organization prevented scores of overdose deaths during the past
two years. But Baltimore's health department appears to be the first in the
world that is planning to allow addicts to act in lieu of emergency medical
personnel.

It's a worthwhile experiment, but one that must be approached with great
caution. The program's goal must not be simply to revive overdose victims
so they can continue their habit.

From the outset, Baltimore officials should recognize and address the
antidote's limitations and pitfalls. Naloxone - and its brand-name
equivalent, Narcan - may perform near-miracles, but it is not a miracle
drug. A shot of the antidote wears off long before the effects of heroin
do, so overdose victims remain in grave danger, unless they get swift care
by trained medical professionals.

Calling for emergency help is not unreasonably burdensome. Even some
otherwise unprincipled operators of shooting galleries make the gesture.
When a client overdoses, they simply drag the listless body into an alley
and call 911. They don't want the added complication of a corpse in their
midst.

But addicts mostly avoid calling for help in overdose situations. Naloxone
is so popular because it offers the false hope of anonymity for an addict
who otherwise might die.

Even if administered with the proper follow-up care, though, the drug has
only limited value. It does nothing to change the addict's destructive
behavior or treat the addiction.

Baltimore's bold experiment can only be successful if it begins with the
understanding that naloxone is an emergency tool. Ideally, no addict will
use it more than once - as part of a rescue leading to medical care,
addiction treatment and, ultimately, a healthy, drug-free life.