AREA EMERGENCY ROOMS SEE MOST OVERDOSES IN NATION

The Eight-County Region Also Has One Of The Highest Rates Of Drug-Related
Deaths In The U.S., A Federal Study Reports.

Drug abusers sought help in Philadelphia-area emergency rooms at a greater
rate last year than in any other U.S. metropolitan area.

A new federal survey of emergency-room data from metropolitan areas across
the country also found that young adults and teenagers in Philadelphia and
its suburbs were more likely to seek emergency care for bad reactions to drugs.

The annual survey, known as the Drug Abuse Warning Network (DAWN), tracks
emergency-room visits caused by the use of illegal drugs and the
recreational use of prescription drugs. It attempts to measure the impact
of drug abuse on the nation's health.

Earlier this year, the survey also reported that people in this region were
dying of drug overdoses at one of the nation's highest rates. The figures
showed that the Baltimore region had the highest fatality rate, followed
closely by Philadelphia, New Orleans and Phoenix.

The overdose survey drew upon reports from 2000 from hospitals in
Philadelphia and the seven counties in Pennsylvania and South Jersey that
surround the city. It found that 937 men and women overdosed in the region
that year.

For years, the eight-county area, along with other metropolitan regions
such as Baltimore, has ranked near the top in the agency's measurement of
drug abuse's impact on health. Local health experts said it wasn't clear
exactly why Philadelphia would report the most serious problem this time,
but it was hardly surprising in an area that includes so many urban cores -
such as those in Philadelphia, Camden and Chester City.

"I think any East Coast inner city has a lot of drug use, whether it's
measured by the emergency department or the police department," said
Jeanmarie Perrone, director of medical toxicology at the Hospital of the
University of Pennsylvania's emergency department.

Perrone said she had seen similar rates of drug-related problems when she
worked in emergency rooms in Baltimore and New York.

In Philadelphia, drug abusers suffering from racing hearts, shortness of
breath, chest pain or other symptoms turn up often at Perrone's hospital.

"We see a lot, a lot, a lot of crack-cocaine use," Perrone said.

Local health officials use the federal survey data, in conjunction with
research from the Drug Enforcement Administration, to keep an eye on which
drugs are most popular among local users. The Philadelphia Health
Department also conducts focus-group discussions twice a year with drug
users in Philadelphia jails to find out about the latest trends.

"You take these indicators in conjunction with each other, and a story
about substance abuse in an area starts to emerge," said Mark R.
Bencivengo, who oversees the drug-and-alcohol-abuse office of the
Philadelphia Health Department.

That story is centered on cocaine. Last year, cocaine sent local residents
to emergency rooms 11,358 times - a number that has held relatively steady
since the crack epidemic peaked in the late 1980s. In 1980, before crack
hit Philadelphia, only 79 people visited emergency rooms for
cocaine-related problems.

The federal study released last week showed that area hospitals had seen
steady increases over the last five years in the use of such narcotics as
heroin, ecstasy, and PCP, and in the mixing of alcohol with other drugs.

There has been a statistically huge, tenfold increase over the last five
years in emergency-room patients who have taken ecstasy, a drug long
popular among middle-class clubgoers.

However, the overall number of users of ecstasy - or X, as it is sometime
called - was still tiny compared with those who had ingested what experts
call "primary drugs of abuse," such as cocaine and heroin. Last year, 203
people who sought treatment showed evidence of ecstasy use.

"X seems to be moving into more of what we would call the street-level drug
culture, whereas it had been confined largely to the rave scene and clubs,"
Bencivengo said. "It is becoming considerably more widespread."

The biggest trend that local health officials worry about is heroin, which
is the purest in the nation here, Bencivengo said.

For 30 years, heroin was cut with other substances to the point that it was
only about 5 percent pure. It now arrives in Philadelphia from South
America at about 70 percent purity, Bencivengo said. That means it's strong
enough for local users to get high by smoking it, rather than the more
common method of injecting it.

"If purity drops off dramatically, people who are using the drug may turn
to injection to get the effects," Bencivengo said. "We could see a blip up
in needle use, which then opens up the specter of HIV transmission."

Bencivengo said he was keeping an eye on methamphetamines, which have
become increasingly popular in Western states but accounted for only 60
visits to area hospitals last year.

"Back in the 1970s, Philadelphia was the meth capital of the U.S.," he
said. "Now, it's not even on the radar screen. Hopefully, we won't see
anything sweep the drug scene the way that cocaine did."

The DAWN survey found there were 252 drug-related emergency-room visits for
every 100,000 people nationwide in 2001. In Philadelphia and the seven
counties surrounding it, the rate was twice as high with 573 visits to
emergency rooms for every 100,000 people.

Philadelphia's 18-to-25-year-olds, who had 1,048 drug-related
emergency-room visits per 100,000 people in 2001, were far more likely to
seek emergency drug treatment than their peers in other regions.