Authorities Weigh Narcan Prescriptions to Stop Overdose

In the wake of more than 400 deaths nationwide from heroin laced with the painkiller fentanyl, some needle exchange programs are giving addicts prescriptions for a drug to keep on hand to halt an overdose.

The antidote - naloxone, which is sold under the brand name Narcan - can save the life of someone who might not call 911 for fear of prosecution, treatment providers say.

Even if a user does call, help can arrive too late.

"If people have to rely on paramedics, more often than not, the overdose is going to be fatal, just because of the amount of time for people to get there," said Casey Cook, executive director of Prevention Point Philadelphia, a nonprofit that runs the city's needle exchange program. The group recently began distributing naloxone prescriptions through a physician.

But others say naloxone is best administered by trained paramedics and that the prescription approach might appear to condone drug use.

"We don't want to send the message out that there is a safe way to use heroin," said Jennifer DeVallance, a spokeswoman for the White House Office of National Drug Control Policy, which sponsored a symposium Friday on the fentanyl problem in Philadelphia.

Fentanyl - an opiate used legally in anesthesia and for some cancer patients - is cheaper than heroin and 80 times more potent than morphine. That makes it an appealing additive for heroin distributors.

At least 150 fentanyl deaths have been recorded in the Philadelphia area, 130 in Chicago and 130 in Detroit.

John P. Walters, the director of the White House drug policy office, said investigators hope to learn whether a clandestine laboratory raided in Mexico last month was the source of much of the illegal fentanyl reaching the United States.

"We think and we hope that the production site taken down in Mexico was the (main) site," Walters said.

Fentanyl can lead to respiratory failure so quickly that one addict in Philadelphia apparently died even before he finished shooting up. A syringe with some heroin still in it was in his arm when paramedics found his body, according to Capt. Richard Bossert of Philadelphia's Emergency Medical Services Administration.

The case underscores the difficulty the medical community has faced in responding to the fentanyl crisis. Bossert said his unit has answered dozens of calls but has saved only two people.

"In other years, we were getting them (non-fentanyl heroin overdoses) to the hospital and they survived," Bossert said.

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