Pubdate: Sat, 29 Jul 2006
Source: Philadelphia Daily News (PA)
Copyright: 2006 Philadelphia Newspapers Inc.
Contact: http://www.philly.com/mld/philly/contact-us/feedback-np2/
Website: http://www.phillynews.com/
Details: http://www.mapinc.org/media/339
Author:  Dana DiFilippo
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)
Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone)

FENTANYL-LACED HEROIN DRAWS PENN POWWOW

Substance-Abuse Experts Eye Ways To Cut Drug's Lure

With a recent explosion of deaths and overdoses from fentanyl-laced 
heroin nationally, local and federal substance-abuse experts huddled 
in Philadelphia yesterday to plot ways to reduce demand for the deadly drug.

The doable: Law-enforcement authorities and health-care providers 
should share information to track the drug's sources, so police can 
snag the suppliers, experts urged.

The difficult: Victims should be automatically screened for fentanyl, 
despite the prohibitive costs and detection difficulties that have 
discouraged many coroners and doctors from routine screening, they exhorted.

The seemingly impossible: Pharmacologists must develop drugs for 
medical use that can't be abused by addicts, they appealed.

Those calls to action were oft-repeated yesterday at the 
"Fentanyl-Laced Heroin Demand Reduction Forum," sponsored by the 
White House Office of National Drug Control Policy.

The daylong forum drew about 200 local and national experts to the 
University of Pennsylvania Medical School's campus, one month after a 
similar gathering in Chicago focused on supply of the lethal drug cocktail.

"It's going to take all of us working together to fight this 
problem," said Patrick L. Meehan, U.S. Attorney for the Eastern 
District of Pennsylvania. "People are dying - they're black and 
white, from the cities and the suburbs - while drug dealers are 
turning a profit."

Nationally, there have been 502 confirmed deaths from fentanyl 
overdoses since April 2005, mostly in Chicago, Detroit, Camden and 
Philadelphia, according to the Office of National Drug Control 
Policy. The tally so far in the Philadelphia tristate region is 170 
deaths and another 300 nonfatal overdoses, Meehan said.

"Heroin users are always looking for a bigger bang," Meehan said. 
"The bang fentanyl creates is killing people. Fentanyl is turning 
heroin and the syringe that's being used into a loaded gun."

In its legally prescribed form, fentanyl is a painkiller that is 50 
to 100 times more potent than morphine and much stronger than 
OxyContin, another legal, frequently abused painkiller, said Dr. Nora 
Volkow, director of the National Institute on Drug Abuse. It's 
typically prescribed to alleviate cancer pain but can also be used to 
anesthetize patients or to control chronic coughing and diarrhea, Volkow said.

Taken improperly, it can cause an irregular heartbeat, an inability 
to breathe and death.

The fentanyl mixed with heroin probably is being manufactured in 
illegal, clandestine labs, like one busted in Mexico several weeks 
ago, said Dr. Bertha Madras, deputy director of Demand Reduction of 
the Office of National Drug Control Policy. Still, fentanyl is a more 
complicated drug than other illegal substances thugs can concoct in 
their kitchens, like methamphetamine, Meehan said.

To pinpoint its source, coroners and emergency-room physicians must 
share information about overdose victims, Madras and Meehan agreed.

"The second someone collapses from an overdose, vital information is 
being generated," Meehan said. "We need to look at new ways to 
expedite this information-sharing. We need to understand how these 
drugs are getting into the market."

Detectives, hospitals, public health agencies, drug treatment centers 
and medical examiners should submit their findings to a central 
information-collection center, like the federal High Intensity Drug 
Trafficking Area program, Meehan said.

Investigators who discover where addicts get the tainted heroin can 
then collar the suppliers and slow the flow of tainted drugs, he 
said. Investigators already have pegged Kensington as a principal 
distribution point in Philadelphia, he added.

"We want to reduce the supply and demand," said John P. Walters, 
director of the White House Office of National Drug Control Policy. 
"If we do that, we can also help people who have started taking 
[tainted heroin] from becoming addicted."

Fentanyl screening is a pricey test and not conclusive, as fentanyl 
"appears in tissues in vanishingly low quantities," Madras said.

Still, Philadelphia authorities now automatically test for fentanyl 
in drug deaths, Meehan said. Cities, counties and states elsewhere 
must do the same to reverse the growing epidemic, he added.

Jeff Moran, spokesman for the city medical examiner's office, said 
all overdose cases and drug deaths between ages of 12 and 70 are 
tested for fentanyl.

Counselors in Philadelphia also now tell addicts who seek treatment 
or participate in needle-sharing programs about the risks of 
fentanyl-laced heroin, said Dr. Charles O'Brien, a Penn professor who 
helped organize yesterday's forum.

Madras also challenged the audience full of researchers "to develop 
drugs that promote therapeutic benefits but have no abuse liability.

"There is much we can do collectively," he said, "to improve the 
public health of our nation."
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MAP posted-by: Beth Wehrman