- The Washington Times - Wednesday, March 5, 2003

BALTIMORE (AP) Health officials will start a program in the spring that will allow addicts to administer Narcan, a drug that can revive a person near death from a heroin overdose.
Vials of Narcan used by paramedics and hospital personnel to treat opium-based narcotics overdoses will be distributed beginning May 1 after a group of 50 addicts is trained.
Training began last week for emergency services and health officials who will teach addict-rescuers basic medical protocol with the drug, syringes, resuscitation techniques and other lifesaving methods.
In the past four years, more than 1,000 people have died from heroin overdoses in Baltimore, officials said. In Maryland in 2001, 516 persons died from heroin overdoses.
"There is a chronic problem here," said Dr. Peter L. Beilenson, Baltimore health commissioner. "A significant number of people are dying each year from heroin overdoses in one year, more than the homicide rate and while this may be viewed as enabling, this is a worthwhile attempt to keep people alive."
Supporters of the Narcan program said lives have been saved in other heroin trouble spots in the nation and world. But critics say the city's plan sends a mixed message to Baltimore's estimated 60,000 addicts.
"The Narcan program sanctions heroin addiction," said Michael W. Gimbel, former director of Baltimore County's bureau of substance abuse and a former heroin addict. "It's like the city has given up."
Critics also wonder whether addict-rescuers can retain the necessary information about varying doses of Narcan needed for different overdose scenarios, all involving life-and-death decisions. There also are questions of whether a heroin user, high on the narcotic, can efficiently administer Narcan to a dying member of their shooting party.
Under the program, addict-rescuers will be given vials of Narcan and syringes. After recognizing an unconscious user experiencing difficulty breathing, the addict-rescuer will be expected to fill a syringe with a specific dose of Narcan and properly administer it.
City officials say the innovative program will save lives and cut the 1,800 emergency calls the Fire Department receives each year to revive overdosed addicts.
The National Drug Intelligence Center of the U.S. Department of Justice said in an August report that Baltimore "has one of the most serious heroin abuse problems in the nation."
Dr. Beilenson said the Narcan project will be accompanied by thousands of educational brochures, some of which have been distributed to addicts, detailing lifesaving steps such as cardiopulmonary resuscitation and how to inject Narcan into a muscle, and instructing them to summon paramedics.
Some paramedics and emergency room personnel said that while Narcan can keep down heroin mortality rates, rarely do addicts revived with the drug seek treatment to end their addiction. Instead, they usually return to the drug dealer who sold them the high-quality heroin that nearly led to their deaths.
Narcan, approved by the U.S. Food and Drug Administration in 1971, works by blocking opiates from brain receptors.
The program is funded for two years by a $300,000 grant, Dr. Beilenson said. Most of the money comes from the Open Society Institute, a private foundation started by financier George Soros. The institute is based in New York and operates in 30 other countries.
Baltimore Mayor Martin O'Malley declined to comment on the Narcan program.

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