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The number of overdoses on heroin and opiates such as Oxycontin has grown up dramatically over the last decade. In fact, users of those drugs are more likely to die from an overdose than to die from AIDS or hepatitis or murder. Public health workers around the country have responded by handing out drug rescue kits to users. They cost just $9.50.

NPR's Richard Knox reports.

RICHARD KNOX: You can find one of the new rescue operations near Central Square in Cambridge, Massachusetts. It's off a side street behind St. Peter's Episcopal Church, through an anonymous-looking door, and up some stairs to a program called Cambridge Cares.

Ms. ELIZA WHEELER (Health Educator): Hi.

KNOW: Hi.

Ms. WHEELER: Are you Richard?

KNOX: Yeah.

Ms. WHEELER: Hi, how are you doing?

KNOX: Fine. Thank you.

Ms. WHEELER: We had to make sure. Are you cold(ph)?

KNOX: I feel good.

Health educator Eliza Wheeler cajoles drug users to get tested for HIV and hepatitis, urges them not to share needles, gets them into detox or methodone treatment. On this wintry morning, she's teaching a 34-year-old woman named Elissa how to rescue her friends from a fatal overdose. Elissa has been on methodone for six years, but she occasionally uses heroin when she is under stress.

Ms. WHEELER: All right, so Elissa, the first thing I'm going to do is kind of ask a series of questions about current drug use. So we're going to talk about just the last 30 days.

KNOX: Elissa has had scary experiences with overdoses - her own and others'.

ELISSA: I managed to wake my partner up, who had turned blue. He was not breathing and - which is why I called the ambulance. But I managed to wake him up before they came. And they didn't, you know, take him away. So he went out and convinced them that he was okay.

KNOX: Wheeler runs through the signs of heroin overdose.

Ms. WHEELER: So the first thing you want to is kind of figure out if they're overdosing.

KNOX: When this happens, she says, the first thing to do is call 911. Then you blow some air into the person's lungs, a modified form of CPR called rescue breathing. Then, you open up the overdose rescue kit.

Ms. WHEELER: This is what the box looks like. And then, attached to the box is a little apparatus that makes it into a spray. So it's just a nasal spray, no injection.

ELISSA: Oh, wow, that's so wonderful. I had thought it was a shot. That makes me feel so much better about everything.

KNOX: The nasal spray is a drug called naloxone or Narcan. It blocks the brain receptors that heroin activates, instantly reversing an overdose. Doctors and EMTs have used Narcan for years. But it doesn't require much training because it's impossible to overdose on Narcan. The Cambridge program began putting Narcan kits into drug users' hands last August. Since then, the kits have been used to reverse seven overdoses. New data, compiled for NPR from 16 such programs across the nation, show that more than 2,500 overdoses have been reversed.

John Gatto directs the Cambridge program.

Mr. JOHN GATTO (Director, Cambridge Cares About AIDS): In the work that we do, oftentimes the results are very intangible. This is amazing, to be involved in something that literally can save people's lives. Why wouldn't we do it?

KNOX: Dr. Bertha Madras, has a bunch of reasons why not. She is deputy director of the White House Office on National Drug Control Policy. She's dead-set against the Narcan overdose-rescue programs.

Doctor BERTHA MADRAS (Deputy Director, White House Office on National Drug Control Policy): First of all, I don't agree with giving an opioid antidote to non-medical professionals. That's number one. I just don't think that's good public health policy.

KNOX: Madras says fellow drug users aren't competent to deal with an overdose emergency. But more important, she says, Narcan kits are merely a stopgap that may encourage a person to keep using heroin and take away the motivation to get into detox and drug treatment.

Ms. MADRAS: Sometimes, having an overdose, being in an emergency room, having that contact with a health care professional is enough to make a person snap into the reality of the situation, and snap into having someone give them services.

KNOX: There's not research on the effect on Narcan kits. But one small study suggests that overdose rescue programs drug actually reduce heroine use and get some drug users into treatment

Karen Seal of the University of California at San Francisco is an author of that study.

Ms. KAREN SEAL (University of California, San Francisco): It was one of these great studies where we just kind of all walked away and said, whoa. Yeah, this is terrific. I mean, buy our sheer interaction action with these folks around, you know, life-saving behaviors, we're actually creating some real positive change here.

KNOX: Eliza Wheeler, the Cambridge health educator, says putting overdose rescue kits in the hands of drug users sends them a positive message.

Ms. WHEELER: There is a real potential culture change among drug users because of Narcan, because, from my experience, I feel like drug users internalize a lot of stigma that's out in the world about them, and come to believe that dying is just part of this life that they've chosen.

KNOX: So far, Narcan Rescue programs have sprung up in big cities and in rural areas around the country, with little or no opposition.

Richard Knox, NPR News, Boston.

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