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SCOTT SIMON, HOST:

This is WEEKEND EDITION from NPR News. I'm Scott Simon. Public health officials warn that a tainted batch of heroin is killing people in Western Pennsylvania. Officials say the drug is responsible for at least 22 deaths, with more possible. But their warnings are unlikely to deter all users, so they're teaching addicts how to recognize the signs of an overdose and to get help. Liz Reid, from member station WESA, reports.

LIZ REID, BYLINE: Heroin overdoses are a routine part of life in the emergency room, and they're fairly easy to correct. Dr. Bruce MacLeod is used to seeing them in the ER at Western Pennsylvania Hospital, in Pittsburgh. But over the last week, West Penn and other area hospitals have seen an increase in the number and severity of opiate overdose cases coming into emergency rooms.

DR. BRUCE MACLEOD: A number of them came in that were already, had already died, so that's unusual. And then we saw that echo across Western Pennsylvania a little bit.

REID: Last Friday, the Allegheny County medical examiner, Dr. Karl Williams, saw three overdose deaths; on Saturday, four more.

DR. KARL WILLIAMS: And these four were distinctive because they all came in as obvious narcotic overdoses. They all came in with injection sites; they all came in with stamp bags and paraphernalia.

REID: A stamp bag is the unit that heroin is typically sold in. They cost around 10 bucks apiece. The ones in Southwestern Pennsylvania right now have been labeled with real brand names - in this case, Theraflu and Bud Ice. Williams says he thought the powder in the bags looked familiar, like something he'd seen associated with a rash of opiate overdose deaths in 1988 and 2006.

WILLIAMS: The first drug that came to mind as something that might be sold as, or mixed with, heroin was fentanyl.

REID: Williams was right. The bags contained fentanyl, an opioid that is 10 to 100 times stronger than morphine. Caroline Acker teaches the history of medicine and public health at Carnegie Mellon University, and is a co-founder of Prevention Point Pittsburgh, a needle-exchange program. She says often, when users find out there is something stronger out there, they actually seek it out.

CAROLINE ACKER: That is the kind of thinking that probably underlies, you know, what might seem paradoxical to us; that that which killed this person is what I now want to buy. But it's not completely irrational when you understand the ways addicts strive to struggle to manage their addictions.

REID: That's why there's something extra in the bags of clean needles Ron Johnson is handing out at Prevention Point's exchange site in Pittsburgh this week.

RON JOHNSON: If you look in that bag, you will see - in the green bag - you will see a flier, letting them know about the potency and everything, and what's going on.

REID: Johnson is a former heroin addict himself. He's been clean for 29 years.

JOHNSON: Says here: Deaths from fentanyl added to heroin have been confirmed in Allegheny County. Pure...

REID: The flier explains how to identify an opiate overdose, and what to do if you're with someone who you think has overdosed.

ALICE BELL: That you need to breathe for them, if they're not breathing; call 911.

REID: That's Alice Bell. She works to prevent overdose deaths among IV drug users.

BELL: And we teach people how to administer Naloxone, which is the antidote to an opiate overdose.

REID: Naloxone helped save the lives of three people who overdosed in the small town of Zelionople, about 30 miles north of Pittsburgh. Police Chief Jim Miller says one of the overdoses happened at the home of a suspected heroin dealer who they'd been investigating for years.

POLICE CHIEF JIM MILLER: Our big break was when our officer went in on the overdose and did see the heroin laying there. And it was confiscated, and that was used as part of the probable cause to get a warrant.

REID: The suspect, a 41-year-old mother of three, was taken into custody after officers from the State Attorney General's Office found 18 stamp bags in her apartment. A handful of other arrests have yielded thousands of bags, some of them marked Sky High; and authorities now suspect that dealers might be rebranding the fentanyl-laced heroin. They say the arrests are a start; but that there's no way to know how far the drug will reach, and how long it will remain in the supply.

For NPR News, I'm Liz Reid in Pittsburgh.

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