Naloxone distribution began about seven months ago in the city; the drug, which is effective in preventing fatal overdoses, can't be misused and is easy to administer by syringe. "It's sort of a revolutionary idea, in a way, to put a medicine in the hands of anybody," said Sharon Stancliff, medical director for the Harm Reduction Coalition. "Overdose is really preventable in many, many cases."

Needle-exchange clients are taught how to detect an overdose and how to administer the antidote and perform mouth-to-mouth resuscitation, if necessary; they also are advised to call 911.

About 700 people die of opiate overdoses in New York each year. In addition to allowing the Coalition to distribute naloxone directly to addicts, the health department is considering giving the drug to New York Fire Department EMTs so it can be used when they respond to emergency calls.

"We know about 80 percent of the time people shoot up with a peer. It's like drinking, people don't do it alone," said Department of Health official Andrew Kolodny said. "Historically, heroin users do all the wrong things when they witness an overdose -- there are reports about injecting people with milk, putting ice on people. They are scared to call 911."

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