Health officials in Portland, Ore., are taking the unusual step of offering the city's heroin addicts advice on how to shoot up safely after a string of overdose deaths.
Multnomah County health officials sent a memo to various methadone clinics, detoxification facilities and other organizations in the area, telling people who work there of advice they should give to addicts.
There were seven overdose deaths in a recent seven-day period, which raised concerns at the county health department.
ABC News affiliate KATU-TV in Portland obtained a copy of the internal memo, which outlines tips on how heroin users can avoid a fatal overdose.
Among the tips in the memo was: "Fix with a friend. If someone goes down, call 911. Any information you can give paramedics about the situation can help save a life, specifically what drugs a person has taken."
Other tips included in the memo were: "Take control of your own drug preparation and intake," and "Do a tester shot -- some batches are stronger than others."
The contents of the memo angered one man who works near a parking lot frequented by drug users, as evidenced by the litter of used heroin needles and other drug debris.
"That is ridiculous," Mark Butler told KATU after reading the memo. "We have a drug problem in this town that is pretty much out of control. That is ridiculous."
Multnomah County Chief Health Officer Gary Oxman said he did not get a chance to review the memo before it went out, but he stands behind it.
"We are not saying drug use is OK, implicitly or explicitly. We are recognizing the reality of drugs and providing them with information," Oxman said.
When asked if he thought the memo was an appropriate use of county resources he said, "It is. Yes, it saves lives."
Health department officials said it would be a waste of taxpayer money to give out messages telling people to abstain from drug use, because they say they are ineffective with people who are already addicted.
The memo does say, however, "Injecting drugs has many risks, overdosing being one, and abstaining from drug use is the best way to eliminate the risk of overdose."
Police said they believe the rash of overdose deaths may have been caused by a batch of heroin that was either exceptionally pure or poisoned.
"We're not fans of heroin use," Portland police Sgt. Brian Schmautz told The Oregonian newspaper. "But obviously the last thing we want is to have people dropping dead from this stuff."
He said the overall number of overdose deaths in the city is virtually unchanged from last year.