PORTLAND – City officials are considering whether heroin addicts should have access to an antidote that can reverse the effects of an overdose.

Paramedics already used Narcan to treat overdose victims, and the state last week extended the authority to certain emergency medical technicians.

Maine’s largest city has seen more than 200 overdoses this year, including 18 deadly cases. City officials are wondering whether providing Narcan to addicts will save lives or increase the addiction rate.

“I really want us to brainstorm these things,” said Gerald Cayer, director of Portland’s Health and Human Services Department.

“How do we feel about users having access to this? Who should have access? Should it be only EMS?” Cayer said, referring to emergency medical services.

It’s not clear who would make those decisions. Officials are planning to discuss the issue at a July 17 meeting but say it’s too early to know what kind of program they would consider.

Narcan is a trade name for naloxone, which competes with heroin and other narcotics for the same receptor sites in the body. The receptors bind with Narcan and block out the unwanted drug. Narcan is available to addicts in San Francisco and New Mexico and countries like Italy and Australia.

The possibility of giving Narcan to addicts has already created divisions among health care professionals and first responders invited to the meeting.

“My fear is that if they give the Narcan out there, the death rate will actually go up,” said Deputy Fire Chief Terry Walsh, who oversees Portland’s Medcu unit.

Walsh worries that providing Narcan to addicts will discourage addicts from seeking rehabilitation.

Walsh also said Narcan needs to be administered by professionals. Close medical attention to the victim is essential because Narcan’s effect wears off before the heroin does, he said.

Addicts, Walsh said, may not know how to deal with Narcan’s cardiac-related side effects, and may administer it too quickly, causing vomiting and possible asphyxiation.

But Kim Johnson, director of Maine’s Office of Substance Abuse, said a Narcan program would save lives.

For some people who overdose, she said, it may be the difference between life and death because the people around the victim may not call public authorities for fear of being implicated.

Johnson dismisses the idea that Narcan would keep people addicted or cause an increase in overdoses.

“When they overdose, it’s an accident. It’s not the goal of taking drugs. The goal is to get high,” she said.

Addicts would not be given Narcan blindly but would be trained in its use, she said. The program could help draw addicts “into the system” and pave the path for rehabilitation, she said.