Within the past month, the apparent heroin overdose death of a popular actor, Philip Seymour Hoffman, and the alleged demise of 22 western Pennsylvania residents from fentanyl-laced heroin in the Pittsburgh area, have focused the public's attention on the dangers associated with drug use and abuse.
While the problems of celebrity and metropolitan area drug problems often gain headlines, Blair County Coroner Patricia Ross this week released more than 200 reports of deaths her staff investigated last year, and they show that drug abuse locally differs very little from what is occurring nationwide.
Blair County, which in the past has faced a wave of deaths from illegal street drugs like heroin, is now seeing the fatal abuse shift to prescription drugs.
Mirror photo by Gary M. Baranec
Deputy Coroner William Forsht digs through a collection of prescription drugs confiscated by the coroner’s office on Wednesday. Forsht said one possible cause of overdose is people overusing time-released painkillers to alleviate discomfort.
Ross's reports listed 27 drug overdose deaths, an increase from 20 in 2012. The drugs involved were "all over the board," she said.
Ross said there were five heroin-related deaths, but most of the overdoses involved prescription drugs.
The overdose deaths, listed as "accidental" by the coroner, are not being caused by any one drug but by many different substances.
Many of Ross's deaths are categorized as due to "multi-drug use."
She reported on one death in which the individual had consumed alcohol, amphetamines, marijuana, cocaine and two painkillers.
Cambria County Coroner Dennis Kwiatkowski related the same story as Ross. The number of drug overdoses in his county doubled in 2013 from 25 to 50, and much of that abuse is related to prescription drugs - drugs recommended by doctors.
People taking drugs is "part of our culture," the Cambria coroner said, and he could offer no easy answer to why it is occurring.
He is the secretary-treasurer of the Pennsylvania Coroner's Association, and he said the problem is "just overwhelming."
In Centre County, the increase in drug overdose deaths related to heroin is on the rise, said Coroner Scott Sayers.
His data from 2013 has not yet been finalized because he is awaiting reports surrounding some of the deaths, but he said in the three preceding years, deaths due to heroin were very few - two, one, and three, respectively.
As of August, the number of heroin deaths in 2013 stood at seven, and he suspects when the final tally comes in for the past year, that number will be much higher.
Not just statistics
In talking to Ross and a member of her staff, Deputy Coroner William Forsht, it becomes evident that they are not relishing the statistics that are emerging. They are concerned, and they are touched by the scenes they must deal with when an overdose death occurs.
Forsht, who was on duty last week in the county's new morgue on Fourth Street in Altoona, across from UPMC Altoona, said people are dying from "anything and everything."
While nobody seems to have a complete answer why the deaths are occurring to many middle-aged and older residents due to prescription drugs, Forsht offered some insight.
He said people, for instance, are prescribed medication for pain that has become overwhelming.
They take a prescribed pill, but the pills, he said, are time-release, which means they don't alleviate the pain immediately, so the individual takes another pill and then maybe another, until the number has exceeded the prescribed dose.
The overdose of medication can affect the heart and breathing, he said, resulting in death.
The apparent overdose death of Philip Seymour Hoffman was an example of a person who is often addicted going to the extremes.
News descriptions of the scene depicted Hoffman lying on the bathroom floor with a syringe in his arm.
Fifty packets of heroin were in his apartment, according to police. The apartment was littered with empty syringes, prescription drugs and many empty plastic bags, police said.
Police arrested four individuals and charged them with allegedly supplying the deadly combination to the actor.
Altoona detective Matthew Starr is investigating a death that follows the same pattern that was on display in the apparent death of the famous actor.
It involves 32-year-old Amet Ramazan Latifi, 32, who lived in the Juniata section of Altoona.
He was not a Blair County native, but he was here working at a pizza shop.
When he didn't appear for work, a friend and co-worker went to his apartment to check on him.
When nobody answered, the friend went back to work and then returned to the apartment. This time, he opened the apartment door and found Latifi "inside and unresponsive," according to an affidavit Starr filed for a search warrant of the Latifi apartment.
He was on a mattress in a sitting position, bent at the waist and face down.
Police found an empty Fentanyl package on the table next to the mattress, two burnt spoons and a syringe on the floor behind a dresser. Police found another syringe and several empty small plastic bags.
Also discovered were two empty Suboxone packages in a room next to the bedroom.
He died, according to the coroner's ruling, of an overdose of Fentanyl.
Deputy Coroners Gil Barton and Forsht arrived to remove the body, and when they did, an officer observed a syringe in Latifi's right hand, according to the affidavit.
This occurred Nov. 10, and as of this past week, the detective was still investigating the death.
The search warrant he obtained has enabled him to review the contents of two cellphones he found in the Latifi residence.
He is seeking the person who provided Latifi with the prescription drug that killed him.
If a suspect is pinpointed, the charge will be "drug delivery resulting in death," a violation of Pennsylvania law.
Starr, a veteran officer having served 14 years with the department and 10 years as a member of the West Drug Task Force, said he will continue to pursue leads in the case.
The police don't give up on these cases, he said.
Starr was working last week to solve another drug overdose case from 2010.
While drug deaths typically don't get much public notice, Forsht attested to their horrific nature. Sometimes the syringes are sticking out of people's arms.
One man, he said, died while chewing a Fentanyl patch. It was still in his mouth when he was found.
Working for change
Ross's reports list a medley of prescription drugs that caused deaths in 2013. Hydrocodone killed a 48-year-old male.
An elderly woman died from a Cardizem overdose, a drug used for the heart. This was an unusual death because it was an unintentional overdose while the woman was under treatment in the hospital. Ross listed the death as a "therapeutic misadventure."
Other deaths were attributed to Valproic Acid, a mood stabilizing drug, methadone, morphine, Zanex, and alcohol. A 59-year-old man died when, under the influence, he fell and hit his head. Various painkillers were also involved, but many of the deaths were classified by Ross in her reports as "multi-drug toxicity," "combined drug overdose," or just "multi-drug."
The drug problems in Blair County and at the state level have not gone unnoticed.
Ross said Pennsylvania coroners and medical examiners are required now to fill out a report any time there is a death due to a drug overdose.
The report is to be sent to the Pennsylvania Department of Drug and Alcohol Programs.
The website for the Pennsylvania Coroners Association confirmed the new policy.
It stated, "Pa. coroners and medical examiners are now required to file reports in drug-related fatalities once the final cause and manner of death have been determined. ..."
Carey Miller, a spokeswoman for the department, said the idea is to collect information that is forwarded to a Drug Overdose Rapid Response Team.
That group is trying to find ways to prevent overdoses and also to detect trends and provide information to local authorities on possible problems.
The 22 Fentanyl-heroin deaths in western Pennsylvania represented an example of the type of the crisis that the group responded to.
The information, she said, is sent to police, hospitals and other authorities as an alert.
A nonprofit group called Drug Free Pennsylvania is another example of an organization that tries to stay on top of the drug problems throughout the state.
Scott Serafini, an organization employee, said the Hoffman and Western Pennsylvania deaths demonstrate the epidemic nature of heroin in the nation and in Pennsylvania.
He and his organization said heroin addiction in 80 percent of the cases begins with the use of drugs like OxyContin, Percocet or Vicodin.
Many of the pain medications were developed to aid those with cancer, but Serafini said that some doctors now prescribe those drugs for much less severe pain. He mentioned a toothache.
People, when becoming addicted to the prescription drug, often turn to heroin because it is easier to get and lower in price than the prescribed drugs, Serafini said.
Serafini makes the point that those addicted to drugs are, as individuals, not bad people.
His organization believes the user should be treated.
"It's a disease," he said.
Drug Free Pennsylvania also focuses on prevention, offering programs to businesses on how to address drug problems.
It offers a media literacy program for educators and prevention specialists, discussing how songs that glorify drugs and other media items can affect people.
The organization holds seminars for parents, teachers and others, urging them to pay attention to what's happening with drugs.
"A lot of parents don't realize what the problem is like," he said.
They tend to say it isn't their problem and don't pay attention, but Serafini said the death of a middle-aged, wealthy movie star shows that drug deaths are not just limited to the urban poor.
There are no specific demographics - race, age, economic class - that the drug overdose epidemic does not touch, he said.