A view of Washington, Pa. Last week, Washington County recorded 16 overdoses in 24 hours and 25 over two days. Three people died. (Marvin Joseph/The Washington Post) 
 
 The first call came at 7:33 p.m. last Sunday: Two people had overdosed on heroin in a home just a few hundred yards from the station where firefighters were awaiting their nightly round of drug emergencies. 
 
 Six minutes later, there was another. A 50-year-old man had been found in his bedroom, blue from lack of oxygen, empty bags of heroin by his body. 
 
 At 8:11, a third call. Then another, and another, and another and another. 
 
 By 8:42 — 69 minutes after the first report — a county of slightly more than 200,000 people had recorded eight overdoses, all believed to be caused by heroin. There would be a total of 16 overdoses in 24 hours and 25 over two days. Three people died. Many of the others were saved by a recent decision to equip every first responder with the fast-acting antidote naloxone. 
 
 The toll wasn’t from a supply of heroin that had been poisoned on its journey from South America to southwestern Pennsylvania. Nor was there an isolated party where careless junkies miscalculated the amount of heroin they could handle. Last week was simply an extreme example of what communities in parts of the country are enduring as the heroin epidemic rages on. 
 
 Valerie Mack, left, is comforted by family friend Carla Stormy Efaw in Washington, Pa. Mack lost her brother, Sammy Mack, to a heroin overdose. (Marvin Joseph/The Washington Post) 
 
 “It’s absolutely insane. This is nuts,” said District Attorney Eugene A. Vittone, a former paramedic who is trying to hold back the tide of drugs washing across Washington County, a Rust Belt community 30 miles south of Pittsburgh. On any day, Vittone said, the county averages five to eight overdoses, almost all from heroin. More are recorded each day in towns just over the county line. 
 
 “There’s been a progressive increase in overdoses the last two years, and it just went out of control,” added Rick Gluth, supervising detective on Vittone’s drug task force. “I’ve been a police officer for 27 years and worked narcotics for the last 15, and this is the worst. I’d be glad to have the crack epidemic back.” 
 
 [Cheap fix: Heroin’s resurgence. ‘And then he decided not to be’] 
 
 The United States averages 110 overdose deaths from legal and illegal drugs every day. The heroin death toll has quadrupled in the decade that ended in 2013, according to the Centers for Disease Control and Prevention. By all accounts, it has only grown worse since. In Washington County, there have been more than 50 fatal overdoses this year. 
 
 The national drug-death total, larger than that from auto accidents, is disproportionately concentrated in the Rust Belt, the Great Lakes region and the Northeast. 
 
 “There is a growing sense of community outrage that we can’t accept this like we are accepting it,” said David J. Hickton, U.S. attorney for western Pennsylvania and co-chair of the National Heroin Task Force established by the Justice Department in April. “We just can’t go on like this.” 
 
 In this working-class community near the Monongahela River, where drilling for gas deposits has begun to stoke an economic revival, there is little sign that anything will change soon. 
 
 This man who only wishes to be identified as Sonny, learned that his daughter had a heroin overdose at a nearby Walgreens store in Washington, Penn. (Marvin Joseph/The Washington Post) 
 
 “I’m destroyed. I’m totally destroyed,” Valerie Mack said Thursday on the front porch of the home she shared with her brother and several other people on a modest block here. 
 
 Her brother, Sammy Mack, the second overdose victim in the Sunday night skein, was found dead in his bedroom, curled in a fetal position. Near his body were “stamp bags” of heroin — small paper packets that most closely resemble chewing gum wrappers. They bore the supplier’s brand, “MADE IN COLOMBIA.” 
 
 The label is one of two flooding the area, Gluth said. The other is stamped “BLACK JACK.” Authorities are still investigating but believe both types of heroin are laced with fentanyl, a powerful synthetic opiate that increases the drug’s potency and may have contributed to the rash of overdoses. 
 
 Sammy Mack had long had problems with alcohol and was not unknown to law enforcement authorities. But as so many others have, his sister said, he turned to heroin after treatment with narcotic painkillers prescribed for an ankle injury he suffered a few months ago. Mack’s divorce was recently finalized, she said. His four children are living with his ex-wife not far away. 
 
 [When life begins in rehab: A baby heals after a mother’s heroin addiction] 
 
 As he began to use heroin, Mack’s habits and personality changed, she said. He became withdrawn, spending more time in his room. That Sunday, she was fixing him a chef’s salad and became suspicious when he didn’t respond to her calls. She tried to push open his bedroom door but couldn’t. A neighbor finally forced his way in. 
 
 Mack’s prized possession, a Harley-Davidson motorcycle, still sits in the home’s back yard. He had promised it to his 14-year-old son upon his high school graduation. “I’ll just have to follow through,” Valerie Mack said. 
 
 With so much awry in Sammy Mack’s life, his sister said, “Maybe the Lord intervened and decided just to take him.” 
 
 Jessica Neal, 26, another of last week’s overdoses, is still alive after a close call. She was found unconscious in a bathroom at a local Walgreen’s on Monday, her 2-year-old strapped in a stroller in the stall with her. She was revived with naloxone. 
 
 Her father, Sonny, who has a different last name that he requested not be used to protect his privacy, said he threatened to have her committed to the psychiatric unit of the local hospital that same day after Neal spoke of committing suicide. Instead, she agreed to sign herself in. She was released Friday and headed to jail. The child is in her father’s care, he said. 
 
 “She doesn’t need jail,” Sonny said outside the home where the two lived with Sonny’s wife, who suffers from amyotrophic lateral sclerosis (ALS), until last week. “She wasn’t out stealing or doing crimes. What she needs is help. She needs to be in rehab. And after rehab, she needs to be in a halfway house.” 
 
 Nationally, there are only a small fraction of the inpatient drug rehab beds needed for addicts, but Hickton, in an increasingly common stance for prosecutors, has agreed that users need help more than they deserve incarceration. Even as he has stepped up prosecution of dealers, he is taking a multifaceted approach to the current problem. 
 
 “If they’re using and trafficking, I prosecute them,” he said. “If they’re just using, they need help.” 
 
 Hickton promises to bring homicide charges against any seller he can link to a death. But that is easier said than done. There are no open-air drug markets in this epidemic like the ones that captured public’s attention during drug outbreaks of past decades. Much of the commerce is conducted on cellphones and by word of mouth. 
 
 With many more middle-class people addicted via prescription opioids this time around, heroin is bought and sold in bars, nightclubs, homes and more unlikely places, said Neil Capretto, an addiction psychiatrist and medical director of Gateway Rehabilitation Center, which has 20 locations in the Pittsburgh area. 
 
 Gluth said he has undercover detectives all over the streets making buys, painstakingly working their way up the chain in search of bigger dealers. 
 
 He believes the latest load of heroin came from New Jersey, but Washington County’s location makes it particularly vulnerable to drug traffic. Not far from the Ohio and West Virginia borders, it sits at the intersection of Interstates 70 and 79, east-west and north-south conduits for drugs and everything else. Vittone said the county receives drugs from New York, Newark, Washington, Chicago, Detroit and elsewhere. 
 
 “We’re kind of like ground zero,” he said. 
 
 On the streets here, prescription drugs are selling for about $1 per milligram, or $20 for a single dose. Heroin is much cheaper, at about $8 a stamp bag, Gluth said. It is also much more potent than the heroin of previous eras, Capretto said. Users often start with a single bag, but as their resistance grows, they need increasing amounts. 
 
 All of which signals more overdoses and deaths, at least until authorities can find ways to stem the demand and the supply. 
 
 “If we had a serial killer killing one-tenth as many [people], we’d have the National Guard here,” Capretto said. “We’d have CNN here every night.” ||||| Sign up for one of our email newsletters. 
 
 Fed up with the rising number of opiate overdoses in Western Pennsylvania, an Allegheny County judge is making convicted drug dealers buy lifesaving naloxone kits for the communities where they've sold drugs. 
 
 Judge Anthony Mariani has added the fine to two cases in the past week, ordering Andy Buxton to pay a total of $2,650 to three agencies in the Mon Valley and Larry Richardson to pay $1,250 to Ross/West View EMS — $50 for each brick of heroin the men were convicted of possessing with the intent to distribute. 
 
 Naloxone, known by the brand name Narcan, can reverse the effects of opiates such as heroin and halt an overdose. 
 
 “Ordering the defendant to provide funds for naloxone to the relevant agency will help to rehabilitate him and change his thinking,” Mariani said Tuesday while sentencing Richardson, 41, of Ross on two felony counts of possession with intent to deliver. He ordered Richardson to serve five to 10 years in prison. 
 
 Ross police found a bag with 25 bricks of heroin and 9 grams of cocaine in Richardson's car. 
 
 Fatal drug overdoses in Allegheny County increased 37 percent between 2014 and 2015, for a total of 422 deaths last year, according to an analysis by the Drug Enforcement Administration, which Mariani cited as his reason for imposing the fine. Westmoreland County overdoses increased 43 percent to 126 deaths in the same period. 
 
 Westmoreland County judges have yet to impose similar sentencing conditions. Judge Meagan Bilik-DeFazio said Mariani's plan is interesting and worth considering. 
 
 “The fact is that naloxone is saving lives. I wonder if maybe we should consider ordering the addicts to have naloxone. Having it in more hands is all the better,” said Bilik-DeFazio, one of the county judges who presides over a drug court program. 
 
 Tim Phillips, executive director of the county's drug overdose task force, said making convicted drug dealers provide money for life-saving naloxone kits is a novel approach. 
 
 “This is the first I've heard of it, and I'm sure it could have a positive effect. It could be part of the solution. Anything that will save a life is worth considering,” Phillips said. 
 
 Richardson, who is black, maintained his innocence and said the crisis of overdose deaths was only a result of people noticing more drug abuse across racial groups. 
 
 “It wasn't a problem when my dad and my uncle were OD'ing in the community back in the '70s and '80s,” he told Mariani before his sentence. “We didn't have Narcan. ... Now all of a sudden because it's young white people coming into the city for drugs, it's a problem.” 
 
 Mariani's naloxone fine is a condition of the defendants' probation and consecutive to their prison time, so they won't have to start paying until they have been released. In Richardson's case, Mariani allowed him to pay a minimum of $100 per month once he's out of prison and has secured employment. 
 
 The $1,250 Richardson must pay is little compared with the $20,000 Ross/West View EMSA pays for medical supplies each year. Executive Director Brian Kircher said it could offset some of what the agency puts toward helping overdose victims. 
 
 “We don't get reimbursement from insurance for patients we don't transport. The majority of overdoses end up being refusals (for transport),” he said. 
 
 Ross/West View EMS has carried naloxone for more than 20 years, Kircher said, and was starting to train police in the region on how to administer the drug nasally in cases in which they arrive at an overdose before medics. 
 
 Dr. Karen Hacker, director of the Allegheny County Health Department, said over-the-counter naloxone kits cost about $75, though police and EMS agencies might be able to get them for less through bulk buying, insurance coverage and grants. All EMS agencies typically carry the drug. 
 
 Mark Bergstrom, executive director of the Pennsylvania Commission on Sentencing, said imposing the fines is within the judge's power, though he was not sure whether the law allowed the fines to be steered to specific agencies. 
 
 Mike Manko, spokesman for the Allegheny County District Attorney's Office, declined to comment on the fines but noted that a grant from the Pennsylvania District Attorneys Association allows the office to purchase naloxone kits for county police departments. 
 
 Rich Cholodofsky contributed. Matthew Santoni is a Tribune-Review staff writer. ||||| New Jersey governor wants 'czar' to encourage towns to share services 
 
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 Two drug counselors overdosed and died at a halfway house in Chester County on Sunday. Police found drug paraphernalia near their bodies. 
 
 Two counselors at a halfway house for recovering addicts in Chester County died Sunday of drug overdoses, the county District Attorney's Office said Wednesday. 
 
 Residents found their counselors unresponsive in two bedrooms at Freedom Ridge Recovery Lodge in West Brandywine Township around 2 p.m. They tried to revive one with a nasal spray of naloxone. When the counselor did not respond, the residents called 911. 
 
 The counselors, who lived and worked at the home, were pronounced dead at the scene. Their names were not released. 
 
 Police found used needles and heroin baggies near the bodies in the bedrooms. Both tested positive for heroin and fentanyl, according to preliminary toxicology tests. 
 
 "If anybody is wondering how bad the opioid epidemic has become, this case is a frightening example," Chester County District Attorney Thomas Hogan said in a statement. "The staff members in charge of supervising recovering addicts succumbed to their own addiction and died of opioid overdoses." 
 
 Freedom Ridge operates out of a home used as a halfway house for six men in a residential area. 
 
 Chester County detectives and the West Brandywine Township Police Department are investigating. 
 
 The fatal overdoses follow the deaths last week of an advocate for safe injection sites for heroin addicts in Philadelphia and the cofounder of a Bucks County drug treatment program, both from overdoses. 
 
 An earlier version of this story identified the bags of heroin found near the bodies by symbols on them. At the request of Drug Enforcement Administration officials, who say addicts will actively seek out heroin that has reportedly killed others, the photos and identifications were removed. ||||| Heroin is cheaper and easier to get than beer in Pennsylvania, and the people selling it use sophisticated methods on par with the biggest retailers. 
 
 Those are among the conclusions of a state agency which complied a report and recommendations based on a series of informational hearings held around the state this summer. 
 
 Heroin addiction was long associated with inner cities. 
 
 But the Center for Rural Pennsylvania concluded there is a current "epidemic" that crosses all geographic, economic and racial boundaries, with scores of people becoming addicted and dying in suburban and rural communities. All parts of the state, including its most rural counties, are affected. 
 
 The center's report, called "Heroin: Combating this Growing Epidemic in Pennsylvania," says 80 percent of people using heroin first became addicted to a prescription opioid painkiller such as OxyContin or Vicodin. It said nearly 3,000 Pennsylvania residents have died over the past five years because of abuse of heroin or other opioids. A packet of heroin capable of producing a high lasting about five hours costs $10 or less, said a speaker at an event held to release the report on Tuesday morning. 
 
 State Sen. Scott Wagner, R-York County, who spoke at the event, said York County has been hard hit by the epidemic, with 31 confirmed and six suspected heroin overdose deaths so far this year, up from 17 in all of 2013. 
 
 A group of legislators at the event cited the need for an aggressive and far-reaching effort to combat the problem. This must include local communities, churches, schools, police and state lawmakers. 
 
 The legislators called for immediate approval of several pending bills that would: create a statewide prescription drug database to flag people who might be addicted to prescription opioids or obtaining them for illegal uses; passing a "Good Samaritan law" to allow drug users to summon help for overdose victims without fear of arrest; and making nalaxone, which can reverse an overdose, available to people such as ambulance crews and possibly to families of addicts. 
 
 One lawmaker stressed we "cannot arrest our way out of the problem." 
 
 Another stressed that more intensive and effective treatment must be made available to addicts. He noted that someone who undergoes a 30-day treatment stay with no other supports is highly likely to quickly relapse. And while providing the necessary treatment will be expensive, it's far less expensive than keeping addicts in jail, the lawmaker said. 
 
 The report says 70 percent of people in jail in Pennsylvania have substance abuse problems. 
 
 Heroin and opioid addiction are being blamed for a wave of petty crimes as addicts steal in order to feed their addition. 
 
 State Sen. John Wozniak, D-Cambria County, said people who are addicted to heroin and other opioids don't want to be addicted, and need compassion and help. He said there must be a major effort within schools to educate young people about the dangers of opioids, and local communities must rise up against the problem. 
 
 "We want to get the dealers out of our neighborhoods and we want to heal the people who are addicted," he said. 
 
 Another lawmaker argued that much of the problem can be traced back to the decision, more than a decade ago, to permit drug makers to market directly to consumers. He said this created an idea, especially among young people who have grown up seeing the ads, that there is a prescription drug remedy for every type of physical pain or mental discomfort. He said that notion must be addressed and dispelled. ||||| HARRISBURG Pa. (Reuters) - Young people in rural Pennsylvania can buy heroin more easily than a bottle of wine and getting high with the opiate can be cheaper than buying a six pack of beer, according to an investigative report released on Tuesday. 
 
 Overdose deaths have climbed steadily since 1990, when drug deaths in rural areas of the state were at one per 100,000 population. As of 2011, that figure stood at 13 deaths per 100,000, the Center for Rural Pennsylvania said in the report. 
 
 "Heroin is cheaper and easier for young people to obtain than alcohol,” said State Senator Gene Yaw, the Republican chairman of the center, a joint legislative state agency. 
 
 Pennsylvania is not alone in its heroin problem. In rural Vermont, Governor Peter Shumlin said his state was experiencing a "full-blown heroin crisis," while the overdose rate in New York City has surged as well, especially in the wealthiest neighborhoods. 
 
 In Pennsylvania, Yaw said a small packet of heroin costs between $5 and $10 and delivers a high lasting four to five hours. 
 
 The report, based on evidence submitted in hearings across the state this summer, listed Cambria County in central Pennsylvania as having the highest overdose death rate outside of Philadelphia, 22.6 deaths per 100,000 population. That is equal to Philadelphia’s drug death rate, the report said. 
 
 Yaw suggested Cambria County’s drug death rate was not caused by any special factors, but state Representative Bryan Barbin, a Democrat, was not so sure. 
 
 Barbin said Johnstown is easily accessible from heroin distribution centers like Baltimore. Dealing heroin is an attractive career option for those with few economic prospects, he said, especially those with drug crime records. 
 
 The report called for a number of legislative actions, including making it easier to prosecute dealers whose customers die of overdoses, and a "Good Samaritan" law assuring that people who seek help for overdose victims will not face criminal charges. 
 
 Putting more addicts in jail will not solve the problem, the report said. 
 
 State Representative Richard Marabito, a Democrat, said Pennsylvania has about 760,000 residents with addiction problems, but that only about 52,000 are receiving treatment. Only one in eight addicts can be helped with existing state resources, the report said. 
 
 (Writing By Frank McGurty)
– The Washington Post takes a look at the country's surging heroin epidemic by zeroing in on Pennsylvania’s Washington County, a place one local detective refers to as "ground zero" for heroin in the area. Last Sunday, in less than 70 minutes, eight heroin overdoses were recorded in the county of about 200,000 people. By a day later, that number had jumped to 16; by two days later, 25—three of which were fatal. As the Post notes, this period of time wasn't an isolated case but rather "an extreme example of what communities in parts of the country are enduring." In a Florida community earlier this month, 11 people overdosed on heroin in a 24-hour span, WKMG reported; this year, Cedar Rapids, Iowa, had seen 44 heroin overdoses by June 5, the Gazette reported; New Jersey saw 781 overdose deaths related to heroin last year, 101.5 reported. Just yesterday, NPR ran a story on Marion, Ohio, a small town whose police chief says that his team sometimes responds to as many as three overdoses in just one hour. One of the reasons heroin is booming: It's cheap—cheaper than the prescription drugs that, for some, start them down the road of addiction. And one of the reasons there are so many overdoses? Nowadays, the drug is even more potent. The US attorney for western Pennsylvania is one of a growing number of prosecutors who aren't interested in jailing users, the Post reports: "If they're using and trafficking, I prosecute them. If they’re just using, they need help," he says. But finding dealers—including any linked to fatal overdoses, who will be charged with homicide—is no easy task, as these days drugs are sold via cellphone or even, with more middle-class people addicted now, in unlikely locations like homes. The county's supervising detective sums up the "out of control" heroin problem: "I'd be glad to have the crack epidemic back." Click for the full Post article.