HEROIN DEATHS DECLINE PUZZLES OFFICIALS

Westmoreland County officials are wondering what has led to an
apparent drop in the number of deaths related to heroin this year --
the first apparent decline in the fatalities since 2002.

County coroner records show that through October, there were 29
accidental drug overdose deaths, 16 related to heroin or methadone, a
synthetic form of the drug often used to treat heroin addicts. A
determination remains to be made by the coroner's office in eight
other possible drug cases this year.

In 2006, the number of accidental drug and heroin-linked deaths
peaked in the county, with 55 drug overdose deaths, 32 of which were
tied to heroin or methadone.

Paul Cycak, Westmoreland County chief deputy coroner, guessed the
decline in deaths might be related to the type of heroin being used
or its concentration. Another might be more awareness about how to
handle drug overdoses, he said.

"The only thing I can think of is, either they're cutting it more or
they're getting them to the hospital sooner," Cycak said.

In late 2006, law enforcement officials were concerned that a bad
batch of heroin was in circulation after seven people died in a week.
In June 2006, nine people died in Allegheny County from a deadly mix
of heroin and the pain reliever fentanyl.

Westmoreland County Detective Tony Marcocci, who said heroin use in
Westmoreland County is "at the same level" as in the past, "or
increasing slightly," speculated that alternative drugs might be a
factor in the decline in heroin-linked deaths.

"Possibly, because there are more methadone clinics opening up,
people are seeking help," he said.

Stacy Kriedeman, of the state Health Department, agreed that
prevention programs might be a reason for the drop.

"It's difficult to say why heroin-related deaths have dropped in
Westmoreland County," Kriedeman said in an e-mail. "A number of
factors could be involved in this area as well. The drop in deaths
could be related to increased access to methadone and buprenorphine
treatment programs, access to better health care, and prevention activities."

Cycak and Marcocci said quick responses by medical personnel might be
preventing heroin deaths.

Greg Stull, advanced life support coordinator for Mutual Aid
Ambulance Service based in Greensburg, said his group's statistics
cannot be easily broken down to show the number of drug overdoses
that are handled or the type of drug or drugs involved. Most are
related to heroin.

"That is the one we encounter the most," Stull said.

Often, if paramedics suspect a patient is suffering ill effects from
an opiate-based drug, they will immediately administer Narcan, a drug
that counters the effects of heroin, Stull said.

Stull said his impression is that Mutual Aid, which makes about
65,000 trips annually in covering about two-thirds of Westmoreland
County, has been fielding fewer cases related to heroin use.

After heroin deaths raised a concern in the county in 2002, they
steadily increased for the next four years, according to the county
coroner's office.

In 2002, 12 of the 22 drug overdoses in the county were linked to
heroin. In 2003, 13 of the 33 drug deaths were tied to heroin. In
2004, there were 35 drug overdoses, with 15 tied to heroin. The next
year there were 50 overdoses, 21 related to heroin.

The number of taxpayer-paid admissions to treatment facilities in
Westmoreland and Fayette counties also are down slightly, although
the state number continues to increase.

Public-paid admissions in Westmoreland County declined from 562 in
fiscal year 2004-05 to 510 in 2005-06 -- the most recent year
available in records from the state health department. Fayette County
admissions went from 230 to 141 during the same period.

The number of public-paid admissions to treatment facilities went up
in the state for the same period.

Records show that in fiscal year 2005-06, there were 26,616
public-paid admissions related to opiates in Pennsylvania, up from
25,435 the previous year. In 2003-04, there were 25,045 admissions,
compared to 19,710 in 2002-03.