HEROIN DEATHS INCREASE AMONG OLDER USERS

Coroner Reports 7 Victims Last Year Were At Least 55

A recent comeback in the use of heroin in this region is not only killing
teens and the middle-aged but, increasingly, older addicts too.

Consider the death of Kenneth Pernock, a 63-year-old Army veteran and
bachelor who lived over a Greenfield bar. In August, coroner's deputies
found him dead next to a syringe containing "clear liquid." The death was
due to heroin.

Jesse Short, 56, met a similar end. At 10 a.m. on Sept. 29, Short's
common-law wife checked him into a rehab clinic at UPMC McKeesport.
Strip-searched and admitted, Short stopped breathing about three hours
later while seated in a chair. Authorities believe he took one last dose of
heroin that was undiscovered in their search.

Though heroin addiction is a tragedy for anyone in its clutches, it can be
particularly poignant and tragic for older users. Often they battle a
lifetime addiction and, in some instances, succumb to its deadly consequences.

Last year, 120 Allegheny County residents died of heroin overdoses. Of that
group, seven people, or 6 percent, were 55 and older.

The seven deaths equals the total in the same age bracket who died from
heroin overdoses from 1993 to 2000. Until 2001, Allegheny County averaged
one heroin overdose per year among residents 55 and above.

Experts say the upsurge in heroin fatalities among older addicts is partly
attributable to the potency of the drug now available.

In the late 1970s, during another period when heroin use spread across the
country, heroin was almost exclusively injected. Back then, the drug was
cut and recut with talcum powder, sugar or mannitol, a crystalized
sweetener derived from alcohol. At most, its ratio was 5 percent heroin to
95 percent of other ingredients.

Today, the ratio has nearly flip-flopped. Some officials put heroin purity
as high as 90 percent. Chuck Kritko, deputy director at the Allegheny
County Department of Laboratories, which oversees testing of seized street
drugs, said a $10 stamp bag of heroin, a tiny amount which measures about
an eighth of a teaspoon, is up to 75 percent pure.

In an age of quick fixes, these days a heroin high is just a sniff away.
That's because higher purity heroin, which is more potent and potentially
more lethal, can be inhaled rather than injected, the main method of taking
lower-purity heroin. Users, in other words, can bypass the rigmarole
associated with intravenous use.

Still, most longtime users, some of whom became addicted while soldiering
in Vietnam, remain needle users, said Jan Kusserow, coordinator for the St.
Francis Methadone Maintenance Clinic.

Moreover, addicts have greater access to treatment and are living longer,
sometimes into their 80s.

"It used to be that people addicted to heroin died when they were 30,"
Kusserow said. "We used to say they'd either end up in jail, an institution
or dead. A lot of the time it was the latter, dead."

Now, of the 250 clients who go to her clinic for regular doses of
methadone, a third are 55 or older, she noted. Most were hooked in their
teens and 20s.

Some who live longer may have started out as "chippers," someone who takes
the drug in fits and starts.

"They use it here and there and then stop. Then they'll start again," she
explained. Although the chippers hope they can avoid addiction by
infrequent use -- and some do -- usually their hope isn't realized.

"It's a little more insidious because [chippers] don't think that they're
as bad as those who use every day."

Older users are also wiser users, which contributes to their longevity.
"When a young addict hears that someone died of an overdose, he'll say
'Where can I get some of that?' The elderly have a tendency to be more
careful."

Another explanation for the longevity of older addicts is that, unlike
cocaine and alcohol addiction, heroin does not damage the body to the same
extent. If he can get clean needles and enough heroin, a user could live
out his life without physical consequence, said Allegheny County Coroner
Dr. Cyril H. Wecht.

"More heroin abusers die from the diseases of the lifestyle than from the
injections," he said. An illustration of how long heroin users can live,
Wecht noted, was Sir Arthur Conan Doyle, the Sherlock Holmes creator and
known opium addict, who died at age 71.

On the other hand, older abusers are less able to bounce back than younger
ones. Dr. David Rottinghaus, a toxicology fellow at Allegheny General
Hospital, said young patients arriving at the emergency room in the throes
of drug overdose pop back into consciousness and survive as soon as he
injects an antidote like Narcan.

The older abuser isn't so fortunate.

"If they have an overdose, their body can't recover as easily," he said.

Recovery in any form is beyond the reach of some users, who develop a
lifestyle around heroin.

Such was the case for the late George McDonald, 55. His sister said the
first sign she had of her brother's drug abuse was when he stole from her.

"I knew [he was using drugs] when he stole my radio," said his sister,
Eloise, recalling its disappearance some 30 years ago. He had already quit
high school and gotten a job in a Homestead steel mill. She also knew he
was using drugs by the company he kept. George ran with young drug dealers.

He steadfastly rebuffed the pleas of family members that he seek treatment.
And yet, he had the heart of a teacher.

"When he would be in jail just for overnight, the younger guys would come
to him and say, 'Old Head' -- that's what they called the older guys in
jail -- 'Read this, Old Head. What that say?' He would read their charges
to them," Eloise McDonald said. Their illiteracy dismayed him, she recalled.

"He would say, 'The young users [don't] even know how to read,' " said
Eloise McDonald, who lives in Homewood. "They didn't even know the charges
against them. They don't even know how bad it was for them."

But George's heart, however full it may have been, stopped beating on the
Sunday morning of Nov. 25 and his girlfriend found him on the living room
floor. The couple had gone out drinking the night before and she was used
to him passing out after such an evening. The girlfriend didn't try to
rouse him until morning.

George was dead when Eloise and a brother arrived at the house.

"He told [the girlfriend] 'Never call the paramedics 'cause you know what
I'm doing,' " Eloise said. "If I ever said anything about going for
treatment he would get mad. 'He'd say, 'What ' you mean I need to go to
some rehab. There's nothing wrong with me.' All we could do was hope and
our hope ended that Sunday morning."