By Jonathan D. Silver
Pittsburgh Post-Gazette
Copyright 2006 P.G. Publishing Co.
Pittsburgh police have confiscated more than 1,000 packets of the type of fentanyl-laced heroin suspected of causing up to six overdose deaths in Allegheny County since Sunday, but it was unclear how much of a dent the seizure would put in the supply on the street.
During a news conference yesterday, police revealed few details about their activities — including a large bust Monday in Hazelwood that netted 1,050 stamp bags of the deadly brand of heroin marked “Get High or Die Trying” — but said a dramatic slowdown since Monday evening in 911 calls for heroin overdoses might be related.
However, some investigators believe the confiscation of 1,131 stamp bags overall of the potent heroin and two other types that have appeared in recent days might represent only a drop in the bucket of the lethal supply.
Despite the seizures, the street price remains at $10 to $15 a stamp bag, which could indicate that the amount of “Get High or Die Trying” available in Pittsburgh has not dried up.
With intense police scrutiny in Hazelwood and the Hill District, where the heroin has been concentrated, dealers are going underground, making it a bit more complicated for users to score their next fix.
Authorities cannot be certain that any deaths this week are related to overdoses of heroin until toxicology tests are completed to show the presence of drugs in the blood. That process could take weeks.
However, based on circumstances, it is believed that at least five fatalities among more than 40 people who have overdosed in Allegheny County since Sunday are related to a batch of heroin that police first became aware of Friday.
On Sunday, Joseph Zielinski, 45, of Penn Hills, was found dead in his Greenfield apartment. The next morning, Lynn A. Margavo, 30, was found dead in her home in the 5200 block of Gertrude Street in Hazelwood. An hour later, Dorothy Iannone, 56, of the 5100 block of Roma Way, also in Hazelwood, was found dead.
Yesterday at 12:25 a.m., Diane Pless, 20, of the 4700 block of Centre Avenue in Oakland was found dead by her boyfriend in her apartment. And at 1:20 a.m., Lawrence Jordan, 48, of Ravine Street in Munhall was pronounced dead in his bathroom after being discovered by his girlfriend.
In Mr. Jordan’s case, investigators recovered a stamp bag. The name of the brand was unreadable, but it was in red ink, a hallmark of how “Get High or Die Trying” is packaged.
A sixth death in Aspinwall from yesterday was being looked at in connection with the heroin overdoses, but the Allegheny County Police are not convinced the case is linked.
The county’s crime lab has concluded that fentanyl — a painkiller 80 times stronger than morphine — was present in one sample of “Get High or Die Trying.” A sample of another brand called “Dynasty” also linked to recent overdoses tested positive only for heroin, said Dr. Frederick Fochtman, the county’s chief toxicologist.
A third brand of heroin has come up in the investigation of the overdoses, but narcotics Cmdr. Maurita Bryant would not name it.
Police yesterday revised the number of suspected heroin overdoses being investigated. As of yesterday afternoon, there were 33 in the city and nine in the rest of Allegheny County. Two more possible cases emerged late yesterday. One involved an inmate at the intake area of the county jail yesterday afternoon. Last night, around 11 p.m., police and paramedics responded to an apartment in the 5700 block of Phillips Avenue in Squirrel Hill for a reported overdose. A white male in his 20s was taken to Mercy Hospital where he was expected to recover, paramedics said.
Overdose cases spreading
Non-fatal overdoses possibly connected to the laced heroin continued to spread to additional communities outside the city, including Clairton, Mt. Oliver and West Homestead. All the victims have been white and between 16 and 56 years old.
In the West Homestead case, a 20-year-old man from Castle Shannon was found Monday at 2:15 a.m. after shooting up in his car in a KFC parking lot on Eighth Avenue, West Homestead police Chief Christopher Deasy said.
The man was hospitalized, and two stamp bags were found. A woman in the car said the heroin was bought in Homestead, Chief Deasy said.
Homestead police Chief Jeff DeSimone said his officers have not encountered any overdose victims from the batch of heroin making the rounds — yet.
“We’re keeping our fingers crossed,” Chief DeSimone said. But, he added, “It’s kind of inevitable.”
Dr. David Murray, senior policy analyst with the Office of National Drug Control Policy in Washington, said the fentanyl-laced heroin has turned up in eight states and caused between 150 to 350 deaths nationwide.
He said the pattern of deaths, which started in Chicago and Philadelphia, is following known routes of heroin distribution.
The drugs flow into major cities like Chicago, which become hubs, and then trail out to smaller cites like spokes on bicycle wheels.
Dr. Murray said it would be hard to say what effect the closing of a drug lab in Mexico, which might be the source of the fentanyl, would have on the current overdose outbreak.
“We are trying to put out as much of a public health alert out there that says ‘look there is something very risky out there,’” said Dr. Murray.
Fentanyl side effects
One of the side effects of fentanyl is that the body’s muscles often instantaneously stiffen when it is injected into the bloodstream.
“It is so rapid acting that the addict is often found dead with the needle still stuck in their arm,” he said.
Tom McElree, director of the regional Emergency Medical Services Institute, an agency that provides training and other services to emergency medical services in 10 counties in southwestern Pennsylvania, said the Pennsylvania Department of Health received a notice April 25 of “opioid” overdoses that had occurred that month in New Jersey.
Those overdoses involved some heroin and a mixture of fentanyl or methylfentanyl and procaine, a version of the anesthetic lidocaine.
He said his office is working to get a handle on overdoses in the region and statewide so it can help paramedics and emergency service professionals react properly to the outbreak.
Pittsburgh narcotics and homicide detectives on Saturday launched a joint investigation of the new brand of lethal heroin. Detectives are interviewing overdose survivors. Three drug dealers have been arrested, but police would not provide their names.
The U.S. Drug Enforcement Administration is also involved, but DEA Special Agent Rick McGoldrick in Philadelphia declined to provide specifics.
Although there is an awareness among drug users that “Get High or Die Trying” might prove fatal, many are enticed by the prospect of an incredible high rather than scared away by the potentially lethal consequences.
“Individuals who are addicted to heroin are actively seeking this drug,” Cmdr. Bryant said. “The word is out on the street that it’s pretty much the ultimate high.”
Lt. Kevin Kraus said hardcore users seem to be shrugging off efforts to steer them away from the powerful heroin.
“It doesn’t seem that any warning is successful at all,” Lt. Kraus said. “It’s a very addictive drug, and it’s in great demand right now.”
Heroin addicts often lose the ability to get high on their normal doses and long for the euphoria that first drew them in. The increased potency of the fentanyl-laced heroin is nearly irresistible for serious users, who need more and more of the drug to satisfy their addiction and avoid pain, said Dr. Neil Capretto, medical director of Gateway Rehabilitation Center.
“They’re looking for a stronger effect,” he said. “Many people say, ‘I started using to get high, and now I use to get by.’ ”
Even after they are treated for an overdose, users will often immediately return to the drug and even overdose again, trying to alleviate the withdrawal symptoms caused by reversal agents.
“It feels like the worse case of the flu you’ve ever had, times 10,” Dr. Capretto said of withdrawal. “It’s like having your head in a vise and knives in your stomach.”
People who elect to use the new heroin are essentially playing Russian roulette, Dr. Capretto said, because it is impossible to determine whether the heroin has been laced with anything and how strong the drug will be.
“Addiction is not logical,” said Dr. Capretto. “People will keep using. They say, ‘I know I’ll lose my job, my wife, my family, but I just can’t stop.’”
Moustafa Ayad, Ryan Haggerty and David Templeton contributed.