Overdoses a top killer in county

Jennifer Learn-Andes

February 10, 2013

White Haven residents Theresa and Mark Metzo stayed actively involved in their son’s activities, stressed the danger of drugs and gathered their family around the kitchen table nightly for dinner and conversation.
Heroin still claimed 20-year-old Branden.
They believe he first tried heroin in February 2011, and by that August he died of an overdose.
“That’s how quickly it can happen, how fast it can take a hold of them,” Theresa Metzo said, using family photographs to show the increasingly gaunt appearance of Branden during the span.
After deaths from natural causes, drug overdoses are the leading killer of Luzerne County residents.
About 610 people have died from taking a lethal dose of drugs – usually heroin – over the last decade in Luzerne County, according to the coroner’s office. Annual overdose deaths ranged from 45 to 69 since 2002, with 66 last year, county statistics show.
“I don’t think the average person in Luzerne County realizes that we’re dealing with these kinds of numbers,” said William Lisman, the county’s acting coroner.
He usually encounters one of two extreme reactions when he visits the loved ones of the deceased. “They go from total shock with no idea their loved one was using drugs to an absolute stoic resolve that they knew this was coming,” he said.
He finds the latter scenario most depressing. “I’ve had so many say their loved one was in treatment several times,” he said. “Many put themselves financially on a shoestring to support a loved one’s treatment. They knew death was coming, and they were powerless to stop it.”
The deceased have been “all ages and from all socio-economic groups,” he said. “I’ve been in some very nice-looking homes with some very wonderful parents.”
Heroin is involved in 70 percent of the overdoses, he estimated.
His office conducts toxicology screens and blood tests to determine the types of drugs and levels in a deceased person’s system. Most laboratory results indicate the presence of multiple drugs, or “poly-pharmacy,” he said.
“It’s few and far between that there’s only one drug,” he said.
Lisman randomly picked out a recent screening that showed heroin and five other drugs. Another involved heroin and codeine. He wishes he knew a solution.
“If I could figure out a solution, I’d write a book,” he said.
Hazleton Area students
Last year, six Hazleton Area High School students were simultaneously in treatment for heroin addiction at Serento Gardens Drug and Alcohol Services, said agency director Ed Pane. All six had progressed from snorting the powder to injecting it.
Two of the students were in academic advanced-placement classes, and another had been awarded a college scholarship.
Pane can’t forget the faces of the parents of one 16-year-old honors student. The couple was “crushed to the point they were physically ill” when the boy’s concerned friends reported his heroin use to them.
They had no idea.
“This is an all-American family that went to church and had family dinners every night,” Pane said, noting the boy is doing well in recovery.
The heroin peddled in this region is cheaper than marijuana and many other drugs – and more potent today, Pane said.
Five years ago, a bag of heroin typically sold for $30 in the Hazleton area, he said. Because of increased supply, a bag now sells for $10 on average, he said. One addict told him he was able to buy 10 bags for $50, or $5 a bag.
“I literally felt I was going to vomit when I heard that price,” he said.
When Pane started working in the drug addiction field 37 years ago, the heroin sold in the region was 4 to 6 percent heroin and the rest filler. “The heroin today is about 80 percent pure because there’s such a supply and competition for customers,” Pane said.
Heroin addiction is the leading cause of admissions to drug treatment in the region, he said, describing it as a statewide and national problem. Pane advises people to be on alert if a loved one becomes more secretive, has glassy eyes and pasty skin, is losing weight or has small bruises or marks in the crook of the elbow.
Heroin also can be smoked after it’s cooked on a piece of foil or object such as a spoon. Most people start heroin by snorting, with the “illusion” they can’t get addicted if they don’t inject.
Trying heroin is like “stepping into a bear trap that shuts on them and doesn’t let go,” he said.
“The first time the person may not be addicted to the point of withdrawal,” said Pane, “but the craving and desire for more is powerful and draws the person back. And before they understand what happened, they are physically addicted.”
Heroin emergence
Heroin was barely on the radar screen when Carmen Ambrosino entered the drug addiction treatment field four decades ago. “It’s gone from a drug that was obscure to our number-two drug,” said Ambrosino, head of Wyoming Valley Alcohol and Drug Services Inc.
Alcohol continues to hold top addiction distinction locally.
Wyoming Valley drug users are encountering heroin with purity ranges from 65 percent to 90 percent, he said. “One hit of heroin can be fatal,” he said.
Methadone clinics and doctor-prescribed buprenorphine have successfully helped some recovering heroin addicts, but Ambrosino said he warned years ago these alternative treatments were not “silver bullets.”
“We still have an unacceptable number of overdose deaths,” he said. “We still have a major problem, and we did not get our arms around it as a culture yet.”
The same struggle is playing out across the country, he said.
Faced with an influx of a particularly potent black tar heroin cut with prescription drugs in Portland, Maine, public health workers there are distributing posters warning of the danger and how to avoid an overdose. The suggestions: don’t use alone; do a “tester” shot; avoid mixing drugs and assume a “recovery position on the side with the head resting on an outstretched arm to avoid choking on vomit.”
Ambrosino believes his agency’s 10 full-time prevention workers assigned to public schools offer one of the best lines of attack to prevent future addicts. They try to help children improve their self-esteem, decision-making skills and ways to cope with stress and struggles without chemicals, he said.
“When I’m asked what child is at risk, my answer is every child is at risk,” Ambrosino said.
Young father’s life
Branden Metzo had become a father shortly before he started heroin; he went to rehabilitation three times, trying to develop the strength to resist the drug, his parents said.
He was showing promise of staying clean but crumbled after a beloved neighbor suffered a stroke. Mark Metzo, a former municipal police officer who now works as a forest fire warden, said he and his wife were well-versed on drugs and the importance of setting boundaries, so they weren’t enabling Branden’s drug use.
At one point, Theresa Metzo even resorted to trailing him like an undercover detective to make sure he wasn’t lying about his whereabouts.
But in the end, loved ones often are powerless to force addicts to stop.
“It has to come from within the addict,” said Mark Metzo. “You have to want it to work. He tried. He tried.”
Theresa Metzo, a store clerk, kept her son’s bedroom exactly as he left it, though she recently forced herself to pick up his dirty clothes. She bought new Christmas tree ornaments because she can’t yet face the box containing Branden’s holiday mementos.
When she needs to hear his voice, she plays his last cellphone voice message, in which he tells her he loves her.
Mark Metzo bowed his head, tears welling in his eyes, when she played the recording last week.
“I wouldn’t wish this on my worst enemy,” said Theresa Metzo. “I’d do anything to have anyone not endure what we had to endure.”
She means it. The Metzos have diverted their rage and grief into Branden’s Heart, a drug awareness and prevention organization. (Visit www.brandensheart.org.)
Pane is so impressed with the group, Serento Gardens is pushing for the creation of more chapters in other communities, including Freeland and Hazleton.
The Metzos and other Branden’s Heart volunteers already have taken concrete measures to attack drugs in the White Haven area:
• Reactivating the borough crime watch.
• Scheduling Al-Anon meetings for family members of addicts.
• Acquiring former modular classrooms from the Hazleton Area School District that will be used for a community youth center in White Haven.
• Holding informational forums and parent support group meetings.
• Encouraging families to enjoy activities such as ice cream socials.
Mark Metzo said the region must get over the shame of talking about addiction, to help erase the stigma.
“I don’t know a single person who is not touched by addiction in some way,” Theresa Metzo said.
Death spawns action
West Pittston resident Carol Coolbaugh’s son, Erik, also was among the county’s 611 overdose deaths in the past 10 years, and she didn’t hide the cause of his 2009 death in his obituary.
“I wanted people to know he died after a battle with addiction,” she said. “He was a sweet person, but he had an addiction.”
Erik’s 18-year drug use culminated with an overdose of cocaine and methadone.
Like the Metzos, she is trying to help others through her support group – Grief Recovery After a Substance Passing, or GRASP – for the loved ones of deceased addicts. The group meets at 7 p.m. the second and fourth Wednesday of the month at First Hospital Wyoming Valley on Wyoming Avenue in Kingston, in the first-floor Davis Conference Room.
About five to eight people typically attend the support group meetings, but Coolbaugh believes some seats remain empty because people are still afraid to come forward.
“It’s still very shameful,” she said. “Nobody wants to say their kid or spouse is a drug addict. People judge you.”
She believes much of society forgets that addicts are people. While the initial decision to try drugs might have been a conscious choice, the dependence becomes a “health issue” like any other disease, she said.
“It’s an epidemic, and if it was an epidemic of the flu,” she said, “everybody would be talking about it.”