Pa. drug crisis takes a turn for the worse

State. LV-area coroners can’t agree on deaths

SCHUYLKILL COUNTY — She was a licensed practical nurse with red hair and a bubbly personality who lost her license because of addiction, and she had come home to live with her parents in a small Schuylkill County town.

Her father found her unresponsive in her bedroom before dawn on Jan. 25, 2020. Her mother — who did not want the family identified publicly out of fear of retribution — said she was told her daughter had “enough fentanyl in her system to kill five people.”

But even though the Schuylkill County coroner’s office has classified the tragedy a drug death, the state Department of Health has not.

The Morning Call, which sought drug death information from both the state and county coroners, found 108 fatalities in the first half of 2020 in the Lehigh Valley region where coroners called the situation a drug death but the state did not.

One reason is the state does not include deaths caused by drugs but classified as homi

cides in its data. That was the case with the 26-year-old nurse, whose mother said Schuylkill County Coroner Dr. David Moylan labeled the death a homicide.

The newspaper sought data from coroners and the state in the absence of any publicly available figures on the 2020 toll, despite signs the drug crisis is worsening during the pandemic.

Coroners from the eightcounty Lehigh Valley region — encompassing Lehigh, Northampton, Bucks, Montgomery, Berks, Schuylkill, Carbon and Monroe counties — gave figures for the first six months of 2020 that add up to 553 deaths.

The Department of Health, following multiple inquiries from the newspaper, provided information that shows 445 overdose deaths in those same counties during the same period.

The department said it uses a case definition for overdose deaths provided by the U.S. Centers for Disease Control and Prevention “specifically designed” to identify deaths from acute drug toxicity.

“The overdose surveillance performed by the Department of Health specifically excludes ‘drug-related’ deaths, where drug use may have led to another condition that caused the death, but acute toxicity did not cause the death,” the department noted.

Examples would include deaths caused by infections triggered by use of needles, or by motor vehicle accident injuries where the person was under the influence at the time of the crash.

The department also excludes deaths in which coroners have ruled the “manner” of death was homicide or suicide, even if the cause of death was drugs.

A worsening crisis

By either measure, the drug crisis worsened significantly in early 2020.

The coroners’ drug death figures increased by more than 19% from the first six months of 2019, while the state-supplied figures increased by more than 11%.

The opioid-driven drug crisis was formally declared a disaster by Gov. Tom Wolf in early 2018, and he has periodically renewed that declaration. In 2020, though, its severity was obscured by the COVID-19 pandemic that the state has blamed for more than 23,000 deaths.

On Thursday, the legislative agency Center for Rural Pennsylvania held a public hearing in which state Secretary of Drug and Alcohol Programs Jennifer Smith said drugs are killing 13 Pennsylvanians a day.

Smith also said the death toll for 2020 could end up surpassing the 5,456 drug deaths in 2017, which was the worst year so far in the opioid-driven drug crisis.

Center board member Sen. Katie Muth, a Chester County Democrat, said prior to the hearing it is important to have timely data on deaths to know how severe the crisis is.

“I would argue there needs to be a monthly release of this data” either by the state or by coroners, Muth said. If lawmakers or other public officials make decisions in the absence of reliable data, she said, “You are just flushing money down the toilet.”

Muth said the conflicting numbers brought to mind last year’s attempt by the Legislature to get coroners more involved in counting COVID-19 deaths. A bill that would have strengthened the role of coroners — who questioned the accuracy of state data — passed both the House and Senate but was vetoed by Gov. Tom Wolf.

“I trust the coroners,” Muth said. “The coroners have some really down-in-the-weeds information. We saw that with COVID.”

The president of the Pennsylvania State Coroners Association, Chuck Kiessling of Lycoming County, said his members have the most accurate information.

“We are looking at the stuff, day in and day out, he said.

Another Democrat on the center board, Rep. Eddie Pashinski of Luzerne County, said the effects of COVID-19 on those struggling with addiction is clear.

“They can’t get to their counseling. They don’t have the one-on-one,” Pashinski said. As a result, in terms of making a comeback from drug use, he said, “There is a piece of the puzzle that is missing.”

The longtime chairman of the center board, Republican Sen. Gene Yaw of Lycoming County, sounded a similar note. COVID19 shutdowns, he said, have crimped the “social animal” nature of many vulnerable people.

“We need contact,” Yaw said.

Child tragedy

One of the 11 drug deaths in the first half of 2020 included in data Carbon County Coroner Robert

Miller gave the newspaper was that of a 3-year-old child who ingested drugs.

State data shows only 10 overdose deaths in the same period for Carbon. Miller identified the child’s case as the one-case difference, because it was ruled a homicide.

The data given by the coroners to the newspaper was not entirely uniform. At least one coroner, for instance, did not include drug deaths classified as suicides.

In Schuylkill County, though, 30 of the 68 drug deaths in the first half of 2020 were homicides and three more were suicides, a coroner’s office spokesperson said.

Those 33 go a long way toward explaining why state data shows 16 overdose deaths in that time period, while the county coroner’s data shows 68.

Moylan, the coroner, said late last year that drug deaths in his county are skyrocketing.

Just over a year after the overdose of fentanyl and methamphetamine claimed her 26-year-old daughter, the Schuylkill County woman said no one has been charged in the case.

“I have a lot of unanswered questions that I have come to realize I am not going to get answers to,” she said.