ODs are down amid signs of recovery in hard-hit neighborhoods, but the region’s opioid binge still leaves a trail of heartache.
Shawn Wypych used to buy drugs at the house on Carrick’s Kirk Avenue, in which he now sits on dusty furniture in a gutted room. Though he’s been off dope since August, he plans to move in, and soon.
The house itself has been in recovery since May, when a platoon of men and women started cleaning up and remodeling a place that, per Mr. Wypych, used to be “totally disgusting.”
“The carpets were disgusting. The walls were disgusting,” he recounted in November, as he sat in one gutted room. “You could hear kids crying back here,” he said, gesturing toward an area that used to be a disgusting kitchen.
Today the Kirk Avenue property is the latest addition to a network of “serenity houses” for recovering drug users. It’s also a concrete symbol of an uneven and fragile regional recovery from an opioid binge that started to take its toll in 2014, when fatal overdoses in the state’s southwestern corner exceeded 500 people. Last year, in the same nine counties, drugs took more than 1,400 lives.
While a final count of 2018’s fatal overdoses won’t be available until spring, it’s likely that Allegheny County — which typically accounts for half of the regional drug death toll — will see its first decline since 2013. According to Dr. Karl Williams, the county medical examiner, there’s strong evidence that 2018’s total may more closely resemble 2016’s tally (650), than last year’s record-smashing 737.
That’s one of several statistical suggestions that the opioid epidemic may have peaked for the region as a whole. Those who have long battled the effects of pills, heroin and fentanyl, though, are warning that this is no time to let up. And for the many families affected by the past decades’ surge in narcotics, recovery is just beginning.
The Pittsburgh Post-Gazette chronicled the epidemic’s effects on the city’s southern neighborhoods in a series titled Riding OD Road, and on children, parents and grandparents in another series, The Needle in the Family Tree. Some of the people described there are recovering. One is imprisoned, another is dead, and several are mourning. The last two conditions reflect one grim factor in the drop in overdoses.
“You have to realize that we lost a lot of people,” said Dr. Karen Hacker, director of the Allegheny County Health Department, “and those people cannot die again.”
Finding a purpose
“I actually overdosed on [Brownsville Road],” said Mr. Wypych, 24, originally from Belle Vernon. “Found dead. Down close to Brentwood.”
He was revived, of course, but not all are so lucky. Carrick and the neighborhoods to its north — Knoxville, Mount Oliver, Arlington, Allentown, Beltzhoover — have seen the most drug deaths (194) of any ZIP Code in the county since 2008.
In August, Mr. Wypych was strung out in the South Hills and struggling to find a recovery house that would accept him and his dog. “Everyone’s like, ‘No, no, no, no,’” he said. Finally, he called Gus DiRenna. “And Gus is like, ‘Yeah, bring your dog.’”
“Big mistake!” Mr. DiRenna, 59, quipped. Off drugs since 2010, he’s the wise-cracking recovery director of the ARK Allegheny Recovery Krew and Serenity House Recovery Homes.
Mr. DiRenna took Mr. Wypych into one of his houses in Carrick, and bunked in the next room during the difficult beginning of the young man’s recovery. In November, Mr. DiRenna moved into the mostly-remodeled Kirk Avenue house, along with two other recovering men, with Mr. Wypych and others to follow as the work progresses.
Mr. DiRenna is involved with nine serenity houses in which nearly 30 recovering users get their own rooms, unlike the three-to-a-bedroom arrangements at some three-quarter houses. Serenity house tenants pray together and support each other, and many are employed improving other houses.
“Before long they feel like they have a purpose, and their life is going to unfold into something good,” he said.
His chief collaborator, Rev. Jay Geisler of St. Peter Episcopal Church in nearby Brentwood, bought the Kirk Avenue house. His congregation has invested heavily in recovery housing, and they’re open to donations of money or material.
“It really blows my mind,” said Mr. Wypych, of the disgusting drug house that has flipped so dramatically. “Three years ago, the only thing was to destroy your life, to get drugs, destroy your life, kill yourself, you know what I mean? And now it’s like, instead of killing yourself in this house, you’re learning how to live in this house.”
Several of the men and women working at the Kirk Avenue house said they wouldn’t be alive today if it weren’t for naloxone and a loved one, friend or first-responder willing to use it. Often referred to by the brand name Narcan, naloxone reverses opioid overdoses, and has helped to curb the death toll.
“When you think about naloxone, to me, that’s been a dramatic attitudinal change, in like, two years,” said Dr. Hacker. As recently as 2017, there was sentiment in some neighborhoods that drug users should be left to fate if they kept overdosing. Lately, she said, “We don’t hear any of that.”
Since October 2015, anyone in Pennsylvania has been allowed to buy naloxone. It took years for the supply to ramp up.
Kits distributed by Allegheny County Health Department in 2018*
“Saves” made — almost all by other opioid users — using naloxone distributed by Prevention Point Pittsburgh since 2017
Naloxone kits left at scenes of overdoses by Pittsburgh medics since February
Source: Allegheny County Health Department, Prevention Point Pittsburgh, City of Pittsburgh Public Safety Department
*Correction, posted Dec. 27, 2018: In an earlier version of this story, the number of naloxone kits distributed by the Allegheny County Health Department was micharacterized. 6,400 kits of naloxone, which reverses opioid overdoses, were distributed in 2018.
Prescription opioids, blamed for luring more Americans into narcotics addiction, still factor into around one in five of the region’s overdoses, according to data on OverdoseFreePA.org, run by the University of Pittsburgh’s School of Pharmacy. Opioid prescribing is down, though, by about 23 percent in Pennsylvania since August 2016, when the state required that doctors first check patient drug histories. Alice Bell, Prevention Point Pittsburgh’s overdose prevention project coordinator, has heard injection drug users say, “I saved four people last week,” and knows one needle exchange client who has administered naloxone to overdosing acquaintances 28 times.
“I think it’s taken a really long time, but people recognize that this is a public health crisis and are beginning to treat it as such.”
Drug treatment appears to be on the upswing. In Allegheny County, 9,396 people got publicly funded rehab from mid-2017 through mid-2018. That’s up 20 percent from two years prior, according to the Department of Human Services.
The concept of a “warm handoff,” in which emergency rooms steer overdose survivors directly into treatment, has caught on in the county, to the tune of 220 such referrals this year through September, according to the state Department of Drug and Alcohol Programs.
The city launched a Post-Overdose Response Team, consisting of a person in recovery, a community medic and a police officer, who would reach out to survivors and try to help them. PORT never took off in the way expected, and the city is weighing other approaches, said Laura Drogowski, critical communities initiatives manager for Pittsburgh Mayor Bill Peduto.
On the plus side, she’s seen an increasing recognition in city neighborhoods that addiction isn’t primarily a law-and-order issue.
“I think it’s taken a really long time, but people recognize that this is a public health crisis and are beginning to treat it as such,” Ms. Drogowski said. “I think addressing overdose deaths is step zero. It’s the absolute minimum.” Heroin addiction still harms many, she said, and the deadly synthetic fentanyl isn’t going away.
Ms. Bell said that users “are probably becoming more savvy about how to use fentanyl.” Prevention Point gives out fentanyl test strips which help users to detect the drug that is often added to, or substituted for, heroin. Find the fentanyl, and a smart user can inject less, avoiding overdose.
Finding the unicorn shoes
Late last year, Jessica Webber’s daughter, Kennedy, then 6, brought a grim report back from a supervised visit with her father. “She said, ‘Mom, daddy’s gray,’” Jessica recounted. “And I said, ‘What do you mean, baby?’ And she said, ‘He’s gray. You need to help him.’”
Ms. Webber knew what that pallor meant: heroin. She tried to reach her ex-boyfriend, Gary Fisher, but he didn’t respond. “It was about two weeks later I got the phone call that he’d passed away,” Ms. Webber said, as she sat behind her McKeesport home. “And Kennedy said, ‘I told you he was sick, and I asked you to help him.’”
Four weeks before his death, Mr. Fisher’s videotaped description of overdosing and addiction appeared in the Post-Gazette’s Riding OD Road.
“He was very happy about telling his story,” said Ms. Webber. “He was very happy about trying to help other people.” He just couldn’t help himself.
Kennedy, now 7, had been a regular visitor to the Allentown homes of her father and his relatives since she was a toddler. Mr. Fisher’s on-and-off romance with heroin, the 14 non-fatal overdoses that he blamed on fentanyl, eventually cost him most of his custody rights — but never obliterated Kennedy’s love for him.
After her father’s death, Kennedy “held everything in for a good two months,” said Ms. Webber. “Didn’t break down. Didn’t ask questions. And then all of a sudden it hit her at once.”
Around Father’s Day, Kennedy told her mother that she’d seen her father, sitting in a chair. She’d wilt when one of her five step-siblings would note that she was the only one without a dad. Then came the school bus incident.
“She has a bandana that was Gary’s, it was his blue bandana, and she would always have his bandana in her bookbag,” said Ms. Webber. Two older kids on the bus asked her about the bandana, and she told them, “’That’s my dad’s and he died.’ And they started picking on her and hit her in the head and told her, her dad can’t protect her.”
Ms. Webber now drives Kennedy to and from school. She also takes her daughter to events for survivors, and hunts down gifts that Mr. Fisher had promised, like a pair of hard-to-find unicorn shoes.
At the same time, the 30-year-old mother was dealing with her own father’s addiction — which took a sudden turn.
“He was on a binge,” Ms. Webber said of her father. There were signs that things were about to get worse. “I made my dad watch Gary’s interview with [the Post-Gazette] and my dad chose to go to recovery. … My dad went to treatment, and it was because of Gary’s story.”
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A better person
Around 30 people gathered for the December meeting of the Carrick Overbrook Block Watch — a poor turnout, but another number made up for it.
“If you look at the crime stats sheet [for November], we only have one page for Carrick,” crowed Carol Anthony, longtime leader of the block watch, presiding over her final meeting in that role. “I don’t think we’ve ever had only one page before.”
Ms. Anthony, of Overbrook, who revived the block watch in 2011, said the neighborhood is in a better place than it was last year, when Riding OD Road brought some 100 angry residents to her monthly meeting. Young people are getting involved in neighborhood groups, economic development is kicking into gear, and holiday activities that had fallen by the wayside are back, she said.
Public safety demands down
Drop in the number of police responses to overdoses — fatal and nonfatal — in Pittsburgh’s Zone 3, which includes Carrick, through late November of this year vs. last year
Drop in crime in Zone 3 over the same period
Drop in city paramedic responses to OD calls, through September of this year vs. last year
Source: Pittsburgh Public Safety Department
Last year’s blotters occasionally referenced the 100 block of Santron Avenue, where the center of heroin’s gravity was the home of Glenn Jeffries. In August 2017, Jenn Dolton, 35 and a mother of two, visited Mr. Jeffries’ house, and was later found two doors down, dead from an overdose. A few months later Mr. Jeffries, now 42, checked into rehab. Sixteen months ago, the blotter passed out to the block watch was three pages long, including 12 non-fatal overdoses to which police responded. There was just one OD on the November list.
“Well, as you see, my trips to rehab October, November, December  didn’t work out for me. I walked out all three times,” he wrote to the Post-Gazette, from prison, last month. In February, he was arrested in Clarion County and charged with theft, recklessly endangering another person and other counts for cutting down telephone lines, in an apparent effort to get metal to sell. He’s now serving three to six years.
That’s three or more years without hugs from his two daughters, who may be adopted by his friend and former landlord. “I won’t sign the papers,” he wrote, but that may not save his tenuous parental rights.
“I believe I am done with the drugs,” he continued. “I had a chance to do some in here a few times and turned them down, so I felt good about that. … I look at this as maybe I’ll be a better person when I leave.”
‘I’ll serve cookies’
There’s no hard evidence that illegal opioid use is down, said Aaron Arnold, executive director of Prevention Point Pittsburgh. “If people are going to survive overdoses, then we have to start thinking about all of the other things that may affect their health and the health of the communities in which they’re living,” he said.
Mr. Arnold would like to see the withdrawal prevention drug buprenorphine — often referred to by the brand name Suboxone — become much more available, including via mobile clinics. Police and courts should have more non-jail options for users, he added. And he spent much of the summer trying to win city approval to bring his agency’s needle exchange van to a parking lot on Spencer Avenue in Carrick.
Intravenous drug users sometimes share needles, putting them at risk of contracting HIV, Hepatitis C, and bacteria that can cause problems all the way up to endocarditis, an infection around the heart. Needle exchange is meant to reduce the spread of disease, and can be a bridge to treatment.
The Health Department approved needle exchange in Carrick, but City Council did not. Mr. Arnold said that talks are underway that could have the needle exchange van somewhere in the South Hills by spring.
Needle exchange “is pretty harmless,” said Councilman Anthony Coghill, who represents Carrick, as well as Beechview and Brookline, which have also seen scores of overdoses. However, he added, “we got petitions of people who just weren’t happy — the neighbors — and I didn’t feel right saying, ‘Ah, the heck with what the neighbors think.’”
Some neighbors “said that it would bring the druggers into the area,” said Donna Williams, a Carrick woman who lives a few blocks from the nixed Spencer Avenue needle exchange site and is stepping down from a longtime role on the Zone 3 Public Safety Committee.
She disagrees with those neighbors. For a neighborhood struggling with substance abuse, to reject Prevention Point is “like calling the cavalry and shooting them when they come,” because needle exchange can be a pathway to rehabilitation.
“I told them, ‘You know what? Park [the van] outside of my house,’” she said. “Park it in my driveway. I’ll make coffee. I’ll serve cookies.”
The pain isn’t going away
After waking up covered with bruises one April morning, Raven Iandiorio, 35, escaped from a Beechview house in which, she said, she was a virtual prisoner of her addiction and her hosts. She made it to UPMC Mercy Hospital, where her raging infections were treated before she was transferred to a nursing home.
Mid-autumn found her at Gaudenzia Erie, a rehabilitation center where, she said, she had just had “a great visit” with her younger daughter. She said her older daughter was proceeding with caution. “I don’t blame her because I’ve been in and out of her life for a long time, because of the opioid use.
“But she’s slowly coming back around. She’s finally saying ‘I love you’ back to me now.”
One thing Ms. Iandiorio brought up in group therapy sessions was the December 2017 death of her friend, Danielle Walker. “She’s part of my story.”
Ms. Walker, 37, was hanging out with Ms. Iandiorio the evening before she overdosed at the Beechview apartment of Vincent Zeitlman. Ms. Walker’s body was later found outside of the apartment, in an icy, concrete pathway. In October, police accused Mr. Zeitlman, 47, of moving the body, charging him with abuse of a corpse and tampering with evidence.
“I think the only reason they made the arrest was because I kept bugging them,” said Donna Walker, Danielle’s mother.
Though she’d pushed for Mr. Zeitlman’s prosecution, it has not eased her pain. “It’s just not gotten much better. I don’t know how people do it,” she said.
“You still get overwhelmed with emotion for no reason. It just doesn’t go away,” Marty Walker, Danielle’s father, added.
The couple recently moved themselves and their 10-year-old granddaughter, Isla Capri, who goes by Izzy, out of the South Park house in which Danielle was raised, to Ohio Township. They’re trying to negotiate a visitation agreement with the adoptive parents of a grandson they’ve never met.
Izzy has settled into her new school, joining a group for girls called ROX, for Ruling Our Experiences. She dresses and holds her old dog, Rooney, as if he was a baby. She and her grandmother play video games, do yoga, and go through old photos, putting them into collages, including one featuring lost loved ones.
“And I asked [Izzy], ‘What are you thinking when you see this?’” Donna recounted, as she looked at a collage including photos of Izzy’s mother, Danielle, and father, Shaun Urcini, who also died from an overdose last year. “And I saw her start trembling, and she just bawled her eyes out.”
It was Izzy’s first big cry. Until recently, said Donna, “I don’t think she understood that she’s never going to see them again.”
Design, Development Zack Tanner