Drugs Rank as Western Pennsylvania's Top Killer

Article excerpt

James "Tinny" Trasp was motionless and blue in a chair at his wife's makeup stand in their Jefferson Hills bedroom. His wife, Toni, frantically pumped his chest in a futile attempt to restart his heart. A syringe lay nearby.

"Somewhere along the way he started using intravenous drugs," said Toni Trasp, recalling that afternoon of July 25, 2008. "I didn't know about it. I had no clue."

To outsiders, Trasp, 49, a father of two, seemed unlikely to die of a drug overdose. He was white, middle-aged, an iron worker who lived in Jefferson Hills, a middle-class South Hills suburb.

Yet a computer-assisted examination by the Tribune-Review of Allegheny County Medical Examiner records from 2006 through 2008 reveals the circumstances of Trasp's death are not unusual.

Drug overdoses killed about 650 people in that period -- more than murders and car crashes combined, records show. That does not include 70 drug-related suicides during that time.

The drugs most often involved came from the medicine cabinet, not street corners.

"If it's not blunt-force trauma, not homicide and not an obvious suicide, I almost just assume it's going to be a drug overdose," said Dr. Karl Williams, the county medical examiner. "That's how frequent of an experience it is here."

The perception that drug addiction and deaths largely affect inner-city black men couldn't be further from the truth, Williams said.

The Tribune-Review analysis shows:

2 of 3 deaths involved at least one prescription drug.

4 of 5 victims were white.

7 of 10 were men.

2 of 3 victims lived in the suburbs.

Between 1990 and 2006, prescriptions for painkillers nationwide increased tenfold, according to the U.S. Centers for Disease Control and Prevention.

Overdose deaths increased about fivefold during that same span, the CDC reported.

"There is no real mystery here of where (the overdose deaths are) coming from," Williams said. "It's in exact correlation with the prescribing of these drugs."

Fatal overdoses here have quadrupled since the 1980s, when the county averaged 58 a year. Drug deaths topped 100 for the first time in 1998; four years later, the figure doubled to more than 200 annually. It has not dropped below since.

Drugs and suburbs

Twenty-five years ago, it was rare for a National Honor Society student from an upper-middle-class family or a 45-year-old accountant with an MBA to fatally overdose, said Dr. Neil Capretto, medical director of Gateway Rehabilitation Center, which has 20 locations in Western Pennsylvania and Ohio.

"Now, it is commonplace," he said.

Nearly 7 million Americans abuse prescription drugs -- "more than the number who are abusing cocaine, heroin, hallucinogens, ecstasy and inhalants combined," according to the federal Drug Enforcement Administration.

Between 1992 and 2008, the percentage of people 50 and older seeking drug-abuse treatment nearly doubled, according to a recent study from the Substance Abuse and Mental Health Services Administration. Alcohol still leads admissions, but sharp increases were seen in the number of people seeking treatment for heroin, cocaine and marijuana, the study noted.

Hydrocodone, which includes the name-brand drug Vicodin, is the most-commonly abused pharmaceutical in the United States, according to the DEA.

It ranked fourth locally on the list of most-common painkillers discovered by toxicologists in medical examiner's cases, trailing methadone, oxycodone and fentanyl.

Those narcotics are manufactured to mimic pain-numbing properties found in opium, the source of heroin. Once metabolized by the body, heroin turns into morphine. Such was the case for Trasp.

A combination of hydrocodone and morphine was found in Trasp's body, a toxicology report showed.

"We now have a record number of people addicted to heroin in Western Pennsylvania, and the majority started on prescription drugs," said Capretto, who estimates he has treated more than 1,000 people who became heroin addicts after starting with narcotic painkillers. …