(Editor’s note: This article was first published in January 2019.)
This is a story about addiction. It’s about people suffering and lives lost to opioids, heroin, and other drugs.
It is a story that many people don’t think much about, because addiction is something that could never happen to them or anyone they care about.
But, in this story, you hear the same thing again and again from people in Centre County who didn’t think it could happen to them – until it did.
You see, this is not just a story about the wrong side of the tracks. This is not like the movies. It can happen to anyone.
This is a story about people in pain, people who are sick. It’s about people who may be looking for a way out; they just might need a chance.
It’s a story of at least 18 people dead in 2018, and more than 50 in the past three years, from drug overdoses in Centre County.
And this is a story without complete answers.
But this is also a story about a community working to help and looking for those answers.
It’s a story about strength and recovery.
This is also a story about hope, but it needs the whole community to care.
For recovery is possible, but it is not easy.
It is impossible to do justice to the memory of someone who is lost, someone whose memory is loved. Too many people have died in Centre County over the past five years from overdoses, and all of them deserve to be remembered.
Pastor Bonnie Smeltzer lost her daughter five years ago. Liz was a fun, caring person, but she struggled to fit in during high school. She had overdosed once before and Smeltzer and her husband, both pastors in State College, were shocked to find their daughter was using heroin.
“People think that heroin addicts, that it would be obvious, that you would be aware that they were an addict, but that is not the case,” Smeltzer says. “We think that she was not a daily user of heroin, but more recreational. The hardest thing is just wondering what she might be doing now if she were still here. What would she be like, what would she be doing?”
She wants people to talk: to talk about addiction, about her daughter, about heroin and opioids.
You can feel the pain as soon as Veronica Gower walks in the door. After driving in from her Clarence home, she apologizes for being late. She just woke up. She didn’t sleep last night and had dozed off. She rarely sleeps much at night anymore; there is too much going on in her head.
Her son Jeremy died almost two years ago from an overdose, and the hurt is still there. She doesn’t think it will ever go away.
She carries Jeremy’s ashes around her neck in a locket that means the world to her.
“He is always with me, wherever I go,” Gower says. Her voice trails off when she says it, and she looks away.
Jeremy was 30 years old when he overdosed in his bed, just before he was ready to make a big life change and come to terms with the person he felt he really was.
Gower plans to be there when a young man is sentenced this spring for selling her son “a bag of death.” She’ll be there so that young man can see her, see the pain he has caused.
Five years after she died from an overdose, Emily Rossman’s room in her mom’s home in Unionville remains the same.
Her mom, Katie Bittinger, found Emily in her bed that morning. Emily was 20 years old. She was beautiful, smart, and caring, Bittinger says. And drugs took her away.
“That smell, her perfume, it is still there. Good memories and bad memories, I guess,” Bittinger says.
Bittinger believes Emily is with her all the time, leaving clues that she is there. She is taking those memories and trying to help others. She is a support for others, such as Gower, who have suffered a loss. She is a wealth of information about opioids and legislation that has passed surrounding it. She is strong and caring.
And, she understands that none of it will bring her daughter back. But she hopes that she can help someone else.
“If we can help one person, than that is something. People need hope,” says Bittinger. “Nobody can hide from this; it affects everybody. Whether you are a janitor cleaning toilets or you are the CEO of a company, you can be affected by this epidemic that is taking over our town.”
It’s easy to see that Amy Mitchell loves her grandson with all of her heart. She speaks glowingly of him and has a warm smile on her face as she shares pictures of the 3-year-old.
Mitchell’s daughter Rebecca Bennet grew up in Bellefonte and the Bald Eagle area; she died last March after years of struggling with addiction. She had gone to rehab and jail many times over the years. Mitchell’s grandson was born while her daughter was on furlough from prison. After his birth, Mitchell brought her daughter back to prison and has been caring for her grandson since.
Her daughter’s struggle with addiction took its toll on Mitchell. It caused emotional stress for the whole family. She tried rehab, she tried everything, but eventually she had to let go, because the pain was too much. The lying, the stealing, the fighting, the worry – it was all too much.
Now she has her grandson. It is a common theme: grandparents raising kids whose parents have been lost to addiction, and it is not easy, Mitchell says.
“I wasn’t expecting this at this time in my life. I did not plan for it; it is not an easy thing to navigate” she says.
But she will always be there for her grandson; he is her whole life now.
Mitchell has set up a support group that meets every other week for grandparents or other relatives in similar situations.
‘Crisis of such magnitude’
On January 10, 2018, Gov. Tom Wolf issued a Proclamation of Emergency Disaster stating that “the opioid crisis is of such magnitude or severity that emergency action is necessary to protect the health, safety, and welfare of affected citizens in Pennsylvania.”
The governor noted that the number of fatal overdoses was rising. In 2016, there were 4,642 fatal overdoes in Pennsylvania, up 37 percent from 2015. Pennsylvania has been hit hard compared to other states, with a rate of drug overdoses at 36.5 per 100,000, more than double the national average of 16.3 per 100,000.
Two days before Wolf’s proclamation, Will Denton, a 19-year-old Penn State sophomore, was found dead from an overdose in his dorm room.
This is young man who was loved by his parents, brother, and friends. He was a good student in gifted classes, got great grades, and he was doing well at Penn State, maintaining a 3.66 grade point average in health policy and administration. Yet, for as bright as he was, his family remembers him even more for being a good person who cared for others. He was deeply involved in Thon. He was Penn State.
“Will’s spirit and love provided a great light in the lives of myself, his mother, and his brother,” says Van Denton, Will’s father. “He rarely walked out of our house without turning to us and saying, ‘I love you.’ Being loved by Will was an amazing gift.”
That was Van Denton’s victim statement used during the sentencing of Mark “Short Rico” Grover, of Pittsburgh. Grover is the one who delivered the heroin and methamphetamine to Will before his death. On December 14, Grover received a 7.5-year sentence for delivering the drugs that killed Will.
A multifaceted approach
“None of them are good stories; none of what we deal with are good stories,” says Centre County District Attorney Bernie Cantorna.
DUI, theft, and crimes that involve getting money to buy drugs are typically the types of offenses committed by people who are using opioids. But, despite all of what he sees every day, Cantorna says he does also see hope.
“Those with a substance abuse disorder can get in recovery and come back to the person they were before. That is one of the things that we have here is the opportunity to save people’s lives,” says Cantorna.
“We cannot arrest ourselves out of this epidemic. … We do actually have resources for people who cannot afford help in treatment; there is help in the county for them through the county drug and alcohol office. They can coordinate treatment for them.
“As bad as it is, and despite every death that we don’t want, we are one of the healthiest counties in the commonwealth, and I think that is not by accident.”
Cantorna pointed to the county commissioners, who provide the resources for the county drug and alcohol office and support the HOPE Initiative. He cited the Centre County Drug and Alcohol Task Force and law enforcement agencies that work together to go after drug trafficking in the county. There are fewer individuals coming into contact with opioids from medical prescriptions than in the past, according to police, because of state laws monitoring prescriptions.
The county set up a drug court this year that looks to provide treatment and intense monitoring to help people overcome their addiction. Cantorna believes the program will be expanded in the future.
His team’s policy is to prosecute a dealer who has supplied drugs that have resulted in the death of another person.
“A common route for people in Centre County is Williamsport, an hour and five minutes, and heroin is readily available,” he says. “Our policy is to investigate those cases to attempt to arrest the person who is selling it in bulk, not the users who are driving in a car and sharing the drugs. That would be an easy prosecution, but that does not get dealers off the street. They come from Williamsport, Johnstown, Harrisburg, Philadelphia. Those are the people we want to prosecute.”
No matter how hard they prosecute and how much time people convicted of dealing drugs serve, the families who suffered a loss will never truly get justice.
“Do those sentences bring a loved one back? Do they make a family feel whole? No, not at the end of the day they don’t. There is no sentence to provide them the justice that they truly desire, which is for their child to still be in this world,” Cantorna says.
A chance for life
Chris Snare will never forget the breathing. Twice coming onto a scene where someone had overdosed, where there was a blue tinge to a lifeless person, the slow, shallow, breathing is the thing that haunts Snare, a Spring Township police officer.
Snare has been on the force for five years and he says the number of situations that he has had to deal with involving opioids has at least doubled. When he or any of his fellow officers are dispatched to an overdose, they carry medical kits equipped with Narcan (naloxone is the generic term), a drug that revives a person who is overdosing on opioids.
After the person wakes up, officers must use caution, says Snare, because suddenly there are EMS and police in the person’s space. It is surely unnerving.
“You come to and there is law enforcement standing over you; you don’t know where you are,” says Snare. “I get it. Anyone would be uncomfortable in that situation.”
The Pennsylvania Opioid Overdose Reversal Act 139 – David’s Law – allows first responders, including emergency medical services, firefighters, and law enforcement, to administer naloxone to individuals experiencing an opioid overdose. The Good Samaritan Law also provides immunity from prosecution for those responding to and reporting overdoses.
The drug counteracts the receptor in the nervous system, reviving a person almost instantly from an overdose.
As Snare described, breathing is the thing. During an overdose, breathing slows down and may eventually stop – this is how people die while overdosing.
After a dose of Narcan, a person should begin to breathe more normally and it will become easier to wake that person. It is very important to give help to an overdosing person right away. Brain damage can occur within only a few minutes of an opioid overdose because of a lack of oxygen.
Frank Cianfrani has been working at Centre LifeLink EMS for 14 years. He says that the number of responses to people overdosing on heroin has increased over the past five years, but he feels it is worse in other parts of the state. Every overdose call is different, he says.
“Sometimes, it can be in the bathroom of a big house; sometimes, you are responding to the side of the road somewhere,” he says. “That is how opioids are. They can affect every demographic.”
It is important for people to call first responders because opioids cause a person’s breathing to slow down and even if naloxone is administered, if the person has stopped breathing, the naloxone will do nothing, he says. There are multiple assessments first responders must make and tools they use to save people who are overdosing.
Cianfrani says frustration comes because once the naloxone takes effect, the person often is able to pass basic orientation tests and EMS cannot take them to the hospital for more help. Soon they might be using again. He has heard the stories of first responders coming back to revive the same person multiple times.
It is a strain on the budget of EMS crews who are not generally reimbursed for such calls. But they will continue to respond, because they treat each call as a chance to save a life in the moment, and they hope that the opioid user gets help.
Snare grew up in Bellefonte and he knows the community.
Snare tells the story of once responding to an overdose involving an acquaintance from high school. It all happened fast in the moment, but he remembered that guy and hoped he wouldn’t be a repeat user.
A few months later, while on shift, Snare stopped at a gas station and that same old acquaintance from high school walked up to him, shook his hand, and said, “Thank you. Thank you for saving my life.”
He didn’t get any more details, but Snare hopes that it was the wakeup call for that person to get help, get into recovery, and have a good life.
On December 13, naloxone was freely distributed around the state by the Department of Health. Forty-one naloxone nasal spray treatments were distributed at Centre LifeLink in College Township. By mid-afternoon, all of the available doses were gone, and people were told to put their names on an email list in case more became available.
A difficult road
Opioids take away pain; they provide an escape from problems. Opioids are in a class of drugs that includes heroin, synthetics such as fentanyl, and pain relievers available legally by prescription, such as oxycodone, hydrocodone, codeine, morphine, and others. They are highly addictive and come with significant withdrawal symptoms.
A common story involves people prescribed opioids to treat pain who then become addicted. This is especially an issue for people who have a propensity to addiction, says Cathy Arbogast, administrator of the Centre County Drug and Alcohol Office. Not everyone has certain genetic factors that play into addiction, but for those who do, using opioid pain medication can lead down a difficult path.
The county has set up drug collection boxes around the community so people can return unused medication, ensuring it does not end up in the wrong hands. The state now closely monitors the prescribing of opioids, and doctors are prescribing them less and less, looking for alternative medications.
When prescriptions run out, heroin is cheaper than buying pills on the street, and that is what many with addictions turn to.
Fentanyl has contributed greatly to the rise of overdoses because it is a very strong synthetic derivative that is easily made by drug dealers. The lethality has increased tenfold, Cantorna says. Overdoses in the county are often a result of multiple drugs in the system.
And, addiction is bigger than opioids, says Arbogast. Alcohol is the most commonly abused drug in Centre County. Methamphetamine use is on the rise. Cyclical drug trends often come down to what is available, she says.
“It is just an incredibly complex issue, not just addiction and the disease itself, but what does it take to recover and are we able to offer people the resources they need to recover? And, how much of it is a result of the way that our society has evolved?” says Karlene Shugars, of the drug and alcohol office. “In the meantime, we battle with what is effective and what is not effective. It is really an insurmountable task. But, yet, there is hope.”
Addiction is a family disease; it is a community disease. It means not only working with the addict, but working with the family and working with the community, realizing it could be a long time before this person can function in society. That is an incredible burden for family members.
“So, how do we create an environment where recovery is the norm, where people are supported in recovery?” Shugars says.
Often, someone in recovery will have burned many bridges and might not have a lot of supporters left, she says. The county offers a wide variety of support – including case workers, meeting housing needs, and helping to find employment – for people in recovery.
A meeting with HOPE
The HOPE (Heroin and Opioid Prevention and Education) Initiative was formed by community leaders a few years ago when the statistics brought to light the cost of drug abuse in the county. In 2016, 22 people in Centre County died from overdoses, and it was more than the county could take. HOPE was formed by county officials and community members in response. The county was a step ahead of many others in the state in seeing a need to address the problem head on, gathering statistics, holding town hall meetings, and working to educate.
The Youth Service Bureau runs a prevention program in local school districts that teaches kids ways to avoid drug addiction. Representatives from the county’s drug and alcohol office, Children and Youth Services, law enforcement, drug treatment centers, the district attorney’s office, Mount Nittany Medical Center, and Penn State, among others, are all part of the initiative, along with parents such as Gower who are working toward a goal of fewer people dying from overdoses.
While HOPE has opioids and heroin in its sights, the overall conversation focuses on addiction in general. With methamphetamine use on the rise, the challenges are different, but just as daunting.
County Commissioner Steve Dershem says the stigma that comes with drug abuse causes people to not get help and not seek treatment. HOPE is working to fix that.
Strength and recovery
For “Adam,” every day is a struggle. But there is hope, and many good things happening in his life. He is happy. He is successful, with a good job at Penn State. He gets to travel for work. He has a nice house and a caring wife. He has love.
But there is always the worry; there is always some pain. He is in recovery for heroin addiction. Each day, there is a pill he must take to make sure that he doesn’t go into withdrawal, a pill he must take so he doesn’t relapse.
Adam – not his real name – asked to stay anonymous in this story. Not that he is ashamed, but because there is still a stigma that comes with addiction and managed treatment like suboxone. Some people feel that people are trading one drug for another. For Adam, it feels like he takes a medicine every day, just like most Americans.
Adam grew up in State College, in a nice home. He moved away to a city with some friends when he was a young adult. While living there, he was seriously injured in an accident. Multiple surgeries and a lot of pain meant a lot of pain medication. Soon enough, he was addicted.
“I got hooked right away,” Adam says. Soon, he started finding prescription drugs on the street. First Percocet, then oxycontin. At $40 to $50 a pill, the habit cost him a couple of hundred dollars a day. Heroin was much cheaper: $10 dollars a bag, and easy to get.
“It was inevitable,” he says.
Here he was, a smart young man who grew up in a good home. He had used marijuana before, but heroin or any hard drugs were beyond anything that he had ever imagined trying or even seeing. He thought that hard drugs were for the inner city.
But there he was, using every day.
“I remember the first time I put a needle in my vein and I was like, ‘How did I get here?’ I never would have thought this is how my life would go,” Adam says. For five years, all he thought about was how he would find his next high. For five years, this nice, polite, smart young man from a nice home in State College was addicted to heroin.
He knew that if something didn’t change, he would die.
Eventually, he moved back to State College to get help and be away from temptation.
He found some strength and told his family what was going on. It was hard.
He worked with Dr. Timothy Derstine, a physiatrist who works with addicts in State College, and found help in suboxone treatments.
He made it through.
Things were going well. He went back to school, he met his wife, and he fell in love. He got a great job. But the struggle to remain clean was always there. Two years ago, he relapsed. For two weeks, he started using again. You can see the hurt in his eyes when he talks about it.
“Life was very stable for a long time. I met my wife, things were good. But after a lot of big life changes, I just had a hard time handling a lot of stress and I relapsed for a very short time period, just a couple of weeks. It was tough to take after 10 years of sobriety,” Adam says.
His worst moment was taking money out of the bank account he shared with his wife and not telling her that it was going toward drugs. But, she stood by him through it all, and that made all the difference.
Adam hopes that someday he won’t need to take suboxone, but he knows it has saved him. He takes a dose that does not get him high, but instead takes away the cravings, helping him to fight the addiction and stay in recovery. But, as much as he hopes that he might not need the medicine, he is glad that he has something that works. He is glad to have something that helps him function, thrive, and, ultimately, stay alive.
“I have no doubt that, without suboxone, I would be dead,” he says.
Derstine has been working with people suffering from substance abuse disorders since 2002. Drugs such as suboxone and methadone are used to treat people with physical addictions and allow them to maintain normal lives, he says.
But, this is just part of the treatment. Often, there are underlying issues that must be addressed, including why a person has turned to drugs or alcohol. Counseling, support groups, and other treatment provide a well-rounded plan for patients suffering from substance abuse disorders.
There is a stigma toward treating people with addiction and mental health issues, even though those problems make up a large percentage of the reason people die in this country, Derstine says. People with diabetes or heart disease, too, are often told by their doctors to change their diets in order to help manage their symptoms. Many patients do not do so, but we would never think it was wrong to treat them when they come into the hospital with a life-threatening condition related to their diseases, he notes.
Addiction is also a disease and needs to be treated as such, Derstine says. The free naloxone programs are a good start, but there is a next step that must be taken, he adds. Providing a small supply of suboxone to patients after they have used naloxone during an overdose could help provide a bridge until they find treatment. The hope is that by offering this and information on treatment options, maybe people can make better choices.
There also is still a need for more treatment centers, recovery groups, and other resources in the area, he says.
Derstine works with patients in recovery because he can see real life changes in patients who are working back to having functioning lives.
In that, there is hope.
Vincent Corso is a staff writer for Town&Gown and The Centre County Gazette.