Today and yesterday marked the beginning of a monthly series probing the financial and emotional costs of overdose deaths. The articles will look at the toll paid by those who have lost loved ones to addiction, as well as those who help treat or respond to it. We welcome reader feedback as we continue to probe this difficult subject.

Chris Rhome’s hip is squawking again. Lately, it’s been saying the same thing all too often.

Rhome is Monessen’s municipal fire chief, and the squawking, as he puts it, is his fire radio which covers Westmoreland, Washington and Fayette counties. At least half a dozen times a day, Rhome hears dispatchers report that someone has overdosed and is unresponsive.

And in September 2015, one of those calls hit home. Rhome told his wife Shannon the response was to a 32 or a 34. He forgets just which, but he knew it meant an overdose. And he remembers his wife’s response.

“She said, ‘I hope that’s not my brother, because that’s where he lives,’’ Rhome remembers.

It was Shannon’s brother, Patrick Coulter of New Eagle. Coulter died at age 36, lost to heroin and leaving behind a wife and two children.

Coulter was memorialized at Marshall Marra Funeral Home in Monongahela, which in that same year hosted four funerals for those lost to drug overdoses in a six-week period, said funeral home founder Marshall Marra.

“I don’t see any light at the end of the tunnel,” Marra said. “I think it’s here to stay.”

Rhome is a third-generation funeral director at Rhome Funeral Home in Monessen and knows how costly death is. An average grave space costs from $800 to $1,000, and the opening and closing of the grave will set already reeling families back an additional $1,100 to $1,500, he said.

“Then you have the financial aspect from the funeral home,” Rhome said. “And say their ashes are interred on top of an existing grave … even to bury cremated remains on top of an existing grave, you’re looking at $600 from the cemetery. So there’s a good bit of financial aspects that do have to be covered.”

Shona Trettel of Monongahela knows that all too well. Trettel’s cousin, Christopher Ferris, died after overdosing on heroin laced with fentanyl in 2016, three days before what would have been his 27th birthday.

Christopher’s doting aunt, Tammy Radovich, started a GoFundMe page to help with funeral expenses.

The morning after Christopher’s memorial service, Tammy died of a suspected prescription drug overdose. She was 47. Another family-started GoFundMe page followed.

In the 15 months following Christopher’s death, $9,835 was donated toward his funeral costs; $1,020 was donated to offset expenses for Tammy’s funeral.

But the goal for Christopher’s GoFundMe was $18,000, nearly twice the amount raised.

“You don’t put away for a child’s funeral,” Trettel said. “It’s not natural.”

The goal for Tammy’s was $17,000.

“There’s an obvious financial burden,” said Shelby Ferguson, funeral director at Ferguson Funeral Home in Belle Vernon.

But the financial burdens for those who lose a family member to an overdose are sometimes too much to bear not just for loved ones, but for the Washington and Westmoreland County Coroner’s Offices struggling to keep up with a recent spike in overdose deaths, sapping them of hundreds of thousands of dollars every year respectively.

“That’s something a lot of people don’t think about,” Westmoreland County Coroner Ken Bacha said. “What it’s costing.”

Record-breaking costs to bear

Overdoses and the financial costs in Washington and Westmoreland county budgets have skyrocketed.

Washington County had 109 overdose deaths in 2016, more than the number of deaths by drug overdose the county saw from 1992 through 2002 combined.

In 1992, Washington County Coroner Timothy Warco’s first year in office, the county had two overdose deaths.

“If we had two per year (again), I could take a vacation and go away,” Warco said.

Westmoreland County had 174 deaths by overdose in 2016, 48 more than the previous year and even more than that category’s totals for 2013 and 2014 combined.

The county reported 12 overdose deaths in 2002, Bacha’s first year as coroner, and only five in the 24 years that Bacha’s father Leo served as Westmoreland’s coroner from 1978 through 2001.

“He’s probably up in heaven laughing at me,” Bacha said.

The county is on pace to have about 200 overdose deaths this year, one of which claimed a neighbor four doors down from Bacha last month.

“It doesn’t discriminate,” Bacha said.

Already so far in 2017, three of the 22 deceased Rhome Funeral Home has provided services for were lost to overdoses, higher than the average annual one or two there.

“At 25 years old, do you have a cemetery plot?” Rhome asked. “Do you have life insurance?”

Coinciding with the local rise in opioid overdoses has been a hike in funeral costs. Between 2004 and 2014, the median cost of an adult funeral increased 28.6 percent, from $5,582 to $7,181, according to the National Funeral Directors Association (NFDA). That cost does not take into account cemetery, monument or marker costs, or other common charges, such as for flowers or an obituary. According to the NFDA, the median cost of a funeral with cremation is $6,078.

Ferguson’s funeral home hosted five funerals for those claimed by overdoses in 2016 and three more so far this year, and he notes an issue that has beleaguered families grieving a loved one lost to addiction: life insurance companies not paying on pending death certificates.

That matters because death certificates remain pending for eight to 12 weeks, said Bacha, while the body is autopsied and is toxicology tested. Bacha said his office autopsies decedents 99 percent of the time if there is reason to believe the cause of death was an overdose in order to identify drugs or other indicators.

“The average person can wait a couple of months,” Ferguson said. “But you have a family just starting out and they’re losing that income right away, no paycheck after today — it’s certainly a burden on them.”

Addicts who fatally overdose spend money on drugs, Bacha said, so they leave behind a legacy of debts and desperation instead of anything that can offset the cost of death expenses.

Will Hiles of California has been clean for two and a half years, but he used to spend $100 to $150 a day on dope. His addiction transformed him from a maintenance crew supervisor living in Chicago’s trendy Printer’s Row neighborhood to homeless within a year.

Hiles would pick up his drug dealer’s dog feces in his yard and walk in snowstorms to get a few bad bags of dope. To this day, Hiles won’t take his cans in to a local scrapyard because it brings back too many memories of him bringing scrap metal there, half of it stolen, to get dope money. And he went years without paying child support because he had no job.

“It becomes a full-time job,” Hiles said. “You replace your employment with that. That is your full-time job. To get high.”

Running out of money and security

The caseload for Bacha’s office has doubled in the past eight years primarily due to the increase of overdoses, but his staff size has stagnated: a chief deputy, four deputies and a secretary full-time, plus four deputies and a solicitor part-time.

“We’re doing this with the same amount of people,” Bacha said. “It’s wearing my staff down, physically, mentally, emotionally.”

Every death call costs his office approximately $3,000, including an average of $1,600 for autopsy services, $400 for the toxicology and $375 to transport the decedent’s remains one way between the office in Greensburg and Pittsburgh, where the autopsy is performed. That cost multiplied by the 174 fatal overdoses in Westmoreland County equals more than $500,000, a cost Bacha’s office hasn’t been able to cover without additional help.

“It’s typical at the end of the year we’re running out of money,” Bacha said.

Last year was especially bad, though, because of 2016’s escalation of fatal overdoses. Bacha’s office had to request additional funding from Westmoreland County’s commissioners twice, including $137,000 extra to pay for additional autopsies and toxicology testing to add to its roughly million-dollar budget.

Warco estimated death calls cost his office approximately $2,000 each, resulting in more than $200,000 in costs to his office last year when factoring in Washington County’s 109 deaths by drug overdose in 2016.

Also last year, Washington County’s commissioners approved Warco’s request to approve Act 235 Level 1 handgun safety and handling training for deputy coroners at a cost of $115 each to his office’s operating budget.

“We’re out in the drug world,” Warco said. “And the people aren’t very friendly.”

Drugs were stolen from a death scene in Monongahela earlier this year, Warco recalled.

“We looked around, and the drugs were gone,” Warco said.

The squawking on Rhome’s hip is still there, though, even in his funeral home office, as he considers the various words he hears on his fire radio multiple times a day: “unconscious,” “unresponsive,” “overdose”.

“I’m sure there’s a lot more (that) fire departments aren’t dispatched to that I’m unaware of,” Rhome notes.

Rhome looks up from the Westmoreland Drug & Alcohol Drug Takeback brochure featured on his desk that he just got in the mail and considers again the rising number of overdose deaths at his funeral home and throughout Monessen, the site of eight overdose deaths last year according to Bacha’s office. It used to be that there were just a handful of people in Monessen that did heroin.

“And everybody knew who they were,” Rhome says. “They were the crazies. They were absolutely next-level wild. Now, you don’t know whether the person next to you in line at the grocery store is strung out on heroin or not. It’s that prevalent.”

That means more deaths to budget, whether it adds up or not.

“It’s darn scary math,” Rhome says.

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