The following is part of a monthly series probing the financial and emotional costs of overdose deaths. We welcome reader feedback as we continue to probe this difficult subject.
Greg Cominsky, office manager and first responder at Rostraver West Newton Emergency Services, is tired of watching parents cry when he responds to an overdose call.
And he’s tired of the medical records he reviews to ensure billing compliance. They show the same tragedy over and over again.
“I review the medical records and sure enough, there’s somebody DOA (dead on arrival) that’s 23 years old,” Cominsky says at his desk, his voice softening. “And I don’t even have to look for the cause anymore. I mean, my God, you know?”
Sitting at the same computer revealing deaths by fatal overdose to him in ever growing numbers recently, Cominsky swivels forward.
“You come in here and you look. Eighteen years old, dead. Dead!” Cominsky said. “What? And sometimes I come in here and I have three and four of them. What? It’s sickening.”
The agency’s director of operations, Michael Stangroom, recently responded to three drug-related deaths in a single day. One was a young woman’s cardiac arrest at 8:30 a.m. in Rostraver Township. The next was a Monessen man in his 40s, a needle still in his arm. The third was a 38 to 40-year-old man in South Huntingdon Township around 8:30 p.m.
“And for one person to see three dead people, senseless due to drugs in one day, how do you think that takes a toll on you emotionally?” Stangroom asks.
Last month, Stangroom’s personnel responded to a nonfatal triple overdose suffered by a 13-year-old and two 14-year-olds in Washington Township, Fayette County.
“It’s a tough industry right now,” Stangroom says. “I’ve never seen it tougher.”
The dramatic escalation of local opioid abuse in the past several years has resulted in a substantial uptick in overdose victims for emergency medical, police and fire personnel to respond to, area personnel in those departments said.
The resulting scenes are repetitively happening in the same places, to the same people. And both the overdose victims and the drugs they consume are becoming increasingly dangerous to first responders themselves.
“When you’re giving them the Narcan and waiting for it to kick in, you’re kind of expecting them to come up swinging,” said Hayden Roberts of the Charleroi Volunteer Fire Department. “You don’t lean over top of them.”
Overdoses sometimes keep personnel from handling other calls, first responders said.
Stangroom added that very few people who overdose on heroin have health insurance, and Cominsky said that most overdose victims decline ambulance transport after being resuscitated, meaning that EMS personnel do not get paid for their services.
“It’s overwhelming EMS,” Stangroom said. “It’s overwhelming your social services. You’re overwhelming your emergency departments, you’re overwhelming your morgues. You’re overwhelming the system.”
“AT LEAST ONE A DAY”
As of June 14, Rostraver West Newton Emergency Services had responded to 66 calls classified as an overdose so far in 2017, with 87 more categorized as unconscious, calls which frequently turn out to be an overdose.
RWNES responded to 12 calls in those two categories combined in the first two weeks of June alone, and 30 in May.
Paramedic Chuck Biksey has had days where he’s responded to three overdoses himself. Biksey is one of many local emergency personnel who have added drug abuse education to their community service in recent years.
“The only overdose you hear (about) is the one at Walmart, one at school,” Biksey said. “You didn’t hear about the four we had today at the gas station, at the tire shop, at the red light. The first thing somebody does when they get their drug is do it. They get in their car and start driving, and two, three minutes later, they overdose.”
Biksey was coming back from a non-overdose call on Route 51 just after 9 p.m. on a Wednesday night last month when a call for a 25-year-old male in Washington Township came over the radio. It turned out that the patient was vomiting with no indication of an overdose given, but Biksey has learned to assume that any call for someone that age is for an overdose.
“It’s just a sad state of affairs,” Biksey said. “It doesn’t discriminate.”
Charleroi Regional Police Chief Eric Porter said his department responded to three fatal and 15 nonfatal overdoses in 2017 as of June 19, in addition to five fatal and 39 nonfatal last year.
“It certainly wasn’t like this when I started,” said Porter, who joined the department nearly two decades ago, adding that his department dealt with three or four overdoses in a week last month after a bad batch of heroin hit his coverage area.
“The common calls (are) vehicle crashes, domestics, and now it’s starting to become the overdoses,” said state police Trooper Robert Broadwater. “And it just seems like you’re starting to go every day to these.”
“YOU WANT ME TO CARE ABOUT YOU”
First responders said overdoses in parking lots are becoming increasingly common.
“The first thing I tell these people is, my daughter is out on these roads and you guys just don’t care,” Biksey said. “You want me to be nice to you and you just don’t care. But you want me to care about you, and I do care. I give it everything I got.”
But overdoses more frequently happen in residential settings, which presents its own challenges.
“Are we walking into a residence where a family is aware of what’s going on and kind of accepted it?” Broadwater said. “We have done that. We also walked in where they can’t understand what’s going on, they don’t want to accept what’s going on. They can’t believe their loved one has overdosed or their loved one is lost, and it gets kind of frantic.”
Sometimes, young children are on the scene of the overdose, and it’s left to first responders to help shield them.
“Every once in a while, you’ll have a young kid like 2 or 3 (years old) not really knowing what’s going on,” Roberts said. “… You don’t want them to see it.”
Patients often deny that they overdosed, Charleroi Volunteer Fire Department line officer Matthew Prentice said.
“It’s sad that that’s what this area’s come to,” Prentice said.
Monessen Municipal Fire Chief Chris Rhome recalled a time when several of his department’s firemen ran up 34 steps from a street to an overdose victim’s front door, then up two additional flights of stairs to the second floor of the victim’s home — only to watch him deny he had overdosed and initially refuse ambulance transport.
“OH, NOT YOU AGAIN”
Even if the ages vary, the addresses often don’t.
“You start going on these same people over and over again,” Roberts said. “They never get help, they never want help. They get mad at you. They start fighting you because you ruined their high.”
“You have some people who say, ‘I remember you,’” Prentice said. “‘Oh, not you again.’”
Stangroom cited a man who his emergency personnel have resuscitated four times in the past three months.
Roberts said addicts have to come rely on first responders to revive them, so they don’t worry about their addiction.
“But then it comes to nobody was home this time or nobody found them in time, or the person they were with just didn’t care and left,” Roberts said.
“Although we’re willing to go do our jobs with no questions asked, it gets frustrating when you have to go to the same residence in a two-day span for the same situation,” Broadwater said.
“IT’S SOME SCARY STUFF”
Roberts, 19 and a fourth-generation firefighter, recalled getting hit square in the jaw by a revived addict once. He said his family’s previous generations of firemen didn’t have to deal with overdoses like this.
Area first responders said the combativeness of overdose victims upon their revival is a frequent danger.
“That’s one of the reasons I’m not really wild about the firemen being on the scenes of these incidents,” Rhome said.
The threat of carfentanil, a sedative for large animals that can kill anyone who comes into contact with it, is a relatively new concern as well.
“It’s absorbing through the skin, and it’s a safety factor for the crews out there,” Stangroom said.
Several local emergency personnel recalled that a police officer in Washington Township, Westmoreland County had to be revived with Narcan in May after a brush with suspect heroin, fentanyl or both, and that a police officer in East Liverpool, Ohio overdosed in May after brushing fentanyl powder off his shirt.
“It’s some scary stuff,” Porter said.
“You have to look for paraphernalia yourself,” Charleroi Volunteer Fire Department Chief Robert Whiten Jr. said. “You don’t want to step on a needle or bend down and get a needle in your knee.”
Mount Pleasant EMS supervisor Ryan King also works for Oklahoma EMS, which is based in Washington Township, the same municipality in which a police officer had to be revived two months ago.
“I don’t think we carry enough Narcan on the truck to wake them up (from carfentanil),” King said.
Porter said that his department began noticing fentanyl use in 2015. Fentanyl is 50 to 100 times more potent than morphine, according to the Centers for Disease Control and Prevention.
So overdose calls have become something many local first responders, particularly volunteers, feel they didn’t sign up for.
“A lot of guys said they want to be firemen,” Whiten said. “They don’t want to be EMTs. They don’t want to be first aid guys.”
“The father who may be at his little girl’s dance recital or little man’s baseball game or what have you, they can look at their phone and say, ‘Oh, that’s an OD, I’m not going,’” Rhome said. “And there are those who do that. And they have the mentality, am I going to miss my son’s baseball game to go carry an addict out of their home?”
Most of the time, Rhome said, they choose to respond to the overdose anyway.
Whiten said he hesitated to supply his department with Narcan because of the time cost he anticipated it would have on his firefighters, but did so more than a year ago to try to keep up.
“IT JUST NEVER ENDS”
That rise continues to wear on first responders.
“You have to keep that in perspective, make sure it doesn’t become so much of a strain,” Porter said. “I think it can be, especially when you go through spurts of it when we have four, five, six in a few-day period. Of course, it gets taxing.”
When responding to overdose victims, Cominsky thinks of them being somebody’s son or daughter, and it takes an emotional toll.
“(I)t just doesn’t seem like the rest of society gives a damn. Because if they did, they’d be in an uproar. But maybe they don’t really realize how bad the problem really is,” he said.
And first responders are feeling the strain in multiple capacities. In addition to being Charleroi’s fire chief, Whiten is a paid Washington County 911 dispatcher. Prentice is a responder for RWNES as well as a Charleroi firefighter. Rhome helps run Rhome Funeral Home in Monessen, which has seen a marked increase recently in overdose funerals. Stangroom is not only RWNES’ director of operations but a Monongahela police officer.
Cominsky wants anyone getting numb to the escalation in local opioid abuse or accepting it as a new normal to come with him for a week.
“I’ll show you numb,” Cominsky says, 38 years into a first response career that has become disturbingly predictable. “Come with me. Watch parents cry over their child that’s stiff and cold. Come with me. I’ll wake you right up.”
“It just never ends,” Biksey says. “It just never, never ends.”