CHAMBERSBURG, Pa. Pennsylvania State Police Lt. Gary Carter remembers investigating Franklin County's first heroin overdose death in 1998.
The Chambersburg native saw the drug quietly take hold among a small group of residents in the early 2000s. The users and suppliers remained in the shadows for years until the narcotic powder became a less expensive high for people addicted to prescription painkillers.
"Now, it's really all over the place," said Carter, barrack commander for the state police in Franklin County.
Investigators say the increased availability and decreased stigma of heroin use may contribute to new users being less inhibited about trying it. Police are carrying medication to reverse opioid overdose effects and they are providing information to addicts about recovery support programs.
"The whole attitude of policing has changed," Chambersburg Police Chief Ron Camacho said.
Waynesboro Police Chief James Sourbier hears critics say police aren't doing enough about drug abuse in the region. He argues many people have a grave misunderstanding of the depth and breadth of the crisis.
"You cannot arrest yourself out of a situation like this," he said, saying police, doctors, social services, churches, politicians and schools all have roles to play.
Waynesboro police responded to 19 drug overdoses in 2014. Of those, five were classified as intentional and self-inflicted, four were accidental, seven were inadvertent, one was mixed toxicity, one was unknown, and one was inconclusive. Four of the overdoses were fatal.
The department responded to 36 overdoses in 2015. Twelve were intentional, three were accidental and 21 were inadvertent; of those overdoses, 17 involved opioids like heroin. Five people died.
2016 brought the department 47 overdoses, with 11 considered intentional, one accidental, 26 inadvertent, four mixed toxicity, two unknown and three inconclusive. Thirteen people died.
"I don't think we've seen the worst of it yet," Sourbier said.
Waynesboro's police chief believes drug traffickers from the Baltimore area are stopping for periods of time in southern Franklin County to take advantage of inexpensive apartments, social services and walkability of communities. He said some of those dealers continue north to New York.
Carter agreed that Baltimore through Hagerstown is a major thoroughfare for heroin. Still, he sees other supply routes connected to Harrisburg and Philadelphia via the Pennsylvania Turnpike, U.S. 30 and Interstate 81.
"We're easy access," Carter said.
Franklin County District Attorney Matt Fogal, who established a multidisciplinary overdose task force, perceives fewer big dealers setting up shop in Franklin County. He is prosecuting users who are selling off extra inventory they obtained on short runs to metropolitan areas.
"It's less a business enterprise than someone who uses and buys a lot," he said.
Fogal is in the process of seating an investigative grand jury that will spend the next 18 months focused on heroin dealers and trafficking rings. The grand jury can issue subpoenas and compel testimony from reluctant witnesses, with that testimony granted confidentiality.
Pennsylvania law protects from prosecution, in many cases, the person who calls 911 about a friend experiencing an overdose. It also provides immunity to the person who overdosed. There are exceptions, including for overdoses that occur in businesses among the public.
Camacho said his eyes were opened to the reaches of addiction when the son of a coworker died a few years ago. Two decades ago, he never imagined he would be administering naloxone to someone suffering an overdose in hopes he could get that person connected with a treatment program.
He now emphasizes outside-the-box thinking and training to address opioid addiction.
"This is hitting everybody," he said.
"We realize there is no one thing that'll fix or cure this. It really does require a massive team effort," Sourbier said, saying he tries to provide resources to parents and grandparents concerned about their addicted family members.
Fogal spent years skeptical of the effectiveness of addiction treatment initiatives until he saw them producing positive results. Now, he's ensuring recovery and treatment specialists are at the table in the overdose task force.
"I don't accept failure," he said. "That said, I'm a realist and I know the challenges we face."
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