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York County has not yet seen a significant drop in the number of people dying from heroin and heroin-related overdoses, despite coordinated efforts on multiple fronts by county officials, agencies and individuals.

"I certainly hope the numbers will go down, but I won't be surprised if they don't yet this year," York County Coroner Pam Gay said of the heroin epidemic gripping York County and the nation. "Because this problem didn't happen overnight, and it's not going to go away that easily."

Chief deputy prosecutor David Sunday — who with Gay co-chairs the York County Heroin Task Force — said the key is to keep attacking the problem on all fronts and not to expect immediate results.

"It's going to take a while," he said. "We are facing a herculean task. ... The heroin supply that's coming into Pennsylvania is the highest it's ever been, and it's cheaper than it's ever been."

Heroin deaths across the nation nearly quadrupled between 2002 and 2013, according to the Centers for Disease Control, with more than 8,200 people fatally overdosing in 2013.

Heroin usage increased in most age groups and across all income levels, according to the CDC, with the greatest increases occurring in what historically had been groups with low rates of usage. Those include women, the privately insured and people with higher incomes.

York's numbers: So far this year in York County, there have been 17 confirmed heroin deaths, with eight more pending deaths that are expected to involve heroin, according to Gay. There have been a total of 31 fatal drug overdoses so far this year, a number that includes the 17 heroin overdoses but not the eight pending cases, she said.

In 2014, York County had 62 heroin and heroin-related deaths, out of a total of 110 drug overdoses that year, according to Gay.

Records from the coroner's office show that as of this time last year, there had been 29 heroin-related deaths.

Those records reveal the bulk of the deaths were in suburban and rural areas — from Dover to Delta, from Hanover to Hallam, and everywhere in between.

"This is very much a suburban and rural problem," Gay said. "I think that's a shocker for some people, because they don't expect it."

According to Gay, 61 percent of the fatal heroin overdoses in 2014 happened in rural or suburban areas, while 39 percent occurred in York City.

She said in the first part of 2015, the numbers were lower than in 2014, but they started rising as the weather warmed.

"I do think it would have been worse if it wasn't for the Narcan," Gay said.

Heroin antidote: Most police departments in York County started carrying and using naloxone, the generic name for Narcan, the first week of April. The drug is an antidote to heroin and immediately negates the drug's effects, even reviving users who are comatose and near death.

At this point every police department in the county has joined the program, in which the York County District Attorney's Office buys the drug in bulk and distributes it free to the departments, according to Sunday.

Last year, Pennsylvania passed a law allowing nonmedical personnel, such as police officers and firefighters, to carry naloxone. And Gov. Tom Wolf has said every state resident will now have access to the life-saving drug at pharmacies.

Not 'the answer': Sunday said that as of last week, police officers in York County have saved 26 lives with the antidote.

"Narcan isn't the answer, but Narcan is a vital tool for first responders to keep people alive," he said.

Overdose victims saved by Narcan are rarely grateful. Gay said some are angry and rude toward the officers who just saved them, and some refuse to be transported to the hospital for evaluation. They don't even have to accept literature or a pep talk about getting clean, she said.

"Many times ... they go out and use again within a couple hours," Gay said. "It's not the magic bullet."

Members of the county heroin task force — including police, doctors, treatment providers, legislators, EMTs and prosecutors — recently "had a very spirited and very productive dialog" about the issue, according to Sunday.

No arrests: The state's good Samaritan law doesn't allow police to arrest the user, or anyone at the location, for heroin possession, although officers do seize and destroy any drugs and drug paraphernalia. The concern was that users wouldn't call 911 for a fellow user who was overdosing if they were afraid of being arrested.

"We realized we all were saying the same thing, which was that after someone is saved, what happens next?" Sunday said.

"Police want us to bring that to legislators' attention," Gay said, and the task force is discussing possible improvements they could suggest to lawmakers.

"We at the task force have become very effective at thinking outside the box," Sunday said. "I'm confident we will come up with some ideas. Whether they work or not, I don't know. But we're definitely going to try."

— Reach Liz Evans Scolforo at levans@yorkdispatch.com.

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