PITTSBURGH - Three more people were declared dead Sunday from apparent heroin overdoses in Pittsburgh, a day after a county health official reported that 14 people had died from heroin overdoses in the past week.
Allegheny County Medical Examiner Karl Williams said Sunday that the growing number of apparent heroin overdoses is a "major public health crisis."
“I'm only at the very beginning of investigating the number of deaths,” said Williams. “It's all over Pittsburgh. It's all over Allegheny County. It's all over the surrounding counties. It's a major regional issue.”
Williams said that preliminary testing of bags found at the scene of the overdoses and stamped with the word "Theraflu" appear to show that they contain fentanyl, a synthetic morphine substitute that is roughly 100 times more powerful than morphine.
It resembles heroin, though it is much more potent, and it has been blamed for dozens of deaths around the U.S.
Williams said he does not know whether the substance believed to be involved in the overdoses is prescription fentanyl or "something synthesized by some clever chemists."
Each of the people who died in the rash of overdoses has a known history of drug abuse, particularly heroin, Williams said.
On Saturday, Williams' office said 14 people in Allegheny County had died from heroin overdoses in the past week. Deaths also have been reported in Westmoreland County, Pittsburgh Mayor Bill Peduto's office said.
Westmoreland County Coroner Ken Bacha said his office investigated two cases during the weekend likely to be linked to the batch in Lower Burrell and Allegheny Township.
“They know on the street that this is powerful stuff,” he said.
The drug seems to be “very concentrated” in the Alle-Kiski area in northern Westmoreland County.
“Between us, Armstrong and Allegheny County, there's been multiple cases that we believe ‘Theraflu' is involved,” he said.
Westmoreland officials are working with state police. Pittsburgh police are leading the investigation with Williams, city Public Safety Director Mike Huss said.
Police spokeswoman Diane Richard said detectives are interviewing anyone arrested and in possession of the tainted heroin and any witnesses. She said they do not know who is dealing it or where.
“I wish we did. That would be half our battle,” she said.
Fentanyl is a painkiller that doctors say is 100 times more powerful than morphine. When chemists in 1988 mixed it with heroin to make a drug known on the street at China White, about 20 people died, and hundreds overdosed in Western Pennsylvania. A similar batch in 2006 killed nine people in Allegheny County.
“If you're a heroin abuser, you're used to a certain concentration of heroin. If you mix it up with a more potent concentration, and you don't know how concentrated it is, it will lead to an overdose,” said Dr. Bruce MacLeod, an emergency physician at West Penn Hospital in Bloomfield.
The deaths that Williams' office is investigating include seven in Pittsburgh, two in Penn Hills and one each in Aspinwall, Coraopolis, Tarentum and Castle Shannon.
“Sometimes when new suppliers of illegal drugs are trying to get into a new market, they supply a product that is super-concentrated. This is a way of advertising their product, as horrendous as that sounds,” MacLeod said.
Williams said his office handles about 250 fatal drug overdoses a year countywide .
“Fatalities within our system are very rare because we can get to them and revive them,” said City EMS District Chief Richard Linn. During the weekend, he said, Pittsburgh paramedics responded to at least 10 overdoses of suspected Theraflu and three deaths.
Beaver County Coroner Teri Tatalovich-Rossi isn't aware of deaths related to Theraflu. She said the county hasn't seen a spike in heroin overdoses.
“It's been steady,” Tatalovich-Rossi said, estimating that one out of every three or four deaths her office investigates is drug-related.
Williams said his office is testing to determine how much heroin and fentanyl is in bags found with victims and how much is in their body fluids. “It's important to know why these people are dying,” he said.
Linn recalled responding to a call for five China White overdoses at the same shooting gallery decades ago.
“I don't think I've seen anything to compare with the China White heroin,” he said.
MacLeod said it was important to warn heroin users.
“These folks don't deserve to die just because they use heroin,” he said. “They don't want to die from heroin, they want to get high.”
The Associated Press and Channel 11’s news exchange partners at TribLIVE contributed to this report.