The region's illegal drug of choice crosses all ages, races and backgrounds
Barbara DiPietro starts her days in her backyard, where she sits in front of a memorial to her son.
A heroin overdose killed Justin DiPietro, 25, in November, ending his seven-year struggle with addiction.
"We tried everything," DiPietro said. "We followed him, chased him. We tried all the rehabs. ... After he died, my biggest concern was, 'Is he in heaven?' I was worried about the way he had lived. I don't know why, because when he was on Earth, he was already living in hell."
A talented musician and hockey player, Justin grew up with loving parents in an upper-middle class neighborhood of Manor, Westmoreland County. Its brick houses, with trimmed lawns and blooming gardens, are proof that heroin can hijack lives of users from every socioeconomic background.
"Not what you'd expect when visiting the home of a heroin addict, is it?" said DiPietro, 57. "People don't think it can happen to their kid. They feel immune because they send their kids to good schools, they come from a good family, they live in a nice area. ... Heroin doesn't care."
The batch that killed her son also killed Megan Simko, 24, of Murrysville, said Westmoreland County Coroner Ken Bacha.
Cheap, highly addictive and readily available, heroin is the illegal drug of choice in Western Pennsylvania, according to police, medical examiners, doctors, addicts and rehabilitators. It affects not only users but their family members and law-abiding people victimized by junkies who steal to support their drug habits.
"You name any town and there's a problem with heroin right now," said Dr. Neil Capretto, director of Gateway Rehabilitation Services in Moon. "I get calls every day from people living in the 'good name' school districts and they're devastated. In Wexford, Cranberry, Fox Chapel, Upper St. Clair — they think they're safe; they're away from the blight of the city. But they don't realize how much of this stuff is being done out there.
"There is more heroin on the street now than at any point in our lives," he said.
A decade ago, Pittsburgh's gritty Hill District was the place to buy heroin, police said.
It's still there. On a recent night, city police narcotics detectives walked past rosary beads hanging from the wall of an abandoned Hill District house, and followed crumbling stairs to a basement. Hundreds of used needles covered the floor.
"Just a regular old shooting gallery," Detective Mike Reddy said, shaking his head as he swept his flashlight through the darkness to spotlight gloves, latex straps, a spoon with burn marks and debris.
The drug once was relatively weak, with purity levels as low as 8 percent, law enforcement officials said. To get high, people injected it — a method that scared away recreational users.
In recent years, heroin use exploded as purity levels soared as high as 90 percent, officials said, allowing beginners to sniff the drug.
"Everyone does it now," said city police Lt. Bill Mathias. "All ages, races, socioeconomic backgrounds. We had a Delta Airlines mechanic, a mailman on duty, a school bus driver. ... We've arrested 11- and 12-year-olds for dealing, and we've seen 12- and 13-year-olds hooked on it.
"Ten years ago, heroin made up less than 10 percent of all our drug busts. Now, it's 80 percent."
Fueling the heroin boom is a business model that mystifies police: While purity levels rise, prices plummet. Single-shot bags containing 0.02 grams of the powdery drug can be found in the city for as little as $5, officials said. To drive up demand, dealers spike bags with a lethal filler, because once junkies hear of an overdose, they all want that batch, police and users said.
"Oh yeah, that's the stuff you want," said Chris Cook, 29, of New Castle, a recovering addict who works for Washington, Pa.-based Greenbriar Treatment Center. "When someone ODs, you reason it out in your mind, tell yourself that they just didn't know what they were doing, but that you can handle it."
In the summer of 2006, dealers mixed heroin with the painkiller fentanyl and branded the bags "Get High or Die Trying." More than 50 people overdosed on the toxic mixture, and at least eight people died.
Most addicts start with legally-prescribed pain pills, including OxyContin, oxycodone, hydrocodone, Percocet and others, experts said. Teens swipe pills from their parents' medicine cabinets. Nurses and pharmacists take them from work. Others get legal prescriptions after a car crash or work-related injury.
Cook took pills at parties as a teen. All of his friends were doing it, and the pills were easy to get, he said.
"I had a good, normal upbringing," he said.
Yet, by age 18, he took pills every day. Then, he snorted heroin, and eventually injected it.
"I hate to say it, but I am the new face of opiate addiction," Cook said. "It's not just an inner-city problem anymore. Heroin is everywhere now."
Gateway's Capretto said Western Pennsylvania was "hit harder than other parts of the country because of our demographics: We have an older and working-class population, which by definition would require more pain meds. But a lot of it got into the wrong hands."
When addicts no longer can obtain pills legally, they turn to the black market, where the price for one OxyContin pill can cost as much as $80, experts said.
Heroin is cheaper and provides a similar high, experts said. And unlike crack cocaine — which mostly blacks in poor neighborhoods used during Pittsburgh's drug epidemic in the late 1980s and early '90s — heroin use is indiscriminate, officials said.
"The demographics are that there are no demographics," Bacha said. "I've seen overdoses of 15-year-old students and 70-year-old retirees."
Bacha became coroner 10 years ago, taking the position his father held for 24 years. During his dad's tenure, Bacha said, "you could count on one hand the total number of (fatal) heroin overdoses." Since 2001, Bacha has handled 168 heroin-related deaths.
Allegheny County Medical Examiner Karl Williams began to notice more heroin overdoses while working in Lawrence County in the late '90s. Now, Williams logs twice as many fatal drug overdoses as homicides, including an average of 58 heroin-related fatalities yearly since 2008.
"This isn't marijuana; it's not what mom and dad smoked in the 1970s," said Lt. Aaron Lauth of the Mt. Lebanon Police Department. "This is a true synthetic drug. It's everywhere — in the suburbs, cities — and it's going to be here for a while."
Addicts quickly build up tolerance to heroin. They need more to get stoned, but never achieve the initial, life-changing high, users said.
Soon, what started as a bag-a-day habit morphs into 10 bags a day or more. After a while, users don't get high, but continue to use because the alternative is to get "dope sick," akin to extreme flu, experts said.
"I was just doing it so I could function," said Cook, a daily user of pills or heroin for three years.
Desperate addicts rob relatives, friends, dealers and banks, experts said. They panhandle, break into cars, prostitute themselves.
"Just about every damn crime committed in this county comes back to heroin," Westmoreland County Detective Tony Marcocci said.
Justin DiPietro stole $25,000 in cash and other property from his parents to support his habit, his parents said. He sold his drums, his shoes, even his bed for heroin, they said.
Police make arrests, but said nonviolent users typically spend little time in jail. Dealers strike plea bargains, even those with past convictions, police said.
At Greenbriar, people wait for rooms to open up, said CEO Holly Martin. In 1998, 4 percent of patients there were heroin addicts. Today, more than half seek treatment for heroin or pain pill addictions, Martin said. Greenbriar has 62 beds at its Washington treatment center, and 50 beds at two halfway houses.
"But eventually, you become a fully functioning human being," said Cook, who has been clean since July 2003. "The first year is tough, but it gets easier. I do not go home at night and hide in a closet, reading my (Narcotics Anonymous) text and praying not to get high. People do get clean."
Duane DiPietro, 61, is skeptical. Parents can teach kids right from wrong, but there's no guarantee they'll avoid drugs, he said. Five high school friends who graduated with his son, Justin, became heroin addicts, he said. Three died, one remains addicted and the other is trying to quit.
"If I ever ... have a week or a month to live, please get me some heroin," DiPietro said. "It's crazy, I know, but I'm serious: I'd like to experience it, just once. That way, I can see what he gave his life up for."
'But eventually, you become a fully functioning human being. The first year is tough, but it gets easier. I do not go home at night and hide in a closet, reading my (Narcotics Anonymous) text and praying not to get high. People do get clean.' Chris Cook; Recovering addict • clean since 2003 • works for Greenbriar Treatment Center
'If I ever ... have a week or a month to live, please get me some heroin. It's crazy, I know, but I'm serious: I'd like to experience it, just once. That way, I can see what he gave his life up for.' Duane DiPietro; His son, Justin, died of a heroin overdose in November at age 25
'You name any town and there's a problem with heroin right now. I get calls every day from people living in the 'good name' school districts and they're devastated. In Wexford, Cranberry, Fox Chapel, Upper St. Clair • they think they're safe; they're away from the blight of the city. But they don't realize how much of this stuff is being done out there.' Dr. Neil Capretto; Director of Gateway Rehabilitation Services in Moon