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In Pennsylvania, it is estimated that opiates, like heroin, killed at least 1,300 people last year. In Massachusetts, more than a thousand died. And in Connecticut, heroin deaths jumped more than 85 percent in two years. But figuring out the size and scope of the problem is harder than one might think. As part of our reporting this week on a wave of addiction, we sampled the problem in Pennsylvania, which, like many states, does not require reporting of specific details on drug overdoses, and whatever other information is available is at least two years old. From member station WITF, Ben Allen reports.
STACY EMMINGER: So it's Anthony Perez, and it has all his personal information.
BEN ALLEN, BYLINE: Stacy Emminger is showing me the death certificate for her son Anthony, who was addicted to heroin. But that's not what's listed.
EMMINGER: Immediate cause of death is multiple drug toxicity, accidental. So basically an accidental overdose.
ALLEN: Emminger, who lives in Mount Joy, a small, quiet town in Pennsylvania's Lancaster County, says heroin killed Anthony. But the state's database doesn't have that level of detail.
KURT NOLTE: It's critical. It's absolutely critical.
ALLEN: Dr. Kurt Nolte is the executive vice president for the National Association of Medical Examiners. He helped to write a report that recommends listing out every drug found in a person's system.
NOLTE: The interventions for whether it's heroin or other illicit substances are different than, for example, if they are prescription drugs. And if you can't tell the difference because everybody's classified as multi-drug toxicity, you have no idea what's really killing people.
ALLEN: Not only does Pennsylvania's database only broadly note drug overdoses, but the most recent statistics date to 2012. And the Keystone State is far from unique on this. Many others lack a complete, up-to-date and accurate database. Why does all this matter? In western Pennsylvania, heroin mixed with the pain drug fentanyl killed 22 people in a matter of weeks last year. Gary Tennis, acting secretary for Pennsylvania's Department of Drug and Alcohol Programs, says with a real-time database, paramedics might be better prepared to stop an overdose.
GARY TENNIS: You might require more than one administration of naloxone. The first one might not do it. It's really useful for our emergency medical services to have that information that fentanyl's there.
ALLEN: Beyond stocking the antidote naloxone, law enforcement also knows what to target in undercover stings. And Tennis himself can use the statistics when pushing for state funding for specific treatment programs. Tennis estimates that the CDC numbers for Pennsylvania missed hundreds of opiate deaths.
TENNIS: They're still high. I mean, they're still incredibly high and tragically high, but I think probably more than that died.
ALLEN: Since Stacy Emminger lost her son Anthony, she's joined grief groups online and says parents all over the country talk about how it's a crisis in their area.
EMMINGER: It's just amazing, suddenly, how heroin has just ballooned out of control. If you don't know how many people are dying from it, how do you know how to combat it?
ALLEN: In Pennsylvania, coroners can now send the state a standard form detailing all the drugs in someone's system. But the extra steps aren't required, and there's no public database set up yet. Until it launches, Pennsylvania, like so many other states, will have to rely on a patchwork of statistics to figure out exactly how deep the heroin crisis cuts. For NPR News, I'm Ben Allen.
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