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Updated 11 minutes ago

Terry Wayne Mathias Jr. was doing well in drug rehab.

But a slip-up in April was fatal for the 39-year-old Greensburg man, leaving his two children devastated, angry and asking questions, said their mother, Kimberly Brant.

“I don't think he knew that he was buying fentanyl,” Brant said. “I think he thought he was buying heroin.”

Mathias was one of at least 86 people in Westmoreland County whose overdose deaths last year were attributed, at least in part, to fentanyl, a synthetic opioid more powerful than heroin. Fentanyl-related deaths have exploded in the region since 2014. That triggered alerts to crime scene investigators about how to handle even a speck of the potentially lethal substance and to the public about clusters of overdose deaths near Cleveland and in Philadelphia.

Westmoreland County Coroner Ken Bacha said butyryl fentanyl, a “designer opiate” new to the county, contributed to three deaths last month in Greensburg, Ligonier Township and Leechburg.

A national opioid epidemic has led to a record-setting number of deaths, a strain on taxpayers and a coordinated response from officials trying to slow the casualties.

Between 2012 and 2015, Westmoreland County experienced 377 overdose deaths, according to coroner statistics. Another 151 fatal overdoses have been confirmed in 2016, and 21 suspected cases are still being investigated.

According to the Centers for Disease Control and Prevention, 5,544 people died from a drug overdose involving synthetic opioids in 2014, a 79 percent jump from the 3,097 in 2013.

Changing forms

Different types of fentanyl are being produced overseas and brought into the United States, turning what were once heroin packets into a dangerous mystery to police and forensic scientists.

“It's just another something new,” Bacha said. “Every time we turn around, we see something different.”

Officials at the Drug Enforcement Administration know the feeling.

Fentanyl was developed as a painkiller and anesthetic. The pharmaceutical version comes in a variety of forms, including patches and sprays. Its potency made it an attractive substance to manufacture, likely in Mexico and China, and then smuggle or ship into the United States, DEA special agent Patrick Trainor said.

With a tweak of the molecular structure, a new form of fentanyl can be illicitly created in laboratories. That makes it difficult for the agency to keep track of ever-changing forms and ban them. In November, the DEA added the synthetic opioid furanyl fentanyl to the controlled substances list, Trainor said.

“We have seen a lot of (synthetic opioids) available online,” he said. “That's part of the concern — a lot of these things are being sold online as research chemicals, so they're not intended for human consumption.”

Forensic scientists at the state police crime lab in Hempfield have seen new forms of fentanyl — and an increase in drug cases — as they analyze evidence for police departments in the 14-county region, said Leonard McCoy, forensic lab manager. They've identified the elephant tranquilizer carfentanil, which contributed to deaths in Beaver County, and 3-methylfentanyl, he said.

“Every time we have something new, we have to buy a standard to compare it with,” McCoy said. “It is more time-consuming.”

The scientists are careful in handling every piece of evidence, but a kit of naloxone — an opioid overdose reversal drug — is kept in the lab as a safeguard, McCoy said.

“We are seeing (stamp bags) with fentanyl and no heroin,” he said. “We're still seeing plenty of heroin; it's not gone.”

Growing toll

In December, Mathew McGowan, 22, bought seven bags of purported heroin from his brother, Markus McGowan, 29, of Jeannette, according to police. But the packets contained fentanyl, and Mathew overdosed and died, police said. Markus McGowan is charged with selling his brother the fatal dose.

“Heroin can be laced with fentanyl, but what we're seeing more frequently is bags of straight fentanyl,” Greensburg Detective Sgt. John Swank said at Markus McGowan's preliminary hearing.

In March 2015, the Drug Enforcement Administration issued a nationwide alert about fentanyl and versions of it after noticing an uptick in seizures of the opioid. That year, 27 overdose deaths in Westmoreland were attributed to fentanyl or acetyl fentanyl.

That was more than the three previous years combined.

In Allegheny County, fentanyl contributed to at least 184 drug overdose deaths in 2016. From 2011-13, fentanyl didn't even break the top 10 of drug types that caused deaths there, medical examiner statistics show.

Altering tactics

The Allegheny County Health Department sends out alerts when clusters of fatal overdoses occur, said director Dr. Karen Hacker.

“Mostly, what we've been seeing is fentanyl,” Hacker said. “That has really been the biggest problem.”

Police departments have changed their protocols for handling scenes where deadly fentanyl or versions of it may be present, as a result of the DEA alert. There's no way to look at a stamp bag and know what it contains, Westmoreland County Detective Tony Marcocci said.

“We're not even field-testing suspected heroin anymore,” he said. “Leave that to the chemist.”

In September, the DEA issued a warning about synthetic opioid carfentanil, which is 100 times more potent than fentanyl, after the elephant tranquilizer was blamed for deaths across the country, including Beaver County.

Carfentanil typically is found in tiny amounts, which means that forensic scientists at the crime lab have to boil down the sample and re-run tests to identify it, McCoy said. However small, it is incredibly dangerous to the user as well as law enforcement, Trainor said.

Other types of synthetic opioids have been found elsewhere, including U-47700, or “pink,” in Allegheny County, Trainor said.

“And there'll be something else after that,” Marcocci added.

Crime lab officials stay in contact with police and read scientific literature to stay abreast of what unknown substance could surface, McCoy said.

“We do think about what could be coming up next,” he said.

What all overdose deaths — regardless of the drug — have in common is that loved ones, like Kimberly Brant and her children, struggle with unanswered questions. Mathias, a former plasterer, was working two jobs when he died April 19, she said.

“He had such talent and everything going for him, and I just don't know why he turned the opposite direction,” Brant said through tears. “Everybody wants it to stop, it's terrible. It just leaves me speechless. I just don't understand it.”

Renatta Signorini is a Tribune-Review staff writer. Reach her at 724-837-5374 or rsignorini@tribweb.com.

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