It was spring 2016, and Sharon Stinebiser believed her sons had escaped the maw of the opioid epidemic that was claiming lives all around her Youngwood home.

Her oldest son, Josh Gunther, 29, had been clean for nine years.

He kicked the heroin habit that gripped him from ages 16-20 to set an example for his cherished brother, Dylan Fisher.

He had a place of his own. He had worked his way up to a supervisory position at DeLallo's distribution center and had purchased his first new car.

And Dylan, 20, was filling out paperwork to attend Westmoreland Community College.

The night of April 6, the brothers were playing video games in Dylan's basement bedroom while their mother slept upstairs.

Around 10:30 p.m., Stinebiser awoke to Dylan, her youngest son, frantically pounding on her bedroom door.

Josh wouldn't get up, he cried.

Stinebiser rushed downstairs.

"Josh was cold and white. His lips were blue," she said.

Stinebiser began CPR. Paramedics and police arrived.

At 2:30 a.m., they declared Josh dead.

Dylan was beside himself. But he agreed to go to the funeral home with his mother in the morning.

After a sleepless night, Stinebiser went downstairs three hours later to check on Dylan.

He was dead.

Surrounded by family photos, Sharon Stinebiser pets the family dog, Crosby, and holds a photo of her sons Dylan Fisher, 20, and Josh Gunther 29, who died from heroin overdoses seven hours apart. (Dan Speicher | Tribune-Review)

Growing list of victims

Her sons overdosed on fentanyl-laced heroin seven hours apart in the same basement bedroom, victims of the scourge that claimed 825 lives in Westmoreland County during a decade of death — 2007 through 2016.

"I'll never forget that night," the petite, soft-spoken woman said, as tears welled up in her eyes.

By the time toxicology reports for 2017 are complete, officials say at least 183 more names will be added to the list.

Like lists that have vexed authorities across the region, it encompasses a diverse group, from teenagers to senior citizens: a nurse, a chemist, a high school valedictorian, a Marine Corps sniper, a plumber, an electrician, and a mother, father and daughter who all died in the same Jeannette house within two years.

Although areas such as Derry Township, Jeannette, Greensburg, Hempfield and New Kensington were especially hard hit by death in the last 10 years, few communities escaped.

"Heroin doesn't discriminate," Stinebiser said.

The mother who buried her only children side by side in Youngwood Cemetery shares her story at schools across the region. Her heartbreaking tale draws tears from some students.

"If I can just save one life, it will be something," she said, sitting on a sofa next to a Christmas tree decorated with ornaments her sons made as children. "My sons' deaths have to mean something. They would want me to do this."

Changing face of addiction

While Stinebiser's sons were young when they succumbed to opioids, that hasn't always been the case. A decade ago, many of the victims were middle-aged or older.

Authorities believe most became addicted when doctors unwittingly prescribed new opioid painkillers, assuming the latest incarnation of the drugs were not addictive.

In 2011, two-thirds of the casualties in Westmoreland County were 41 or older. Oxycodone was the top prescription drug that contributed to fatal overdoses in 2009, 2010 and 2011, records show.

By the time doctors recognized the powerful attraction of these painkillers, a full-scale epidemic was brewing.

Between 2010 and 2015, as physicians pulled back on opioid prescriptions, men and women desperate to feed their addiction turned to the streets. There, they could find a $10 hit of heroin rather than an $80 prescription.

The death statistics shifted: heroin became the top contributing factor in overdose deaths between 2012 and 2015. By 2016, more than half of the victims were younger than 40.

Now, fentanyl, a synthetic opioid far deadlier than heroin and often mixed with it, contributes to the most overdose deaths in Westmore­land and elsewhere in the region.

The gravestones of brothers Josh Gunther and Dylan Fisher. (Dan Speicher | Tribune-Review)

Experts suspect these lethal synthetic opioids, rather than any dramatic increase in drug use, may be driving the death toll uptick.

"Most of these are coming in from China. You can go online and, within 10 minutes, you can buy fentanyl — and they guarantee delivery. If the DEA seizes it, they send a replacement," said Dr. John Gallagher, a Sharon-based gynecologist and chairman of the Pennsylvania Medical Society's opioids task force.

Stinebiser said one of Josh's friends told her he had been ordering drugs online shortly before his death. She suspects an auto accident that left Josh with six broken ribs and a prescription for painkillers reignited his taste for opioids and led to his death.

Deadly move to Derry

Rosie Nixon's daughter, Sara, 36, had been battling addiction for 10 years when she was kicked out of a rehab center in Southern California and headed back to Pennsylvania to make a clean start. She chose the Ligonier area, where the family lived when she was a teen.

Sara, who always viewed Pennsylvania as home, wanted to kick the habit and go to cosmetology school.

"She knew she had to change," said Rosie Nixon, of Colorado.

Initially, Sara stayed with friends "here and there," but then she made a new friend in Derry. Unbeknownst to Sara, she was moving into a rural community that had been one of the first areas to see fatal overdoses about a decade ago.

"We began seeing two or three deaths a year there long before anyone heard of it in Greensburg, Jeannette or New Kensington," said Donna Kean, longtime director of the St. Vincent Drug and Alcohol Prevention Project.

Sara died June 26 at a house in Derry, just a few weeks after moving there.

Rosie Nixon said toxicology reports showed she had three kinds of fentanyl in her system.

<img src="https://s13.postimg.cc/5h3i77gbb/gtr-decadeofdeath.jpg" width="100%"

Sara Nixon. Submitted photo

Toll on the living

By the end of 2016, the rate of overdose deaths in Westmoreland County had soared to 47.6 per 100,000 people, about three times the national average of 16.3 deaths per 100,000. In Allegheny County, the death rate had climbed to 52.9; in Armstrong it was 59.5; in Washington, 51; and in Cambria it had soared to 65.4.

Those numbers are shaking the foundation of decades-old community institutions that are clamoring to keep up, as well as new groups created in response to the epidemic.

Carmen Capozzi of Irwin channeled grief over his son Sage's death into the formation of awareness and activism group Sage's Army.

Sage was 20 when he died in a Hempfield motel room on March 4, 2012. His father, a flooring contractor, still agonizes over what he might have done differently.

The losses just piled up for Capozzi, who looked on in anger and disbelief two years ago as a jury acquitted Sage's dealer of drug delivery resulting in death, the equivalent of third-degree homicide.

"I just couldn't believe it," he said, talking about his crusade several weeks before Christmas.

Sage's Army operates on a shoestring out of an Irwin storefront. Volunteers staff a hot line and provide support groups, treatment referrals and speakers who have dealt with addiction and loss.

The pleas for help never seem to end.

"I'm just so tired, man," Capozzi said, shaking his head.

Carmen Capozzi of Irwin channeled grief over his son Sage's 2012 death into the formation of awareness and activism group Sage's Army.

In the trenches

The Rev. Sam Lamendola has presided over four drug-related funerals since taking over pastoral duties at two Derry area parishes in July. He regularly hears stories from parishioners and counsels families who are struggling with addiction.

"The ones I've buried, they've all been young people," Lamendola said, adding that the funerals are different from others. "There is a palpable sadness that is quite profound."

Randy Highlands of Jeannette EMS knows the frustrations those on the front lines of the battle feel.

The stressed-out paramedics drive to the same houses for the same people overdosing in the small city that has seen 19 deaths in 2017 — a record number.

"We would never withhold treatment, but none of us signed up for this," Highlands said, echoing the oft-repeated sentiments of volunteer and professional first responders across the region.

Westmoreland County 911 logged 1,108 overdose calls last year. That is just a baseline. Many callers can't or don't identify the emergency as a drug overdose.

Scot Graham, captain of special operations with Mutual Aid Ambulance Service, said his staff is busier than ever answering overdose calls.

"Years ago, it was a weekend thing. You might have one here and one there. And now this is all week long, all hours of the day and night," Graham said.

Dr. Bill Jenkins, director of the emergency department at Frick Hospital in Mt. Pleasant and director of EMS services for Excela Health, said the epidemic is exacting an increasing toll on staffers there as well.

"We see a lot of unnecessary death. There's a lot of frustration," he said. "You will sometimes see the same overdose victim two or three times in one week."

Sometimes, the best his staff can do is revive an overdose victim.

"They insist on leaving," he said. "They don't want to be referred to treatment. That's frustrating, because you see them again the next day."

Like the region, Frick has morphed and changed with the epidemic.

Unused space there was transformed in October 2016 into a 16-bed detoxification and inpatient rehab facility operated by Gateway Rehab, one of the region's oldest drug treatment providers.

But not everyone makes it to treatment.

In 2016, McCabe Funeral Home in Derry handled arrangements for at least six drug overdose deaths.

"Five, 10 years ago, we might have seen one or two a year," said John McCabe, funeral director. "When you lose a loved one, grief is grief. ... You still have the same pain from loss. They think, 'Oh, my gosh, if it wouldn't have been for drugs, this would have been prevented.' "

Debra Erdley and Renatta Signorini are Tribune-Review staff writers. Reach Signorini at 724-837-5374, rsignorini@tribweb.com or via Twitter @byrenatta. Reach Erdley at 412-320-7996 or derdley@tribweb.com.

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