Allegheny County Medical Examiner's Office Continues To See Uptick In Overdose Deaths

Mar 13, 2017

The Allegheny County Medical Examiners Office is one of only a few in the country that also has an in-house forensic laboratory.

90.5 WESA’s Deanna Garcia spoke with Medical Examiner Karl Williams about the facility and ongoing trends.

Their conversation has been edited for length and clarity. 

What do you do as the chief medical examiner? 

“We have two primary responsibilities here. One is that we are responsible for issuing death certificates on all unnatural deaths: homicides, accidents, suicides, as well as all deaths that are unexplained at the time of the death.

The only deaths that we do not get involved with are death certificates issued by physicians that know the patient and know the nature of the death, the cause of the death and they’re natural deaths.

We get calls on 9,000 deaths a year that we have to figure out whether we have jurisdiction. We take jurisdiction in about 2,000 of those; we bring about 1,400 cases into this office every year to do an autopsy on.

The other part of our operation, which is really unusual if not almost unique, is that we also get every piece of evidence from crime scenes. So we have a complete crime laboratory involving DNA, involving trace evidence, drug paraphernalia, drug bags, fingerprints, firearms and cartridges.”

What makes that unique?

Historically crime labs were run by police. Twenty to 30 years ago, as we started to get what we call kind of the wet stuff, the DNA or the toxicology, those labs tended to come over especially to medical examiners systems. But in coroners' systems it's anybody's guess.

So, in Texas there are few laboratories. It's starting to become more common, but it's still very rare that they all fall under one jurisdiction.”

How does it work elsewhere? 

“If someone dies of a drug overdose in a county where there's a county coroner, they will hire somebody to perform the autopsy. But all of the evidence from the crime all the stamp bags all of the syringes will go to the Pennsylvania State Police because that's the other large crime laboratory in the Commonwealth of Pennsylvania. Pennsylvania State Police doesn't do any autopsies but they get all of the evidence from any crime scene outside of Pittsburgh and Philadelphia.”

Dr. Williams showcases the website overdosefreepa.pitt.edu. It's a resource site which also houses customizable data.
Credit Deanna Garcia / 90.5 WESA

What is keeping your office most busy these days? 

Oh, well, it's the same as everywhere else in the country. We did 1,100 autopsies in 2014. That increased to 1,200 in 2015. And it went up to 1,400 last year and that increase is almost exclusively due to the extraordinary number of drug overdoses we're getting.

(It’s) a nationwide phenomenon. In Allegheny County we’re the tip of the Appalachian Mountains and in that area it's largely opioids. It's largely the Oxycodone, the heroin, Fentanyl, the other opioid drugs. Other parts of the country may have a methamphetamine problem, they may have a synthetic cannabinoid (problem). It's different everywhere in the country so it's essential that you know what's happening locally.”

Why is that? 

“If you’re going to try to address the problem, it’s got to be evidence-based. The evidence comes from knowing why people are dying from the drugs. The sooner you can get that evidence out, the sooner you can get it in the hands of the people in each county who are trying to deal with the problem, the better it is. If you look at Allegheny County, as opposed to Westmoreland County, there are different patterns of the overdoses. They're largely opioids, but the ages shift, the presence of prescriptions shifts. If you're going to address the problem it's got to be evidence based, the evidence comes from knowing why people are dying from the drug."

Over the last couple of years with the drug crisis increasing, has it been surprising to see the demographics it affects? 

“It's really striking to watch. You know 20 years ago we used to say, 'Oh it's just all a specific population and a specific part of the city,' and you know there used to be people saying, “not in my backyard, doesn't affect me,” and then their brother dies of an overdose. You know it's the legislators, we now have government officials, police officers, people at all levels where it's hit home personally. That's how widespread the problem is and it goes from 18 to 68. I mean I've had 62-year-old Caucasian males that have had coronary artery bypass grafting that are dying of heroin.”

Williams said that even though the opioid epidemic is being addressed at the federal, state and local levels, he doesn’t see the overdose rate decreasing any time soon.