Butler County, like many communities around the country, is feeling the effects of the opioid epidemic more strongly than ever before. This week the number of overdose deaths confirmed by the county coroner's office reached 74, matching the record-high total from 2016. With toxicology reports still pending on several deaths and six weeks left in the year, the coroner expects the county will see another record death toll. The people who have lost their lives have ranged from ages 17 to 62 and have left behind parents, siblings, children and friends — many of whom watched them struggle with their addictions to no avail. Meanwhile, law enforcement, government workers, the court system and families are all trying to find answers to the epidemic.

Lethal fentanyl

Fentanyl, the powerful synthetic painkiller originally used to treat terminally ill cancer patients, is driving the toll of fatal drug overdoses this year — like in 2016, according to local and state police and county narcotics officers.

“They are almost all fentanyl,” county Detective Tim Fennell, who heads the Butler County Drug Task Force, said of the fatalities.

In most cases, the victims' last fix came from the contents of a stamp bag packaged as heroin. But in many, if not most of those cases, there was little if any heroin in the bag.

“It's almost all just fentanyl,” Fennell said, “or fentanyl analogues.”

The analogues include ultra-potent forms of fentanyl such as carfentanil — which is legitimately used to tranquilize elephants and other large animals.

Other analogues that have shown up in the toxicology of overdose victims in the county are methylfentanyl and parafluorofentanyl.

“The potency of the fentanyl content is the reason for the rise in overdose deaths we've seen,“ Fennell said.

Fentanyl is 50 to 100 times as powerful as morphine, according to the National Institute on Drug Abuse. Its analogues are even stronger.

When fentanyl is added to heroin or cocaine, it too becomes more potent.

For dealers, fentanyl is a godsend for one primary reason — it's cheap. That boosts the profit margin. It also looks a lot like heroin,

It's not uncommon for dealers to spike heroin with the more inexpensive fentanyl and fentanyl analogues.

But in more and more instances, according to law enforcement officers in Butler County, bags of heroin are 100 percent fentanyl.

That's how they are being sold by drug gangs from Philadelphia and Detroit doing business in the county.

And that's what customers want, Fennell said. They crave a stronger high from fentanyl.

“They know what's going on,” he said. “They know what they're buying. Their addiction doesn't allow them to have a choice.”

He bases his conclusion on first-hand observations, including numerous addicts' cell phones that he has scoured.

“You'll see messages in which they are asking (sellers), 'Are they fenty bags?'” Fennell said. “That tells you they're aware of it, and they want it.”

The rise in overdose deaths, said Butler Police Deputy Chief David Adam, is indicative of an economic principle at play when it comes to the popularity of fentanyl and other opioids.

“Where there's demand,” he said, “there will be supply.”

Life or death consequences be damned.

The drug is so toxic that some departments, including the county's drug task force, won't allow officers to touch confiscated stamp bags without proper protective gear, for fear that it could cause a potentially fatal drug overdose just through skin absorption.

The Drug Enforcement Administration earlier this year circulated a booklet — “Fentanyl: A Briefing Guide for First Responders” — that warned about various synthetic drugs.

Those drugs, the booklet said, are “designed to be absorbed into the body by all means, including ... via transdermal transmission (through the skin). As such, accidental exposure by first responders is a real danger.”

Fennell said he enacted a policy in 2016 that forbids officers from touching bags that could have fentanyl in them, without wearing at least one layer of gloves and a respiratory mask.

Mark Pfeffer, chief deputy with the Butler County Sheriff's Office, said that the death toll would be even higher if it were not for the frequent use of opioid antidote naloxone.

“The sad truth is we are having more deaths still despite the fact that there are more reversals. How many more deaths would there be without the naloxone being out there?” Pfeffer said.

Officers with every police department in the county now carry naloxone. They are supplied either through the county, which is supplied through a program with the state commission on Crime and Delinquency, or through partnerships with health care providers.

The county also supplies naloxone to some fire departments and this month the program was expanded by the state to include library staff, after-school program workers, public transit drivers, public defenders and homeless shelter workers.

Families are hurting

Justin Freyermuth's family says he loved to tell jokes and entertain people. A graduate of Knoch High School, he had the lead roles in school musicals, played multiple instruments and was the singer in a band, Branded by Society. He earned good grades and was accepted into Penn State New Kensington after high school.

Justin and his younger sister, Jaimee, were a couple of years apart at Knoch. When they were teenagers, they both did a modest amount of partying, Jaimee said.

Jaimee says she was never tempted to do opioids or other hard drugs. Justin was not as lucky.

“We hung out with all the same people and I did almost everything that Justin did growing up — including drinking and smoking — but I could walk away from it,” she said.

Justin's family believes he started taking pain pills when he was 19 or 20 and then moved on to shooting heroin. When confronted by his family about five years ago, he admitted to having a problem and spent most of his 20s going in and out of rehab centers.

He died of a drug overdose earlier this year at age 27, leaving behind a young daughter, his parents and four siblings.

The family hopes that by talking openly about Justin's struggles they can raise awareness of some of the issues that drug addicts face.

Some people have a genetic predisposition to addiction and the human brain is still maturing and susceptible to chemical changes into a person's late 20s, said Eileen Freyermuth, Justin's mother.

“We as a society, we call it a disease, but nobody treats it like a disease. They treat it as a moral failure, as a poor choice, when in reality most people who struggle with addiction merely have made a wrong decision in their life,” she said.

After dropping out of college, Justin was able to hold down carpentry jobs and live independently for stretches of time. He did not steal from his family or do anything violent, but he would try and hide his drug use from employers.

“Nobody wants to be an addict. He was ashamed of it,” said Ed Freyermuth, Justin's father.

He also struggled to get sober and stay sober.

Justin was clean for nine months last year and seemed to be doing well living in a house with other sober people in Beaver County. But he had a relapse, seemingly out of the blue, around Christmastime.

Eileen said she believes rehab was sometimes counter-productive for her son. He wanted to get clean, but he ended up meeting more users who could help him get drugs.

In his obituary, Justin's family asked for donations to Shatterproof, a nonprofit organization that works on evidence-based solutions to drug addiction and advocating for policy change.

“It shouldn't be a cookie-cutter recovery program,” she said.

Getting more people talking and educating themselves about the opioids, addiction and how it affects families is an important part of fighting the crisis, said Charlene Eckert, who runs a support group for families called Hope for Broken Hearts.

As more people are tragically lost, more people become affected.

“There are a lot of families out there that are hurting,” Eckert said. “Most people actively want to make a difference. They don't want other people to have to go through what they are going through.”

Eckert said she believes that the more people talk about the issue of addiction, the more the stigma will be lifted among the public.

In 2013, Eckert started Hope for Broken Hearts, a support group that meets at 7 p.m. Tuesdays at Mount Chestnut Presbyterian Church in Franklin Township. There are other support groups in the Butler area. She said there should be more.

“I encourage people to find a group or start a group. You don't have to know everything to start a group. You have to be compassionate, learn as you go and help educate other people,” she said.

Children exposed to addiction

The county's Children and Youth Services has been affected by the opioid crisis in Butler County.

Charlie Johns, CYS director, said police, ambulance personnel or a family member can ask county emergency dispatchers to send a CYS caseworker to an overdose scene where a child is present, which happens frequently.

In the past, CYS may not have received a report on the situation until days after the incident.

The new arrangement, which has been ongoing over the past year, was made possible through a collaboration between CYS and the district attorney's office.

“It's necessary that we're able to assess that situation, if possible, while the situation is occurring,” Johns said.

He said he has seen an uptick in recent years in the on-call caseworkers being dispatched after hours, but part of that is a result of the laws passed after the Jerry Sandusky child-molestation situation in 2012 at Penn State.

When a CYS caseworker responds to the scene of an overdose, the caseworker determines whether an arrangement has been made with a responsible family member to care for the child, Johns said.

If a family member is taking the child from the scene, the caseworker runs criminal and child-abuse background checks on that family member before allowing them to assume custody of the juvenile.

The checks can be completed at the CYS office during business hours and by 911 dispatchers after hours, Johns said.

One thing many people do not understand about CYS, Johns said, is that the state Department of Human Service's Office of Children, Youth and Families mandates that maintaining the family unit be considered first in every CYS case.

Johns said he would not be resistant to a shift in focus at the state level to the safety of the child being CYS' top priority.

“I would be behind it 100 percent,” Johns said.

He said there are many actions he or intake caseworkers would like to take, but they can't do what they feel is necessary in a situation.

“We are governed by the laws of the state and the courts,” Johns said.

Increasing caseload in the courts

The Butler County Court system has also been affected by the drug epidemic, with an increase in caseload and defendants coming through the courts.

Judge Timothy McCune, who presides over many of the criminal cases involving this issue, said this is “the same problems we've seen for a number of years” with a lot of crime driven by addiction.

“Anecdotally, every case I have has drugs or alcohol involved in it,” he said.

This led to the development of specialty courts, including the Drug Treatment Court, Behavioral Health Court and Veterans Court, which are diversionary programs to help address addiction issues while also decreasing prison populations.

“We've seen through our specialty courts that if you do closely supervise long-term, there can be a lot of progress with addictions,” McCune said.

Judge William Shaffer, coordinating judge of the Drug Treatment Court, declined to comment, stating that he presides over many of the criminal cases involving opioids that come through the court.

McCune said the Butler County Prison has also changed the way it approaches treatment of addiction issues, “trying to give them as much education as they can.”

He said follow-up supervision, including random routine drug testing throughout parole and probation and referring defendants to appropriate levels of treatment, whether outpatient or inpatient, helps stem the tide of the crisis.

District Attorney Richard Goldinger said his office has seen its workload increase “drastically because of what has been going on.”

Goldinger said about 90 percent of the caseload is drug-related in some fashion, with crimes ranging from drug possession to distribution, and even property crime such as retail thefts, burglaries and forgery, which are committed to fuel drug addictions. This also included driving under the influence prosecutions, which account for a large number of criminal cases, he said.

“We are also dealing with six homicide cases, most of which are drug-related,” he said. “And that is unusual for this county.”

Goldinger said in his budget request to the county commissioners for 2018, he has included a request for a temporary assistant district attorney position to “help address the overload right now.”

“We are trying to plan ahead for it,” he said.

Public Defender Joseph Smith said his office has also seen a correlating rise in caseload due to the drug crisis.

Smith said there are two halves to the judicial system: the initial crime and punishment stage, and then the parole and probation stage, where he said his office is also seeing a rise in violation cases due to new arrests and drug use.

“The criminal justice system and active addiction is a recipe for continued violation,” he said.

McCune said the court attempts to rehabilitate defendants through the use of drug programs, but sometimes that isn't successful.

“One of the problems with addiction is naturally denial and the continued use despite the negative consequences,” he said. “There is not a short-term fix to serious addiction problems.”

Goldinger said he also instituted a tough on drugs stance in early May with the “Not In My Backyard” campaign, which seeks higher bail amounts, up to $100,000, and sentences, which for a first-offense heroin dealer can include state prison for at least 12 months for both local and transient drug dealers in felony cases.

He said plea bargains are being extended to allow for pleas to felony charges and associated state prison time, with the condition that other charges be dropped, but if a defendant wants “to roll the dice and go to trial,” his office is prosecuting to the fullest extent, which could increase prison time.

“We probably have more drug dealers in jail right now who are waiting to go to trial because they don't like the plea offers they are receiving,” he said.

Goldinger said while he can't point out specifics as far as sentences imposed that were stiffer, he believes the program to be a success.

“In six months we will have an even better idea how this is helping,” he said. “I have been too busy to worry about statistics currently. We know how things weren't working before, and are trying to do something about it.”

First Assistant District Attorney Patricia McLean said she believes it is too early in the program to assess how much of an impact it is having.

Eagle staff writers Jim Smith, Joe Genco, Andrew Carr and Paula Grubbs contributed to this report.