Heroin and opioid abuse is making headlines in northcentral Pennsylvania, and counties across the state are dealing with the repercussions of overdoses, increased crime rates and the other issues that come along with drug dependence.

There have been efforts by officials at the county and state levels to combat heroin/opioid addiction, which begins, for many people, with legally-prescribed prescription drug abuse.

The epidemic is affecting individuals from all walks of life, all income levels, and diverse backgrounds. Seven people overdose and die each day in the Commonwealth, and the majority of those deaths are caused by opioids.

Pennsylvania legislators introduced several measures to help combat the problem in 2014, including allowing private citizens to carry and administer the drug Naloxone to revive an overdosing individual; allowing for “good Samaritan” reporting of overdoses without fear of arrest; and strengthening of prescription drug monitoring through electronic health records to keep the most dangerous prescription medication off the black market.

While heroin has traditionally been viewed as an inner-city problem, the epidemic has spread to rural communities, and is killing off residents just as quickly as in larger areas.

The Drug Enforcement Agency (DEA) indicates the death rates in Elk County were the seventh highest in the state, with 25.65 individuals per 100,000 dying of a drug overdose in 2014. That year, Elk County lost eight people; McKean County lost six. Cameron and Potter each reported zero deaths.

Officials believe the epidemic has worsened in the past year, with more heroin and opioid abuse being reported by law enforcement and court officials than ever before.

Each county has had a slightly different approach to combatting the problem, though the four counties in the region — Cameron, Elk, McKean and Potter — are all working together on some initiatives.

Potter County has made the biggest changes to its criminal justice system, introducing specialty courts for DUI and drug offenders that are less punitive and more therapeutic in nature.

“We were told initially that we would see reductions in recidivism, we would see improvements in mental health and also changes in the family unit. All of this has proven to be true. All of it,” said Potter County District Attorney Andy Watson. “Data showed that the treatment courts had higher success rates than any other federal or state program.”

Through the specialty court programs, which got its start through the utilization of various grants, the county estimates it has saved 1,449 jail days. Of 3,888 substance abuse tests given, only seven have shown the presence of drugs or alcohol.

Watson said the program began with the DUI court. The drug court began later but has presented more issues. Participants relapse more, but drug court personnel remain committed to helping participants lead healthier, more productive lives.

“I’m not saying that every defendant in this program is going to be successful, because they’re not,” said Watson. “But we have taken some people into the program who have overdosed and almost died and they are learning sobriety; they’re learning education; they’re getting jobs. They’re actually becoming parents to their children, spending more time with their spouse, going to church. They’re learning a new way to live.”

The county has launched additional initiatives, including the development of a Women’s Rehabilitation Center, which treats women for addiction in a residential setting with time for family therapy, job training and placement and re-entry plans; in-jail programs for men and more intensive re-entry planning; strict enforcement with the Potter County Drug Task Force; stricter sentencing for upper-level drug dealers; and the CLEAN Protocol.

The CLEAN Protocol is an interesting concept, and the opposite of what is expected from a district attorney. Individuals with drug dependence issues can approach any police officer in the county, turn over any drugs they have on them, and receive immediate help to be placed in a detox or rehabilitation program.

“This is a means of public outreach. We don’t want to arrest you, we want to get the drugs off the street,” Watson said. “We’re more interested in getting you rehabilitation services.”

Potter County works with entities in McKean County to provide medication-assisted treatment, and works with Alcohol and Drug Abuse Services of Cameron, Elk and McKean counties to provide additional assistance, as needed.

Meanwhile, Cameron County District Attorney Jeanne Miglicio said her counterparts have learned that punitive measures alone are not enough to change a person’s way of thinking and allow them to become drug free.

“When a person comes into contact with the court system, we require assessments and referrals are given for treatment and follow-up. We realize that the first try might not work — that’s something we’ve learned,” Miglicio said. “One failed try doesn’t mean a failed person. Some people need more than one try.”

Miglicio said she avails herself to a District Attorney Association network that provides information on best practices, treatment options and the newest methods of combatting the issues.

The county also commits women who meet the criteria to the Women’s Rehabilitation Center in Potter County, and other individuals are mandated to attend long-term rehab programs, as warranted.

“It’s (Women’s Center) has been a real benefit. It’s too bad we don’t have a similar men’s center,” Miglicio said. “The biggest issue is balance. We have to address their issues on a criminal level, because they have committed crimes, while at the same time we have to address the individual’s needs to help him or her become more productive and return to society.”

In neighboring McKean County, the heroin epidemic has been ramping up, though the most recently-released numbers, for calendar year 2014, do not necessarily illustrate that as officials believe the problem has worsened of late.

“We are a very rural county and many of our young people, our McKean County kids, are dying in the last several months, so this is an issue that all of us take very personally,” said McKean County District Attorney Stephanie Vettenburg Shaffer.

The McKean County Drug Task Force is focusing efforts on heroin and opioids, and public service announcements have been made, and will continue to be made, when the need arises.

Vettenburg Shaffer commended local law enforcement, and the public, for helping spread the word on issues. Social media has been a big help in getting the word out when it is deemed necessary, such as earlier this year when three overdoses — one fatal — were reported within just 36 hours. Officials released information on the substance and its packaging, which is often made unique by dealers to indicate a specific “brand” of heroin. The task force was able to retrieve unused bags of the substance following the PSA release.

In 2015, McKean County prosecuted 95 drug cases. As of the end of March 2016, 43 cases had already wound their way through the criminal justice system. In the last two years, the county has seen an increase in property crimes, like burglaries and thefts, which are typically associated with drug activity.

Vettenburg Shaffer said that ongoing training and education is one tool that her county is using, along with working closely with law enforcement and treatment specialists from across the region.

All counties work with drug task forces, either their own county’s or the North Central Drug Task Force. Education and training is ongoing throughout the region, and treatment is becoming the norm rather than the exception in an effort to save lives and communities in rural, northcentral Pennsylvania.