Xylazine's role in Westmoreland overdoses continues to surge, coroner's report shows

A veterinary sedative that can’t be counteracted with anti-opioid medication contributed to 42% more deaths in 2023 than the year before, continuing a troubling trend even as Westmoreland County’s overall overdose figures decline.

Accidental drug overdose deaths continued to drop in 2023, but the number of deaths caused by xylazine climbed from 31 to 44, making it the second-largest factor in fatal overdoses, according to the Westmoreland County Coroner’s annual report, released this week.

There were 95 accidental overdoses in 2023, down from the 118 overdoses in 2022. The report shows a sharp downward trend from 2021, when that figure hit 168.

“I feel like the saturation of Narcan we’ve provided, and the training, has had a direct correlation to the decreases,” said Breane Minardi, director of clinical and case management services for the nonprofit Westmoreland Drug and Alcohol Commission. “In 2023, we distributed 5,016 Narcan kits. That’s a 30.5% increase over 2022.”

After hitting a high point in 2017 with 193 drug overdose deaths, the statistics dropped dramatically and 2023’s numbers cut that figure by more than half.

Heroin has continued to disappear as a major factor in overdose deaths. Fentanyl was the main contributor in 77 deaths in 2023 — 89 when including a dozen overdoses attributed to derivatives such as acetyl-fentanyl and para-fluorofentanyl — while heroin was the primary cause in just three.

Overall, the overdose figures are the county’s lowest since 2014.

Minardi said the commission has adjusted its approach with the onset of fentanyl and xylazine, offering not just the Narcan kits but also drug testing strips that can recognize the presence of both substances.

“We developed harm reduction kits, and just like the Narcan kits, we can send them by mail and we have them at our offices in Monessen, Mt. Pleasant and Greensburg,” she said. “So if someone is not ready to quit, they can at least test their drugs and know what they’re taking.”

Unlike opioid-based drugs, xylazine cannot be counteracted with Narcan or naloxone, its generic form.

The annual report released showed a slight drop in Coroner Tim Carson’s caseload, from 3,309 in 2022 to 3,120 last year. The number of autopsies performed has fallen dramatically since 2022, when it dropped from 208 to 128, and then to 117 last year. Those are the lowest figures since 2014 (153).

There were 27 traffic-related deaths and four homicides. In addition, deaths by suicide — 60 — were just two shy of the county record set last year.

The number of suicides has remained between 46 and 62 for the past decade. The coroner’s office has been working with Ray of Hope, the county’s suicide awareness and prevention task force, to get resources to families when the deputies respond to death by suicide calls.