During months of probing fraud in the sober home industry, the investigative team at The Palm Beach Post encountered another disturbing problem: young people dying from heroin or fentanyl overdoses at an alarming rate.
Post reporters knew it was a huge public health crisis that needed to be exposed because little was being done to stop the dying.
They decided to unveil the scope of the epidemic and put a face on the people dying by telling each and every story of the 216 men and women who lost their lives to heroin-related overdoses in Palm Beach County in 2015.
Until The Post began its reporting, no one had compiled a comprehensive list in the county of the people who had overdosed on heroin, fentanyl or illicit morphine. As a result, local politicians, police and fire-rescue officials and community advocates lacked the most basic information needed to combat the epidemic.
The linchpin of the project would be a single image, the wall of photos on today’s front page.
I-team reporters studied hundreds of pages of police reports from 15 agencies. The team compared police findings against autopsy results to sift through a list kept by the Palm Beach County Medical Examiner’s Office of more than 350 people who died with the presence of up to 100 different drugs in their system. Few knew the list existed.
For further verification, police and autopsy records were matched against official death records assembled by the Florida Department of Law Enforcement from local medical examiners.
While overdose deaths typically involve multiple drugs, The Post looked for the presence of one or more of the three narcotics linked to the opiate epidemic: heroin, fentanyl and morphine.
Fentanyl often is mixed with heroin or sold as a more powerful replacement for the better-known opiate. Morphine deaths were considered because illicitly obtained morphine is used as a substitute for heroin, its chemical cousin. Further, once ingested, heroin quickly turns into morphine. It is standard practice for medical examiners to consider all evidence relating to a death to determine that morphine deaths are caused by heroin.
The Post did the same. If the person had at least one of the drugs in his or her system at autopsy, editors and reporters then discussed each person’s records on a case by case basis, looking for a history of drug use, drug paraphernalia found at the scene and observations made by friends, family and law enforcement.
The Post excluded cases in which heroin was not detected and morphine or fentanyl appeared to be a legitimate medical treatment, unrelated to addiction.
To find what other states and towns were doing to address the epidemic, a Post reporter and photographer traveled to small towns in Kentucky, West Virginia and Virginia and interviewed local officials there. Medical and public health experts were interviewed to detail both the science explaining the epidemic and the shifts in drug culture pushing the death toll.
But The Post realized the numbers, no matter how powerful, could never tell the real story. The decision to publish names and photographs followed extensive discussion among editors and reporters. The paper reached out to experts in ethics, people in recovery and with treatment counselors.
Reporters called family members in New Jersey, Delaware, New York, Rhode Island, Texas, Louisiana, Maine, Indiana, Colorado, Pennsylvania and Ohio as well as throughout Florida.
The Post reached at least one member of the family of 60 percent of those who died. Of those, nearly 100 supported publication of their loved one’s name and another two dozen took no position. Fewer than a dozen expressed sharp objections.
To compile life stories, reporters conducted more than 100 interviews with friends, family members and business associates. They scoured social media sites, as well as archived web sites, birth records, police reports and corporate, financial and property records.
About 400 photos were collected from families, obituaries and social media, predominantly Facebook.
When no other sources of information could be found for those who died, The Post relied on police and medical examiners’ reports of their last days.
To reach Post reporters, readers can email firstname.lastname@example.org or call 561-820-4401.