Drug dealers have to pay for heroin overdoses on their turf, says a Pennsylvania judge. 
 
 Allegheny County Judge Anthony Mariani has sentenced two convicted Pittsburgh drug dealers with probation conditions requiring them to pay directly to local EMS agencies $50 per brick of heroin found in their possession. This money will pay for the Narcan doses administered to overdose victims. 
 
 Narcan, also commonly known as Naxolone, is an opiate reversal agent that can save the life of someone acutely overdosing, reversing the effects of any opioid-based drug. 
 
 The rising prominence of heroin overdoses in western Pennsylvania prompted Mariani’s innovation, he said. 
 
 Allegheny County was ranked 12th in Pennsylvania for drug-related deaths in 2015, 70% of which were heroin-related, according to the Drug Enforcement Administration. Middle-aged, white males made up the majority of those deaths. Allegheny county saw a 37% increase from 2014. 
 
 Philadelphia, in comparison, ranked first in the state for drug-related deaths, but heroin accounted for a little more than half of the deaths. 
 
 Once on parole or probation, Andy Buxton will pay $2,650 to three EMS and ambulatory agencies in Mon Valley, Pennsylvania. Buxton pleaded not guilty, but continues to serve his sentence while waiting for an appeal. He was convicted of multiple counts, and was sentenced last week to seven to 14 years, said attorney Sumner Parker. 
 
 “I think it’s something people involved in drug trade need to realize. It may take hold and be another consequence they’ll have to deal with for putting poison on the streets,” Parker said. 
 
 A Naxolone kit with which an individual can administer a nasal injection during an overdose typically costs $75, said Dr. Karen Hacker, director of the Allegheny County Health Department. 
 
 Though Naxolone has been a staple tool for EMS for years, according to Hacker, Allegheny police departments just started carrying them within the last year after legislators recognized the heroin epidemic as a problem in need of state funding. 
 
 A previous case inspired Mariani to the idea that probation conditions may not be able to require drug dealers to administer Narcan to overdose victims, but could make them pay for it. 
 
 “A couple of weeks ago a man stood in front of me who overdosed on heroin twice in 48 hours and was brought back by Narcan. I told him he will reimburse EMS who saved him with the Narcan,” Mariani said. 
 
 Mariani on Tuesday similarly charged Larry Craig Richardson Jr. with a $1,250 reimbursement to the Ross/West View EMS-Rescue for the 25 bricks of heroin found in his car, according to court documents. 
 
 Richardson, convicted of possession with intent to manufacture or deliver, received a minimum sentence of five years, according to court documents. Richardson’s attorney declined to comment. 
 
 The extra cash could be a long-term solution to a short-term problem, Executive Director of Ross/West View EMS Brian Kircher said. Kircher said the money would offset costs of first responders, but was hesitant to praise the idea since the individuals are not required to pay the fees until after they serve their sentence. 
 
 Essentially, the check might not be in the mail for more than 10 years. 
 
 Kircher, who’s been serving with the EMS for 35 years, said he’s seen dramatic changes in drug use in the area. 
 
 “In the ’70s you didn’t see as much heroin and opioid-type narcotics as frequently as you do today. Some of that is the availability and the changes in the way we treat pain.” 
 
 He noted man-made opioid drugs are a big part of the problem he sees in western Pennsylvania. 
 
 Kircher’s EMS unit saw 107 overdoses in 2015 in the five boroughs and townships they serve in the northern suburbs of Pittsburgh. In the first six months of this year, there have been 84, putting them on track to exceed 2015. 
 
 Mariani might spark a trend in judiciary punishment of convicted drug dealers. 
 
 This less common use of probation conditions is within Mariani’s rights as a judge, according to the executive director of the Pennsylvania Commission on Sentencing, Mark Bergstrom. Bergstrom noted that the assignment of funds to a specific agency is something creative, and uncommon, in comparison to typical restitution fines that are typically just fed to a municipality’s general fund. 
 
 Mike Manko, spokesman for the Allegheny County District Attorney’s Office, declined to comment. ||||| Sign up for one of our email newsletters. 
 
 Fed up with the rising number of opiate overdoses in Western Pennsylvania, an Allegheny County judge is making convicted drug dealers buy lifesaving naloxone kits for the communities where they've sold drugs. 
 
 Judge Anthony Mariani has added the fine to two cases in the past week, ordering Andy Buxton to pay a total of $2,650 to three agencies in the Mon Valley and Larry Richardson to pay $1,250 to Ross/West View EMS — $50 for each brick of heroin the men were convicted of possessing with the intent to distribute. 
 
 Naloxone, known by the brand name Narcan, can reverse the effects of opiates such as heroin and halt an overdose. 
 
 “Ordering the defendant to provide funds for naloxone to the relevant agency will help to rehabilitate him and change his thinking,” Mariani said Tuesday while sentencing Richardson, 41, of Ross on two felony counts of possession with intent to deliver. He ordered Richardson to serve five to 10 years in prison. 
 
 Ross police found a bag with 25 bricks of heroin and 9 grams of cocaine in Richardson's car. 
 
 Fatal drug overdoses in Allegheny County increased 37 percent between 2014 and 2015, for a total of 422 deaths last year, according to an analysis by the Drug Enforcement Administration, which Mariani cited as his reason for imposing the fine. Westmoreland County overdoses increased 43 percent to 126 deaths in the same period. 
 
 Westmoreland County judges have yet to impose similar sentencing conditions. Judge Meagan Bilik-DeFazio said Mariani's plan is interesting and worth considering. 
 
 “The fact is that naloxone is saving lives. I wonder if maybe we should consider ordering the addicts to have naloxone. Having it in more hands is all the better,” said Bilik-DeFazio, one of the county judges who presides over a drug court program. 
 
 Tim Phillips, executive director of the county's drug overdose task force, said making convicted drug dealers provide money for life-saving naloxone kits is a novel approach. 
 
 “This is the first I've heard of it, and I'm sure it could have a positive effect. It could be part of the solution. Anything that will save a life is worth considering,” Phillips said. 
 
 Richardson, who is black, maintained his innocence and said the crisis of overdose deaths was only a result of people noticing more drug abuse across racial groups. 
 
 “It wasn't a problem when my dad and my uncle were OD'ing in the community back in the '70s and '80s,” he told Mariani before his sentence. “We didn't have Narcan. ... Now all of a sudden because it's young white people coming into the city for drugs, it's a problem.” 
 
 Mariani's naloxone fine is a condition of the defendants' probation and consecutive to their prison time, so they won't have to start paying until they have been released. In Richardson's case, Mariani allowed him to pay a minimum of $100 per month once he's out of prison and has secured employment. 
 
 The $1,250 Richardson must pay is little compared with the $20,000 Ross/West View EMSA pays for medical supplies each year. Executive Director Brian Kircher said it could offset some of what the agency puts toward helping overdose victims. 
 
 “We don't get reimbursement from insurance for patients we don't transport. The majority of overdoses end up being refusals (for transport),” he said. 
 
 Ross/West View EMS has carried naloxone for more than 20 years, Kircher said, and was starting to train police in the region on how to administer the drug nasally in cases in which they arrive at an overdose before medics. 
 
 Dr. Karen Hacker, director of the Allegheny County Health Department, said over-the-counter naloxone kits cost about $75, though police and EMS agencies might be able to get them for less through bulk buying, insurance coverage and grants. All EMS agencies typically carry the drug. 
 
 Mark Bergstrom, executive director of the Pennsylvania Commission on Sentencing, said imposing the fines is within the judge's power, though he was not sure whether the law allowed the fines to be steered to specific agencies. 
 
 Mike Manko, spokesman for the Allegheny County District Attorney's Office, declined to comment on the fines but noted that a grant from the Pennsylvania District Attorneys Association allows the office to purchase naloxone kits for county police departments. 
 
 Rich Cholodofsky contributed. Matthew Santoni is a Tribune-Review staff writer.
– Fatal drug overdoses have jumped about 40% in Pittsburgh and the surrounding area in recent years, a trend one judge hopes an unusual punishment will help reverse. In two cases this week, Judge Anthony Mariani ordered drug dealers to pay $50 to local EMS for each brick of heroin they were convicted of possessing with intent to distribute to fund naloxone or Narcan kits in the hope that they'll reverse overdoses from opiates, perhaps the very ones sold by the dealers, reports the Tribune Review. However, the men won't have to pay until they're out of prison, which will be years away. "A couple of weeks ago a man stood in front of me who overdosed on heroin twice in 48 hours and was brought back by Narcan," Mariani said of his inspiration, per WTKR. "I told him he will reimburse EMS who saved him." Andy Buxton, sentenced to seven to 14 years in prison, must pay $2,650 to local EMS agencies, while Larry Richardson, sentenced to five to 10 years, will pay $1,250, Mariani said. "Ordering the defendant to provide funds for naloxone to the relevant agency will help to rehabilitate him and change his thinking," he added in delivering Richardson's sentence on Tuesday. A single naloxone kit costs about $75, according to Pennsylvania health officials. "The fact is that naloxone is saving lives," says a judge overseeing a court drug program. "Having it in more hands is all the better." The director of a local drug overdose task force adds he's never heard of a judge taking such an approach, but "I'm sure it could have a positive effect," he says. "Anything that will save a life is worth considering."