Stephanie Machen traveled a terrible path before Bensalem police discovered her body last February, ditched in the dead leaves along a quiet road near I-95, drenched by a cold rain.
The Bucks County coroner determined that the 25-year-old had overdosed on heroin mixed with fentanyl, a powerful narcotic meant only for the worst pain. She still wore the identification wristlet from the rehab facility she left just days earlier.
Today, coroner Joseph Campbell counts Machen among the earliest casualties in a shocking year: Opioid deaths in his county shot up nearly 50 percent in 2016. “We set a record,” he said last week, adding that he sees no end in sight. “We had three more this past Saturday.”
In neighboring Montgomery County, where Machen was born and raised, the death toll climbed by 43 percent.
“We’re getting pulverized,” said Alexander Balacki, Montgomery County’s first deputy coroner.
"We used to say we were losing 10 Pennsylvanians a day," said Jennifer Smith, acting secretary of the state Department of Drug and Alcohol Programs. "That estimate may be pretty low at this point."
In Bucks last year, there were 185 fatalities, up from 124 in 2015. In that time, Montgomery County deaths increased to 253 from 177. Considering the size of the populations, the crisis is similar: Each county had about 30 deadly overdoses for every 100,000 residents.
“I don’t think folks realize how bad this [epidemic] is,” said Gary Tuggle, who heads the Drug Enforcement Administration’s Philadelphia division. “We’re in a tough pickle. And we expect the numbers to keep rising.”
The opioid crisis was fueled years ago by prescription drugs as pharmaceutical companies heavily marketed the remedies for undertreated pain and doctors responded by pulling out their prescription pads. Over time, drug abusers trying to avoid the pain of withdrawal sometimes switch to using heroin, which is cheaper and easier to find, but far deadlier. Magnifying the effect: Dealers are juicing up their heroin with fentanyl, Tuggle said.
The extraordinarily powerful synthetic opioid has appropriate medical uses for severe pain. But a few extra grains — most of it made overseas by drug cartels, not pharmaceutical companies — added to a bag of heroin can be lethal.
In Bucks County, nearly 60 people — including Machen — died with the drug in their veins.
“The significant amount of fentanyl we’re finding is driving a lot of these deaths,” Campbell said. “It’s so potent, and there’s no comparison between it and heroin.”
In Montgomery County, the number of fentanyl-related deaths tripled from 2014 to 2015, Balacki said.
In New Jersey’s Ocean County, fentanyl-fueled deaths surged 75 percent, rising from 118 in 2015 to 205 last year.
“It’s a synthetic storm,” said Al Della Fave, spokesman for the Ocean County Prosecutor’s Office. “It’s what’s killing us.”
It is an inconsistent epidemic. Chester County saw 14 fatal overdoses for every 100,000 residents, the lowest in the region. Burlington's rate increased slightly last year to nearly 19 per 100,000 but is still among the region's lowest.
Delaware and Camden Counties' death rates are far higher, at 33, yet they were the only counties in the region to experience declines last year. Exactly why isn't known, but both have tackled opioids aggressively, including widespread use of the reversal drug naloxone by police and emergency responders.
"This decline represents progress, but losing 161 people to heroin overdoses is unacceptable" Camden County Freeholder Director Louis Cappelli Jr. said.
Less populous Gloucester County saw 88 deaths, up 35 percent in a year.
“In a small county like ours, it’s hit a lot of people,” said Jim Jefferson, the Gloucester County freeholder who oversees the office of addiction services. “Everyone knows someone who has been affected.”
* * *
Stephanie Machen’s short life is a window into the nightmare that is addiction. Her story is remarkable in some of the details, but what may be most tragic is how familiar her struggle has become.
Machen was adored by family and friends, and fought to survive — the 16 times she sought drug treatment attest to that. Described as smart and ambitious, the West Chester University graduate wanted to become a nurse.
Some families say they can’t understand how addiction could strike them. Others know it often is a family disease. Long before Machen ever took a pill or spiked a vein, she saw in her father the damage that comes with opiate addiction.
"This is a young lady who grew up around recovery," said her father, John Machen, 63, who battled his own heroin addiction for years and is in recovery. "She knew my story. She knew the devastation."
John Machen grew up and started using in Kensington, which still is the epicenter of the region’s drug scene. But he has seen the scourge evolve.
“Facebook has become like an obituary page,” he said. “And you know what? It’s not Kensington kids dying. All those girls working the avenue -- they’re from the suburbs, South Jersey.”
He was off heroin when Stephanie was born but relapsed when she was 6 and went to rehab. Erin Machen, Stephanie’s older sister, believes that absence stuck with her sister.
“She thought he left because she wasn’t a baby anymore,” said Erin, 38, the mother of five now living in Boyertown. “She carried that burden her whole life — that feeling of not being good enough.”
As a child, Stephanie lived in the Norristown area with her mother, Helene, but remained close to her father as well. She attended Ancillae Assumpta Academy and Lansdale Catholic High School. She played field hockey. Summers brought family visits to the Jersey Shore.
In high school, Stephanie started drinking some. In time, she began taking the opioid painkiller Percocet recreationally. At West Chester University, Stephanie studied nutrition. She wasn't accepted into the nursing program she wanted. Later in rehab, she would tell people she was a nurse, as if trying to manufacture the self she had not managed to become.
She waitressed, she tended bar. She needed fast, daily money as her drug habit grew.
But her family still saw the Stephanie they loved, especially when she was with her little nieces and nephews who called her “Aunt Fluffy” because they couldn’t pronounce her name.
Erin’s first-born, James Hudak, now 10, is on the autism spectrum. The boy showed affection to few people. "Steph was the only other person in his life who he would kiss on the lips and tell her, 'I love you,' " Erin said.
In 2014, Stephanie moved in with Erin and her family after she broke up with a boyfriend. Later that year, Erin found a hypodermic needle in Stephanie’s room. Worried for her kids, Erin said, “I threw her out.”
The long string of rehab stints began, but too often Stephanie would decide she’d had enough and checked herself out “against medical advice,” her father said.
She racked up arrests: traffic violations, thefts, stolen-property charges.
Lisa Foster, 50, who is living in recovery now, met Stephanie at Mirmont Treatment Center in Media. The women ate lunch together every day. “You could see the light in her eyes,” Foster recalled. Yet she sensed Stephanie was gripped by addiction and guilt. She recalled telling the younger woman that it was hard to believe the story of her past.
“I’m not innocent,” was Stephanie’s response.
* * *
On Feb. 16, 2016, about 10 a.m., police got a call from a motorist who found a body on Mill Road, a quiet connector road near I-95 north of Philadelphia.
Another drug abuser, Erik Finnegan, later admitted dumping Stephanie's body after he found her dead in the room where he was staying in North Philadelphia.
Three days before she died, Stephanie had left a rehab in Chester County, bound for a recovery house where she could live in a sober environment. That was a Friday. "The last text I got from her was Saturday,” said John Machen. “She said, 'Dad, I can't do this. I need long-term treatment.' She left."
So many people gathered to pay respects to Stephanie, they couldn’t all fit in the funeral home. No one, Erin said, would have been more amazed at that than her little sister.
Last summer, John Machen opened a recovery house in Pottstown to honor his daughter. Called Steph’s Place, it is intended to be a safe place for women to reclaim their sobriety and their lives.
The day after the house opened, all seven beds were full. It is always hard for him to turn away those who need help.
“In a lot of these girls,” he said, “I see my daughter.”
For more information about the opioid epidemic in Pennsylvania, and where to find help, click here. For county-specific information: Bucks County; Chester County; Delaware County; Montgomery County. The state also runs an information hotline at 1-800-662-HELP (1-800-662-4357)