When Ashley Mooney-Naglieri learned last winter that her husband was homeless and using heroin again, she got in her car and cruised all night through his Highlandtown haunts, shouting “Nick” out her window and stopping to peer into parked vehicles.

“I had heard he was sleeping in cars on Eastern Avenue,” she said. She had heard right. Shortly before dawn that cold January morning, Mooney-Naglieri found her frostbitten husband in the trunk of an SUV.

“He said he wanted help,” said Mooney-Naglieri, a Baltimore County Public Schools employee. “He didn’t want to live like this anymore.”

Over the next three months Nick Naglieri did his best to get help — detox, methadone and rehab. But on April 3 the 33-year-old former mailman and father of two boys was found dead with a needle in his arm. The cause, according to the medical examiner, was accidental fentanyl overdose.

“It seems like it’s getting worse and worse out there,” his wife said.

Through the first half of 2018, Maryland recorded 1,185 opioid-related overdose deaths — 15 percent more than the same period last year. The midyear figure is the most recent the Maryland Department of Health has tallied. If deaths have continued at that pace, as many suspect, fatalities will surpass last year’s record of 2,009. That figure ranked Maryland among the hardest-hit states as the nation recorded 48,000 opioid overdose deaths in 2017.

Driven by a flood of deadly fentanyl, the state’s opioid crisis continues to carve wounds of heartache and despair for loved ones left behind, many of them in Baltimore. By July 1, 483 people in Baltimore had died of overdoses, 88 more than at last year’s midpoint and the most in any Maryland jurisdiction. By year’s end the fatalities will dwarf the city’s 300-plus homicides, most of which are caused by the same drug trade that delivers fentanyl and heroin.

But deaths are rising all over the state. After Baltimore, the next five Maryland jurisdictions with the highest death rates are all predominantly white, rural counties like Cecil, Caroline and Allegany.

Few people in Baltimore have witnessed the suffering more than Erich March, owner of March Funeral Homes. March is frustrated that so many deaths involve the drug trade.

The epidemic began several years ago as over-prescribing practices flooded medicine cabinets with legal opioid pain relievers such as Oxycontin. Once hooked, users began chasing better and cheaper highs from illegal heroin.

While state programs to monitor prescription writing and to distribute the overdose-reversing drug naloxone did begin to lower deaths caused by pills or heroin last year, fentanyl snuffed out any progress. The synthetic opioid was involved in nearly 88 percent of all opioid overdose deaths in 2017.

“Fentanyl has taken over,” March said. “People don’t know what they’re putting in their bodies and they’re paying a heavy price.”

So are their families — no matter race, culture or class.

Even more insular communities like Orthodox Jews in Northwest Baltimore are suffering from the epidemic. But now they’re talking about the issue rather than whispering, said Howard Reznick, manager of prevention education for Jewish Community Services. Prior to 2017, his efforts to educate the community were largely shrugged off, he said.

“I’m noticing an increase at funerals of folks saying out loud that the person was struggling with drug problems,” Reznick said. “In the last year and a half congregations have come to us to do something for their congregants.”

Jewish Community Services has hosted several public education sessions this year that included naloxone training. It is launching a podcast about women and addiction, and starting a grief support group.

“On a community- wide level, it’s never been like this,” Reznick said.

Such grief groups are growing across the nation and the state.

“There isn’t a word for losing a child, especially to substance abuse,” said Laura Cash, a board member for a national peer-grief program called Grief Recovery After a Substance Passing, or GRASP. She lost her 28-year-old son to overdose four years ago and still feels the pain daily.

The group, based in Ohio where Cash lives, has seen national membership grow from 1,000 in 2014 to 8,000 today, including four Maryland chapters.

Michael Shetterly runs the monthly GRASP support group in Perry Hall.

The 51-year-old Essex man and his twin sons have been grieving the loss of their 23-year-old son and brother, Matthew, for four years. Sharing the grief at GRASP meetings has helped Shetterly attain some sense of normalcy this year, he said.

But he also thanks a former stranger: Erv Basdon of Fairfax, Va.

When the two met last year at the Living Legacy Foundation of Maryland’s Baltimore office, Shetterly said he and his wife were still “lost, torn apart.” But when Shetterly pressed a stethoscope to Basdon’s chest, he broke into tears as he heard the pulse of his dead son’s heart.

He had not been so close to this heart since he tried reviving it with CPR in 2014 after finding Matthew lying on the floor of his childhood bedroom, a heroin needle in his arm. Both Basdon and Shetterly are convinced God intertwined their fates: Matthew died on Good Friday that year and his heart was transplanted into Basdon on Easter Sunday.

Theirs is a rapidly growing phenomenon, according to the Living Legacy Foundation of Maryland. In 2015, one out of six organ donors in Maryland had died of an overdose. Today, the number is one out of three.

It took two years before Shetterly could muster the courage to meet Basdon, who was suffering from guilt that it took someone to die to save his life. But Shetterly has found great relief in knowing Basdon, that his son’s fatal overdose had saved the life of someone willing to offer such an intimate encounter.

“I love that man,” Shetterly said.

“Matthew lives on in me,” Basdon said.

Lisa McLaughlin and her husband have also turned to a GRASP support group in Harford County to deal with the devastating death of their 19-year-old daughter, Hannah, who died of an overdose four years ago on the same day she returned to her parents’ home from a Philadelphia rehab.

After arriving that morning, Hannah and a sponsor went together to a 12-step meeting while her Bel Air parents went to work. By the time they returned near 5 p.m. Hannah was dead of a fentanyl overdose.

“The needle was stuffed in her jeans when I found her,” said McLaughlin, who had testified earlier in 2014 before the General Assembly to request widespread availability of naloxone.

The legislature acted too late for her daughter. Today state rules allow any adult to obtain naloxone at any pharmacy. McLaughlin also struggles with regret that she didn’t know her daughter’s attention-deficit problems and unexplained stomach pains were signs of an anxiety condition caused by a childhood trauma that Hannah had never shared.

“So often, by the time a family realizes their loved one is dabbling in drugs, they’re further down the road of addiction than the family is aware,” McLaughlin said.

Alyssa Du Biel can attest to that. When the 25-year-old Carroll County woman confessed in July to her parents that she was a heroin addict, they were shocked and relieved that she was going to a Sykesville rehab. Since September Du Biel has been living drug- and alcohol-free with other recovering women in the Reclaiming My Life Sober House in Westminster.

Du Biel said her drug use started in her senior year of high school with alcohol and marijuana. Once she hit 21, the partying accelerated with her use of pills and cocaine. By 2016 she was snorting heroin for the first time.

Before she knew it, the petite woman was accompanying armed addicts — or going solo — to buy drugs from “very dangerous people” in Westminster or Owings Mills and snorting whatever she purchased, even though she knew it likely contained fentanyl.

Late last year, after snorting heroin in her car with a girlfriend, the pair drove to Arby’s. Just as Du Biel was ordering at the drive-through speaker, her friend slumped over beside her. The woman’s lips were blue.

“She looked dead,” Du Biel said. “I went crazy screaming into the drive-through speaker.”

Paramedics revived her with naloxone and took her away in an ambulance. Du Biel — still dressed professionally from her job at a tailoring shop — talked to police with heroin in her pockets. Still high, she cried until officers let her leave. She drove to her then-boyfriend’s house, where she snorted more.

“I’m certain it had fentanyl in it,” she said. “The fact that I’m alive is a miracle.”

Du Biel credits her success so far to a busy schedule of therapy, meetings and work — and the support of her sober housemates.

Those who have lost loved ones to addiction also can get support from others experiencing the same pain.

Tammy Lofink, whose 18-year-old son Robert died of a heroin overdose four years ago, started a nonprofit called Rising Above Addiction. It not only runs the house where Du Biel is recovering, but helps parents and other relatives navigate the perils of active addiction and recovery.

“Every time I can help someone, it makes it a little bit easier for me,” Lofink said. “It’s a way for parents not to let their children’s deaths be in vain.”

ddonovan@baltsun.com

twitter.com/dougdonovan