CLIFTON PARK -- Early on the morning of Feb. 28, a motorist happened upon a truck stopped at a light on Route 146 -- the driver slumped over, seemingly unconscious.
It was a scene that is becoming more common as the region and nation struggle with an epidemic of heroin addiction. The good Samaritan motorist reported to police that the other driver was unconscious and very pale. His lips were blue. He had no pulse.
The witness shook the man, then slapped him. With troopers and paramedics on the way, he started CPR.
"About the third cycle of chest compressions and breaths, I checked for a pulse again and I found a pulse," the witness told troopers, according to court records. "After I found a pulse the troopers showed up and administered [naloxone]."
Revived with the drug that reverses opiate overdoses and checked out by medical personnel, the motorist, identified in court documents as Brandon Iacovissi, was arrested. He was later released to appear on the charge at a later date.
Two months later and on the same stretch of road, Iacovissi drove his truck head-on into a van carrying four people, seriously injuring all four, according to police reports. Uninjured in the crash, Iacovissi was again charged with driving under the influence of drugs.
Exact statistics on the number of people caught driving under the influence of heroin, opiates or any specific drug are difficult to pin down. The charges for those found to be impaired while driving do not identify which drugs they were suspected of using at the time.
But those charged with driving while ability impaired by drugs -- the equivalent of driving while intoxicated by alcohol -- have risen in Schenectady and Saratoga counties over the last five years, in tandem with the growing heroin epidemic, according to numbers kept by the state Division of Criminal Justice Services. The numbers provided reflect the most serious charge defendants face.
Statewide, the numbers have remained largely flat, with a five-year low of 2,350 recorded DWAI arrests last year and a high of 2,538 the year before.
Saratoga County saw a record five-year low of 29 DWAI arrests in 2013 and a high last year of 68. Schenectady County saw a low of 13 in 2014, then 33 in 2016 and 31 last year, records show.
Albany County reported 68 DWAI arrests last year, up from 52 in 2013. The county, though, saw peaks of 103 and 95 such arrests in 2015 and 2016, respectively.
Schenectady police dealt with an unconscious driver -- believed to be a result of a heroin overdose -- just last month. On April 22, police responded to Becker Street and found 37-year-old Schenectady resident Paul Donzelli unconscious in the driver's seat of a vehicle that had struck a parked car, police said.
Responding firefighters administered naloxone, and he was revived in a scene captured by a Daily Gazette photographer.
City police Sgt. Jeffrey McCutcheon said such scenarios have become more common. Eight of Schenectady County's 31 DWAI-drugs arrests last year were processed by city police, according to the state numbers. The city recorded no more than three such arrests in each of the previous four years.
McCutcheon said the recent DWAI arrests usually involve evidence of heroin use.
"As we get more and more calls for overdoses, we get more and more calls for the same type of scenario: passed out in a vehicle, either while driving or parked," McCutcheon said.
Police departments and paramedics have become increasingly prepared to respond to those scenarios.
The Saratoga County Sheriff's Department has two trained drug recognition experts who are called to determine whether drug use is evident at traffic stops and crash scenes, according to Lt. Shelley Zieske. All deputies are also issued naloxone and trained to administer it when needed.
"They're tasked with determining if a person at that time is still under the influence," Zieske said.
In cases where drug use is suspected, blood or urine samples are taken for testing to better determine which drug or drugs are involved.
Compared with alcohol-related driving arrests, drug-related cases remain comparably small. Albany County saw 884 DWIs last year, Saratoga County 740. Schenectady County saw 194, according to the state numbers.
The Division of Criminal Justice Services conducted training for law enforcement in 2014 on the use of naloxone. In the first three years, according to a report out last June, more than 2,000 officers administered the drug in various settings, and 88 percent of those who were treated with the drug survived.
In the state police, all officers on the road are trained in naloxone's use. Doses of the drug are included with automatic external defibrillators, as the drug and AED are used in similar calls.
According to technical sergeant and state EMS/AED coordinator Jared Pearl, telltale signs of heroin use include pinpoint pupils and extremely slow breathing, as well as blue lips or fingertips.
"Slow breathing can be hard to detect, if you're not looking," Pearl said.
The program can be particularly helpful in rural areas, where ambulances and paramedics can be far away, but troopers may be patrolling nearby, Pearl said.
After Iacovissi was revived on the roadside with naloxone, he allegedly told troopers he had used heroin. Two months later, on the evening of April 20, Iacovissi was again on Route 146, in the same pickup truck and again, authorities say, impaired by drugs. The exact drug is unclear pending tests. As witnesses spoke with 911 operators to report his erratic driving, the truck he was operating slammed into the van.
"I've never seen someone so out of it," one witness to the crash told troopers. "He does not deserve to be driving on the road; he's going to kill someone."
Iacovissi's license was temporarily suspended after a February 2017 Saratoga County DWAI conviction, state records show. But that suspension had been lifted by the time he was found unconscious behind the wheel in February and, with charges from that arrest pending, his license had not been revoked at the time of the April crash.
Another crash suspected to involve opioid use happened in January in Saratoga Springs. City police in that case called a sheriff's office drug recognition expert to the Geyser Road crash scene, where three people, including an 8-year-old boy, were injured.
Police determined the boy's mother, 47-year-old Saratoga Springs resident Wendy L. Cook, caused the crash, and the drug recognition expert found her to be impaired. She faces vehicular assault and other charges.
In her case, investigators used evidence in her vehicle to conclude she was impaired by opiates, police said. They found two hypodermic syringes, as well as multiple small, plastic envelopes commonly used to package drugs, according to court documents.
Naloxone is used in a variety of situations where overdoses are suspect, including in homes and public places.
"I think it's very important," Zieske said of the naloxone program. "We have participated in saving lives. ... We have definitely had some turnarounds for people who might otherwise have died where they were brought back to hopefully get the help that they need."