Hoping others can learn from family's loss

Joe Giandonato's only daughter died from a drug overdose. He wants you to know that, which makes him unusual.

There's a social stigma attached to such deaths, even accidental ones like Alissa Giandonato's. The same type of judgment unfairly stains families affected by suicide.

Giandonato said he does not care about being judged. He came to me and asked me to write his daughter's story. He even shared the brutal findings of her autopsy.

Alissa Giandonato, 20, had a toxic mix of prescription drugs and illegal substances in her system when she died May 6, 2014, a New Jersey medical examiner determined, her death caused by the cocaine, marijuana, morphine, antidepressants, and anticonvulsants jockeying for position in the body of the slight, fair-haired girl with the wide smile.

Joe Giandonato's grief is still raw and near the surface. So is his guilt. But talking about Alissa and her life and death might help someone else, he said. He doesn't want another parent to suffer as he is. And he doesn't want her to be forgotten.

"I should have been there for her," he said during a recent interview. "I should have been fighting for her. I should have protected her. I didn't do that."

The cautionary tale Giandonato wants to tell is multifaceted. It's about divorce and how it affects children. It's about the mental-health system and the laws that allow him to pay his daughter's medical bills but prevent access to her medical records.

But the story is mostly about drugs, those prescribed by doctors and those available on the streets. Giandonato sees this as a silent epidemic, tragically altering and sometimes ending lives. He ticks off a list of people he knows who have fatally overdosed: the daughter of a Facebook friend who lives in California; the son of a coworker's brother-in-law; a young man from a local basketball team.

It's about paying attention, close attention, to what your children are doing. It's about not being too busy or too complacent. When I interviewed Giandonato, I warned him that not all readers would be sympathetic to his loss. Some would blame him. Others would harshly judge his daughter. He still wanted to talk to me.

Giandonato is "willing to put himself out there to say: 'My kid died. Here's how. I want you to know so this won't happen to you,' " said his fiancee, Karen Thomas, the principal of Philadelphia's Bodine High School. "Kids are dying from this. Where is the outcry?"

The number of deaths by drug overdose in the United States has steadily increased since 1999, according to figures provided by the Centers for Disease Control and Prevention. In 1999, there were almost 17,000 deaths by "drug poisoning," which could be an overdose of both prescription and nonprescribed drugs. That year also tallied about 7,500 pharmaceutical overdose deaths.

Ten years later, there were 37,000 drug poisonings and about 21,000 pharmaceutical overdoses. In 2013, the most recent year for which they have figures, there were 44,000 drug poisonings and almost 23,000 pharmaceutical overdoses. Like Giandonato, the CDC uses the word epidemic when it talks about prescription-drug abuse.

Alissa began her struggle with mental issues when she became a teenager. After her parents' divorce, she often felt she was put in the middle of their troubles, her dad says. She was bullied at school, and that worsened after she came out as a lesbian in high school. She began cutting herself, creating permanent marks. As her autopsy drily notes: "There are multiple linear scars noted in both upper extremities in the forearm area. Also noted are multiple scars on right and left thighs and knee joints measuring 3 cm to 5 cm."

Alissa was hospitalized at least seven times for mental-health reasons, her father said. She was released from her last inpatient treatment program three days before her death. She was self-medicating with street drugs. Doctors added prescribed ones.

"From the age of 13, that's all she knew, drugs," Giandonato said. "She came into this world with mental issues and all our health-care system did was throw drugs at her. Even when her problems involved [illegal] drugs, they just gave her more."

Giandonato lives in the city. His ex-wife and daughter lived in Atlantic County. He saw Alissa during set visitation weekends and "she always seemed fine." Often, he said, he learned Alissa had been having problems only when she called him after being placed in an inpatient facility.

When Alissa became an adult, busy with a part-time job and community college classes, Giandonato didn't question when she couldn't see him. They would text or talk on the phone, he said. In March of last year, they went skiing together in the Poconos. It was the last time Giandonato saw his daughter alive. Looking at a photo from that trip now, he sees her sadness.

A week before Alissa died May 6, she broke up with a girlfriend and threatened to hurt herself. After being held in a mental-health facility for a few days, she left with a new set of prescriptions.

Again, Giandonato didn't ask questions, especially when Alissa made plans to attend a Phillies game with him.

"After she was released from the hospital," he says now, "I should have gone down there to investigate what was going on."

Then it was too late. Alissa died in her sleep, a case ruled "accidental" on her autopsy report. The document notes that she was wearing only one pink sock when she was found and her heart "is unremarkable."

But Alissa was remarkable and her death has devastated her family. Her aunt, Rita Giandonato, was one of the last family members to see the girl alive. I met with her in her South Philly home and she showed me an 8-by-10 photograph of her and her beloved niece.

"I guess I feel like we should have done more," she said. "Maybe we didn't see the signs. Maybe our judgment was clouded. Our busy days . . . ." She trailed off, but then added, "I just feel like we should have paid a little more attention."

Natalie Pompilio is a Philadelphia writer