News that a coroner in Lycoming County has begun ruling heroin overdoses as homicides drew skepticism from local coroners.

Lycoming County Coroner Charles Kiessling Jr. had been marking overdose deaths as accidental, which he called standard practice, but said he’s trying to raise awareness of a heroin epidemic that contributed to a 13 percent increase in overdose deaths in Pennsylvania in one year.

“If you chose to sell heroin, you’re killing people and you’re murdering people. You’re just as dead from a shot of heroin as if someone puts a bullet in you,” Mr. Kiessling told The Daily Item of Sunbury.

He has ruled one overdose death in 2016 as a homicide, with four others pending the results of toxicology testing. Homicide is defined as a death caused by another person. Not all homicides are determined to be crimes, and the decision on whether charges should be filed is made by prosecutors.

Lackawanna County Coroner Timothy Rowland hadn’t heard of Mr. Kiessling’s decision when contacted Friday. He has no plans to follow suit.

“As with any death my office investigates, we will continue to examine the facts and circumstances of each death, review all reports and records (and) perform all required tests to determine the most exact cause of death and rule the proper manner of death,” Mr. Rowland said in a written statement late Friday.

Wyoming County Coroner Thomas Kukuchka called Mr. Kiessling’s decision “not very realistic,” because it would be difficult to prosecute.

“Unless you actually have someone who you saw inject the person, how can you possibly prosecute?” Mr. Kukuchka said. “We’re ruling (heroin overdose deaths) accidental.”

Heroin causes far fewer deaths in Luzerne County than prescription drugs, Coroner Bill Lisman said.

The coroner’s office investigated about 95 deaths last year, he said. Of those, about two-thirds came from a combination of medication. About one-third involved heroin, but many of those also involved other drugs, making it more difficult to determine exactly what caused the death.

“There were a limited number that were a death on heroin alone,” he said. “Those few would be only ones that I would possibly consider making (the cause of death) a homicide, and that would only be after serious consultation with the district attorney’s office.”

A homicide determination is one of the most significant decisions Mr. Lisman’s office makes.

“If you make something a homicide, you’re telling everyone that somebody else is responsible for that death, by the statement of making it a homicide. It’s one person taking the life of another,” Mr. Lisman said. “That means in my opinion, somebody else is responsible for the death and therefore in my opinion, the district attorney or police force should be investigating and possibly charging somebody with homicide.”

Pennsylvania law allows for a charge of drug delivery resulting in death, which carries a maximum penalty of up to 40 years in prison. But Lycoming County District Attorney Eric Linhardt said the cases are difficult to prove.

“In fact, we have been able to prosecute only a handful of such cases with varying degrees of success,” said Mr. Linhardt, adding that his office will “continue to aggressively prosecute these cases where we are able.”

Mr. Kiessling said he consulted with the solicitor for the Pennsylvania State Coroners Association, of which he is president, and determined that nothing in state law prevented him from making a determination of homicide in heroin overdose cases. He said he won’t change procedure for opioids like oxycodone if the victim has a valid prescription.

Nationally, since 2000, there has been a 200 percent spike in the rate of overdose deaths from opioid pain relievers and heroin, according to the Centers for Disease Control and Prevention.

Mr. Kiessling said the heroin problem “doesn’t seem to be raising enough eyebrows” in Lycoming, a largely rural county in north-central Pennsylvania that plays host to the Little League World Series each August.

“Calling these accidents is sweeping it under the rug,” he said.

JEFF HORVATH and BILL WELLOCK, staff writers, contributed to this report.