Overdose fatalities overall rose in Philadelphia during the pandemic, but not among the city's white population

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With the onset of the pandemic and the stay-at-home order issued last spring, 2020 is on track to be the worst year on record in Philadelphia for deaths from drug poisonings, according to new data released this week by Mayor Jim Kenney’s administration.

Fatal overdoses were up 11% through three quarters, the latest information available, from just over 850 lives lost in 2019 to about 950 last year. Almost all of the growth was among the city’s Black and Latino populations.

A revamped initiative is underway to combat the spike, which occurred primarily in new areas. During COVID, fatal overdoses rose dramatically in West Philadelphia and North Central Philadelphia, not just in Kensington and South Philly, where they primarily occurred pre-pandemic.

“The supply chains for help and support have been broken, drug-related violence has soared, and the economic downturn meant that budgets to fight this scourge have had to be redrawn,” said the mayor in a report about Philly’s 2021 opioid response.

Outlined in the report is the administration’s plan to address the pervasive problem.

Called the Opioid Response Unit (ORU), the initiative is basically an expansion of the cross-departmental effort previously known as the Philadelphia Resilience Project — which data shows was having a positive effect in Kensington.

The Kensington coordination strategy, started in 2019, “went so well, we looked to replicate it again in 2020,” said Noelle Foizen, who led that project and has been named director of the OUR.

Part of it brings together a group of providers once a week to pool resources and help increase drug treatment placements, reunify more families, and identify which facilities have open beds. This will be permanently in place, Foizen said.

Other stated goals of the program, which will involve 35 different city departments, include:

  • Maintaining existing housing in the city
  • Decreasing employment barriers
  • Continuing encampment resolution
  • Providing home repairs
  • Meeting with stakeholders and exploring funding
  • Engaging youth in target neighborhoods
  • Integrating a trauma-informed framework

ORU was originally launched last year, but was stymied by COVID-19, said Managing Director Tumar Alexander. It is the result of five years of work, he said, describing it as “a coordinated command group looping together city agencies and private partners to aggressively respond to the tragic epidemic impacting our city.”

What will all this cost? Because ORU resources will come from dozens of different parts of Philadelphia government, it’s hard to put a price tag on the effort, according to city spokesperson Mike Dunn.

The unit itself has a $500,000 budget, but will also tap into the health department’s $10.2 million allocation for opioid prevention and surveillance, Dunn said. CARES Act funding could also come into play, per Foizen.

Sharp rise in deaths among Black and Latino communities

The action plan notes a 40.3% year-over-year rise in fatal overdoses among Black residents and a 5.9% jump in fatal drug overdoses among the city’s Hispanic population.

At the same time, there was a 7.3% decrease in fatal overdoses among the city’s white population.

Per the report, this is due to systemic racism, which “has left Black and Latinx communities with the least access to life-saving treatment, technology, public information, and economic resources in times of crisis.”

Public health experts attributed these uneven spikes to of the unique challenges presented by the pandemic, including:

  • Extreme levels of unemployment and social isolation
  • Reduced access to behavioral health treatment and social services
  • Proliferation of fentanyl, a synthetic opioid that is 50 times stronger than morphine, into non-opioid drug sources, including cocaine and methamphetamine

“We have expanded and changed strategies during the year looking at the uptick in overdoses in new communities,” said Eva Gladstein, deputy managing director for the Department of Health and Human Services. “There’s a lot more work on the prevention side that the health department is doing that it was not doing a year ago.”

Doing “train the trainer” sessions with community-based organizations to educate neighborhood residents about the use of fentanyl test strips is an example of increased prevention that will happen in areas that are seeing a spike in overdoses.

The plan outlines a major Fentanyl awareness campaign to make sure people realize it’s no longer just in opioids, but also in cocaine and methamphetamine.

Credit: Philadelphia Opioid Response 2021 Action Plan

Also a major goal is building accountability in physicians and helping them learn about how to administer emergency buprenorphine. The medication assisted treatment entails giving users the prescription for the drug, often referred to as “bupe,” to decrease dependency.

Kenney’s new budget proposes allocating $400,000 to the health department to support higher doses of buprenorphine treatment in Philadelphia jails, one of the most vulnerable populations for fatal overdoses on release.

Considering the ORU was officially rolled out last year, and the numbers have spiked, what indication do officials have that the new plan will work?

Foizen, ORU director, cited the progress the Resilience Project was making before the pandemic, and also noted that the as-yet-unreleased fourth quarter 2020statistics was looking better than the third quarter.

“If you look at … the trends I’m confident that what we were doing prior to COVID was working,” she said.

Foizen said they were less clear about what the cascading effects of the past year would have on the opioid epidemic, adding that “if we need to change our strategies we will.”

Said Foizen, “It’s definitely something that we will be watching as we head into this calendar year.”