As public officials, we have seen the opioid epidemic impact nearly everything we touch. Last year, overdoses claimed the lives of about 1,200 people — four times the number of homicides and exceeding deaths from the AIDS epidemic by over 200 people in its worst year.
With no end in sight, opioid addiction continues to destroy lives. It drives much of the city’s violence and has stressed our EMS system to the brink. Addiction has created ongoing challenges within our prison system and it contributes to the number of people forced to sleep outdoors every night.
Entire neighborhoods are under siege by those suffering from opioid addiction and by those who prey on the addicted.
But, to many Philadelphians, this crisis is nothing new.
Thirty years ago, crack cocaine invaded our city. With it came addiction and violence, and government responded with a so-called “War on Drugs” across the country, particularly in large cities like Philadelphia with a majority-minority population and a historically high poverty rate.
As a society, we failed many people during the crack epidemic by treating it solely as a law enforcement problem rather than a health problem. Many people spent time in jail when they should have spent time in treatment. No doubt, criminalizing addiction happened in part because the people affected were mainly African-American, Latino and poor. Race determined how the country, as well as the Commonwealth of Pennsylvania and the City of Philadelphia, responded to the devastating crisis. These “tough on crime” policies resulted in Philadelphia having the highest incarceration rate of any large jurisdiction in the country.
That was a big mistake. Tragically, too many families, loved ones, and neighborhoods still suffer the consequences not only of addiction, but the policies that tore families apart and decimated communities.
We now know that addiction is a disease. It is well past time to remove the stigma of addiction and help those who cannot help themselves.
While we can’t undo years of regressive policy, we can take an intentional approach to treating addiction and drug-related law offenses with that history in mind.
As city councilman, Mayor Jim Kenney sponsored and passed legislation that decriminalized the possession of a small amount of marijuana in 2014, in part, to address the racial disparity found in those arrested for marijuana possession. Since becoming mayor, he’s created an opioid task force that is to create an action plan and recommendations that the city is using to seek long-term solutions to end this crisis. And, in 2016 Philadelphia was awarded $3.5 million from the MacArthur Foundation Safety and Justice Challenge to invest in strategies that will safely reduce the average daily jail population over the next three years by over a third, and particularly mitigate the incarceration of individuals with low-level drug offenses or with addiction disorders.
District Attorney Larry Krasner believes that the solution to drug addiction is treatment, not incarceration. In his new role, the DA has pledged to build up Philadelphia’s drug court capacity and increase opportunities for diversion, allowing those arrested for drug possession or for minor offenses due to addiction to get the treatment they need instead of incarceration.
The city recently filed a lawsuit against opioid manufacturers to hold them accountable for their role in this crisis. The goal is to end deceptive marketing practices used by these companies and help residents suffering from opioid addiction cover treatment costs. The District Attorney’s Office has also filed a lawsuit against several pharmaceutical companies under the Unfair Trade Practices and Consumer Protection Law to hold them responsible for their role in the opioid epidemic.
U.S. Attorney General Jeff Sessions has expressed his intent to respond to the opioid epidemic with a law enforcement-centric focus, reverting the nation back to the divisive tactics used during the ”War on Drugs” response to the crack cocaine epidemic. It’s important that we resist this and focus on saving lives in a way that research has shown is successful.
The city’s response is multifaceted. The Health Department is working with doctors and insurance companies to reduce the likelihood that people will become addicted. The Department of Behavioral Health has added treatment slots and is directing resources to the most effective treatments. Homeless Services is working toward providing low-barrier shelter to get those who are addicted off our streets and out of our neighborhoods. The city is expanding programs to clean up needles, encampments, and trash that is directly related to opioid users. Local law enforcement has partnered with our federal and state partners to arrest drug dealers and distributors.
Opioid addiction affects all of us. While more whites are dying from overdose these days, we know that black and brown lives are being taken by opioids, as well. In both 2016 and 2017 more African Americans died of overdoses than of homicide in Philadelphia. In 2016, the Medical Examiner’s Office reports that, of the 907 overdose deaths recorded, 398 were black non-Hispanic, Hispanic, or other.
These are unprecedented times and we are taking unprecedented steps. That is why the city is actively encouraging the philanthropic and nonprofit community to establish and support Comprehensive User Engagement Sites (CUES).
A CUES would be a facility that engages injection-drug users who are not yet in treatment, offering them help to get into treatment, and at the same time, helping them stay alive until they begin treatment. Furthermore, these sites are expected to take some people off the streets where their active addiction impacts the safety and environment of the rest of the neighborhood. At a CUES, drug users would be given sterile medical supplies for injection, and allowed to inject them on site. If an individual has an overdose, trained staff members can immediately provide life-saving Naloxone. We cannot emphasize enough, however, that a CUES is more than a place where people in addiction will use drugs under supervision – the sites will also provide a direct link to treatment, resources for housing and meals, and, most important, save lives.
CUES are just one part of a multicomponent strategy to deal with the opioid crisis, along with efforts to prevent drug abuse, help drug users get into treatment, and help the homeless obtain housing.
This crisis is bigger than us all and we know that we need community support to make progress. Learn more about the comprehensive plan developed by the Mayor’s Opioid Task Force to prevent drug abuse and help those experiencing homelessness in the city by visiting www.phila.gov/opioids.