Overdose deaths dropped slightly in Philadelphia in 2018 — with 1,116 people dying of accidental overdoses compared with 1,217 people the previous year, according to figures released by the city’s Department of Public Health on Tuesday.
Still, the city’s opioid crisis remains among the worst in the nation, with an overdose rate more than triple the homicide rate. Deaths declined in most demographic groups, but the rate escalated sharply among victims ages 55 and up.
Death rates continue to be highest among white residents, for whom the fatal overdose rate was around 75 per 100,000 residents; followed by 58 for Hispanics and 32 for black residents.
Philadelphia Health Commissioner Thomas Farley noted that the death rate still far exceeds what it was just a few years ago. "It’s still at crisis levels -- 1,116 deaths is an enormous number compared to where we were five, 10, 20 years ago. These are lives we can save.
“The real news here,” he said, “is not the size of the drop, but the fact that it dropped at all after unrelenting and huge increases.”
Much credit, officials say, goes to the fact that so much naloxone — the reversal drug also known by its brand name, Narcan — has been distributed that people often are saved from a deadly overdose by friends, family, police, even strangers.
It’s a common sight on the streets of Kensington, the Philadelphia neighborhood that has seen the largest number of deaths, though overdoses occur everywhere in the city.
Jesse Gibase, 23, has lived on the streets of Kensington for about a year since leaving his hometown of Chester. Camped outside of St. Francis Inn, the longtime soup kitchen on Kensington Avenue, on Tuesday, he says he’s seen more people on the streets getting “brought back” from overdoses because it seems like everyone has Narcan. If you don’t have any, he said, “all you have to do is scream ‘Narcan’ " and a vial will appear.
Though he came to Kensington originally to buy heroin, he’s now also using the potent synthetic cannabinoid K2 -- cut with fentanyl and other substances he cannot even name. It’s a mix that is getting more and more popular, he said.
The opioid epidemic largely has been painted as affecting mostly whites, who continue to make up the largest share of fatal overdoses. But Andre Burton, 30, a black man who has been using since he was 21 after getting prescribed Percocets for a football injury, sees all races affected. Interviewed in Kensington on Tuesday, he said he probably uses Narcan on five people a week.
“Chinese people shoot heroin,” he said, “Indian people shoot heroin. It doesn’t discriminate.”
Ashley Melendez, a 34-year-old mother of four, most recently relapsed after five months in recovery from a heroin addiction and returned to the streets a few weeks ago. A native of Kensington who’s Irish and Puerto Rican, she says the main differences she has seen are the prevalence of K2 and how easy it is to get free samples of drugs. People come out to Somerset and Kensington Avenues and call out, “Samples!” as they direct folks to certain corners. One free sample could last for the day, Melendez said, or else it’s possible to get multiple free samples from different dealers.
It’s not clear what is driving higher rates of overdose death in older adults. Farley said it’s possible that some in that group may have been using opioids “maybe since the heroin problem from the 1960s and 1970s." But now, they are encountering heroin mixed with the deadly synthetic opioid fentanyl.
Even with the spike, the death rate for those 55 and over remains less than half that of people between 45 and 54, which Farley termed “the most dangerous age” for an overdose. The impact on older adults, he said, is a sign of how the crisis began for many with a physician’s prescription.
“People who had painful conditions like arthritis went to their doctor and got opioids -- they initiated this drug use much older in life." Still, the fact that deaths solely from pain pills have dropped by more than half since 2012 is an encouraging sign that efforts to curb prescription patterns are working.