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The Opioid Epidemic in a Time of Pandemic (Series) Article 1: An Overview

By Geoff Watkinson, Contributing Editor

On November 30, 2021, The Philadelphia Inquirer reported that “the Fatal overdoses in the first six months of 2021 rose by nearly 10% compared to the same time period last year, putting Philadelphia on track to see its highest-ever overdose death toll by year’s end.” This news, unfortunately, isn’t shocking. Between 2019 and 2020, the number of overdose deaths hardly changed: however several factors are contributing to the rise this year. Aubrey Whelan wrote “Fentanyl, the powerful synthetic opioid that has replaced much of the heroin in Philadelphia, is turning up in overdose deaths involving other drugs, suggesting that people unused to opioids may be unknowingly ingesting drugs contaminated with fentanyl.” In this regard, Philadelphia is merely a microcosm of the county at large.

From the poppy farms in Mexico to the streets of Kensington, the first line of defense comes from the federal government. The Council of Foreign Relations (CFR) cites the Drug Enforcement Agency (DEA), who calls Mexican cartels who control heroin production and distribution centers in major US cities as “the greatest drug trafficking threat to the United States.” The CFR states that “most fentanyl in the United States is smuggled across the southern border…Mexican cartels will ‘almost certainly have the greatest direct impact’ on the U.S. fentanyl market in the coming years, the DEA cautions.”

Cartels smuggle narcotics across the border in vehicles and underground tunnels. Significant amounts of heroin are also brought to the US via South America, notably Colombia, and enter by air and sea.

The federal government is only able to stop a small fraction of what actually comes into the country, and it’s naïve to think that—on a national level—we will ever be able to create a wall high enough or a DEA powerful enough to keep narcotics off our streets. It is clear that just because the DEA seizes more, seemingly year after year, this doesn’t mean that it is impacting use, addiction, deaths, or crime. As ABC reported in April, “6,494 pounds of fentanyl were seized by authorities at the border, compared to 4,776 pounds in all of 2020. In fact, fentanyl seizures have been increasing since 2018.”

According to data released in mid-October by the US Center for Disease Control and Prevention’s National Center for Health Statistics, during the 12-month period ending in March 2021 more than 96,000 drug overdose deaths were reported in the United States. This is a new high  and as with all epidemics, its reach has been great.

The epidemic permeates every aspect of a community—and a country—and this includes pregnant women. The City of Philadelphia Health Department’s Substance Use Prevention and Harm Reduction division’s Annual Report highlights “an increase in cases of NAS, a clinical diagnosis used to describe a collection of signs and symptoms that occur when a newborn infant withdraws from certain drugs. In 2020, there were 275 NAS cases reported to PDPH, a 6% increase from 260 cases in 2019.”

Kensington Voice journalist Henry Savage writes that, “The Department of Public Health attributes the increase of fatal overdoses in 2020 to a variety of factors, including barriers to medical treatment and social isolation during the start of the coronavirus pandemic. A high percentage of overdoses occurred in personal residences as well.” Coronavirus has become an easy scapegoat for a lot of cultural issues, and this is especially true for the opioid epidemic.

In the 2021 Action Plan for the Philadelphia Opioid Response, published in April 2021, Mayor Jim Kenney’s Statement blames COVID-19, almost entirely, as the reason for escalating overdoses: The opening statement reads: “…since March of last year, COVID-19 has prompted an increase in fatal drug overdoses. 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. Equally important, this past year has demonstrated the vital need to center racial and social equity in our response. We must rebuild and rejuvenate, while also reckoning with our past.” Here’s the thing: this is way out of proportion with the facts, and all it takes to know this is a quick look at Savage’s bar graph from back in May. The COVID-blaming ignores the fact that, as the Council on Foreign Relations reported in September, “Overdose deaths involving opioids have increased more than sixfold since 1999.”

The reality is that the epidemic is getting worse, not better, and this is true and has been true throughout the city and the United States since well before COVID. The question is this: what can we do about it when we know there are no simple answers?

This series will explore the ways in which Philadelphia is currently handling the opioid epidemic in a time of pandemic, and solutions moving forward.

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Pivedite Team

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