‘People die of stigma. They don’t die from heroin.’

Paul Cherashore of the Philadelphia Overdose Prevention Initiative holds a dose of naloxone, an antidote for opioid overdoses. (Courtenay Harris Bond)

Paul Cherashore of the Philadelphia Overdose Prevention Initiative holds a dose of naloxone, an antidote for opioid overdoses. (Courtenay Harris Bond)

Paul Yabor, 55, was a Philadelphia native and an activist in the HIV/AIDs and harm reduction communities, dedicated to causes such as the establishment of supervised injection facilities. Such spots would provide safe spaces for drug users to inject under medical supervision. And those medical personnel could then help with treatment such as wound care and provide links to recovery programs if desired.

Of course, this idea is very controversial in general, and even in Philadelphia, where 907 people died from overdoses last year, approximately 80 percent of which involved opioids.

So it seemed particularly cruel that Yabor, who suffered from a substance use disorder himself, and who was in and out of recovery, died last week Tuesday of a drug overdose down at the Conrail tracks, an open-air shooting gallery in the Kensington and Fairhill neighborhoods of Philadelphia, where users go to buy and inject drugs out of sight of mainstream life.

“Even if you wipe out the drug market in Kensington, which is highly doubtful, it will move somewhere else,” Yabor told me several months before his death. “It’s not going away, and we need to address the problem. We’ve got to stop the dying.”

To do his part, while battling his own demons, Yabor volunteered for years at Prevention Point Philadelphia, one of the largest needle exchanges in the country, which also provides counseling, medication-assisted treatment, and other services to drug users in the city. Plus, Yabor was an honorable gentleman and articulate advocate, happy to show a rube journalist like myself around Philadelphia’s “Badlands.”

The day he played tour guide for me, on our drive down to the tracks in Kensington, he told me about the dealers slinging dope on every corner of what Drug Enforcement Administration agents have said is the largest open-air heroin market along the East Coast. Then suddenly he spotted a familiar face at the K&A, Kensington and Allegheny avenues.

“Hey, Mike!” Yabor yelled out the window of the minivan. “Want to talk to a reporter?”

Mike jumped in.

He told me how, somewhere in his “sick mind,” he thought that the next bag of heroin that he held in his hand would be like it was 20 years ago. “And it’s not going to do it,” he said. “I have to get help, because I’ll die. I gotta make a decision before the summer, because I think I’ll wind up dying. It’s that bad out here.”

It is that bad out there.

According to the report from Philadelphia Mayor Jim Kenney’s Opioid Task Force, released on May 19, the rate of drug overdose deaths in Philadelphia in 2015 far outpaced those in other large cities, such as Chicago and New York. The task force estimates that there are 70,000 heroin users in Philadelphia, not including individuals who have sought care in private treatment facilities.

In 2014, Philadelphia heroin purity on average was the highest in the country, and the situation has only grown more dire with the increased use of synthetic opioids, such as fentanyl and carfentanil — anywhere from 50 to 10,000 times more potent than morphine.

Yabor said that stigma and misunderstanding was getting in the way of people’s thinking about how to address the opioid crisis. For him, the battle was personal.

“I’ve lost friends,” Yabor told me. “I’ve been impacted by my own life, and I don’t want to see other people die. And I know for a fact that people die of stigma. They don’t die from heroin. You can’t treat a dead person.”

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