Philadelphia city officials expect opioid-fueled drug overdose deaths will be down in 2018 for the first time in five years.
The estimated 1,100 people to be counted in the year-end fatal overdose tally would represent a 9 percent decline from 2017’s death toll, something city officials are declaring a milestone.
“We’re certainly optimistic that this is a turning point in overdose deaths,” said Brian Abernathy, a top city official who next month will be Philadelphia’s managing director. “But we’re not out of the woods yet.”
Public health data from the city underscore Abernathy’s cautionary tone.
Although any year-to-year drop in overdose deaths in midst of the opioid crisis is considered progress, the 2018 fatal overdose rate remains startlingly high.
From 2007 through 2013, the number of those who died from an overdose every year hovered around 450.
In 2014, the fatality rate exceeded 600 – and it continued climbing to the more than 1,200 people who died from the effects of an overdose in 2017. Officials point to the introduction of the deadly and unpredictable synthetic drug fentanyl into the opioid marketplace as the largest factor in intensifying the death rate.
Officials now think that 2017 will be the high-water mark in Philadelphia’s opioid crisis, saying they hope that preliminary projections for this year indicate the epidemic is beginning to turn the corner.
“It’s a good trend,” said Eva Gladstein, the city’s deputy managing director of Health and Human Services. “Every life saved is one that is cherished by family and friends.”
Gladstein, who said there is no way to perfectly measure what caused the decline in overdose deaths in 2018, said she suspects that the overdose-reversing drug naloxone blanketing the city has helped.
This year alone, city figures show, the medication that goes by the brand name Narcan was administered 3,000 times, mostly by paramedics. But police officers and SEPTA officials also used it. And that tally does not count the bystanders, family members and others who used the medication to save the life of someone overdosing on opioids.
The city also has had mobile units providing medication-assisted treatment to those struggling with opioid addiction. Even city prisons are now expanding the use of prescriptions that combat withdrawal symptoms. Officials say the city is planning a media campaign in 2019 to help promote the services to those who are addicted and may be unaware that it is available.
“Obviously, we still have a tremendous amount of work to do, but the broad distribution of naloxone to community members, to family members, to those who are addicted, increased access to medically assisted treatment – all of those things are contributing to the work we’re doing around overdoses,” Abernathy said.
One thing city officials and public health advocates stress is to not let a one-year dip in deaths distract from how severe the crisis remains.
Philadelphia, which now has more opioid-related deaths than any other big city, has the third-highest rate of fatal overdoses in the nation, according to Pew Charitable Trusts. Only Pittsburgh and Baltimore outpace the city’s opioid-driven mortality level.
“It’s still a horrifically high number,” said Ronda Goldfein, director of the AIDS Law Project of Pennsylvania who is also the vice president of Safehouse, a nonprofit planning to open the country’s first supervised injection site. “We still don’t have a handle on this,” Goldfein said of Philadelphia’s opioid crisis.
Despite crackdown threats from the U.S. Justice Department, Goldfein said Safehouse is considering its legal options, continuing to raise money and scouting possible locations for the site where people can bring their own drugs to use under the eye of trained medical staff. The controversial approach, in use abroad, has been shown to prevent fatal overdoses and provide a link to treatment.
Yet advocates of the proposal face another layer of resistance from some elected leaders and residents of Kensington. Goldfein said additional outreach efforts in 2019 will be aimed at continuing talks with community skeptics.
“We haven’t lost momentum. We’re moving ahead,” Goldfein said. “We still think it’s a valuable intervention.”