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Overdose deaths dropped in Philly for the first time in five years. But deaths are soaring among Black men.

Overdose deaths were down overall, but the citywide health analysis signaled a demographic shift in those who are dying.

Catalyst Twomey sets up a memorial with a rose that signifies each of the 1,116 deaths to overdose in Philadelphia in 2018 at the Federal Courthouse in Philadelphia in 2019 during a protest advocating for the city to open a supervised injection site. Philadelphia officials say overdose deaths among all residents decreased in 2023, but deaths among Black and Hispanic residents are rising.
Catalyst Twomey sets up a memorial with a rose that signifies each of the 1,116 deaths to overdose in Philadelphia in 2018 at the Federal Courthouse in Philadelphia in 2019 during a protest advocating for the city to open a supervised injection site. Philadelphia officials say overdose deaths among all residents decreased in 2023, but deaths among Black and Hispanic residents are rising.Read moreMargo Reed / File Photograph

Overdose deaths in Philadelphia decreased last year for the first time in five years, but the toll is still staggering as rising death rates for Black men signal a demographic shift in the ongoing opioid crisis, health data released Wednesday show.

In 2023, 1,122 Philadelphians died of unintentional overdoses, a 7% decrease from the year before. That’s still nearly three times the number of Philadelphians lost to homicide in 2023.

And any progress in curbing deaths overall is tempered by a growing racial divide: Overdose death rates have been rising alarmingly for Black and Hispanic Philadelphians, even as they are declining among white residents.

Black men, in particular, are now significantly more likely to die of an unintentional drug overdose. The overdose death rate for Black men in Philadelphia last year was twice as high as the city’s overall overdose death rate.

The counts released as part of a citywide health analysis called PhilaStat do not include the total number of people who died of overdoses in the city, just the number of Philadelphia residents who fatally overdose.

Health officials have not yet released data on Philadelphia’s full overdose death toll for 2023, but state data show that 1,316 people died of overdoses in the city that year. That’s a 6% decrease from the year before and still the second-highest overdose death toll the city has ever seen.

The drops in Philadelphia come as national overdose deaths have also decreased, with Centers for Disease Control and Prevention data showing a 10.6% drop in the year ending in April. Still, more than 100,000 Americans continue to die each year of overdoses.

“We still have major crises on our hands, and we can’t stop thinking about them as crises,” said Megan Todd, the chief epidemiologist for the Philadelphia Department of Public Health.

Particularly concerning, she said, are the widening racial disparities in overdose deaths in Philadelphia, a trend also seen nationally.

“There are huge increases in the rates of overdose mortality in Black and Hispanic populations. It’s really affecting all Philadelphians,” Todd said.

Only heart disease and cancer kill more Philadelphians

Overdose deaths have long been a leading cause of death in Philadelphia, and in 2023, only heart disease and cancer claimed more lives here.

While death rates have risen dramatically among all demographic groups in the last decade, the crisis in recent years has accelerated in communities of color even as deaths decrease among white residents.

For Black residents, overdose deaths were the ninth-leading cause of death in 2013, with 107 deaths in that group. By 2023, they were the third-leading cause of death, killing 556 Black Philadelphians.

Overdose deaths were the third-leading cause of death among Hispanic Philadelphians in 2013 and jumped to the second-leading cause in 2023.

By contrast, the rate of overdose deaths is slowing among white Philadelphians, with overdose deaths their fifth-leading cause of death in 2013 and the third-leading cause by 2023.

The trends in Philadelphia follow statewide demographic shifts that have been building for years. Black Pennsylvanians, as a whole, are disproportionately affected by overdose deaths, with death rates now double that of their white counterparts.

Black residents make up just 12.3% of the state’s population — but 25.3% of its overdose deaths.

Life expectancy as a whole for Black Philadelphians is lower than that of their white counterparts, and the disparities are particularly stark for Black men. COVID-19 caused life expectancy rates to drop at the beginning of the decade, and those rates are only just beginning to recover to pre-pandemic levels.

But, Todd noted, life expectancy for Black men in Philadelphia is still only about 67.5 years, compared to 76.2 years for all Philadelphians on average. This is in part, she said, because structural racism can limit access to resources that contribute to a healthy life, like adequate health care and housing.

“That is just really, really low,” she said. “Where people are born, where they live, what education they get, poverty rates — all have a big impact. And that’s pretty true for [most] health outcomes. You see these disparities.”

Aaron Wells, the executive director of the North Philly Project, a nonprofit that focuses on wellness initiatives in the neighborhood, said generational poverty there is inextricable from the addiction crisis.

“There has to be a simultaneous response to the poverty and the addiction and overdoses,” he said. “They go hand in hand, and it’s going to be impossible to heal one without healing the other.”

Outreach efforts expanding, still limited

In recent years, the city has expanded its drug awareness outreach to Black communities where overdose deaths are rising, but access to measures that reduce the harms of drug use are more limited.

Regular teams of outreach workers now hand out naloxone, the overdose-reversing drug, in neighborhoods in North Philadelphia, where some zip codes saw deaths spike as much as 66% between 2019 and 2022.

Wells’ North Philly Project recently received $100,000 in funding from lawsuits against opioid painkiller manufacturers and distributors, who are widely blamed for fueling the current overdose crisis. The organization is using the money to educate more people about addiction and harm reduction in North Philadelphia — and also address the trauma of families of overdose victims.

“There’s collateral damage — there are families trying to put their lives back together,” he said. “What about that trauma. How do we support that group of people?”

At a recent drug prevention event, Wells said, he spoke with a 20-year-old man who had lost both parents to overdoses within three months.

“He talked about the fact that those were his supports, his go-tos,” he said. “He said, ‘I know I gotta keep living.’ I walked away with so much admiration, but my heart hurt for him.”

Declining homicides show progress against gun violence

The city’s newly released statistics reflect plummeting homicide levels, which are now the lowest in nearly a decade.

In 2023, homicides among Philadelphians dropped to 402 deaths, a 24% decrease from the year before, according to PhilaStats. This year, homicides are even lower, with police reporting that fewer than 200 people had been killed in homicides through the end of September, the lowest-year-to-date tally since 2015.

The decline is particularly striking after the city experienced three years of record-setting gun violence during the pandemic.

Nonfatal shootings were also down by nearly 40% this year, police said. Officials including Commissioner Kevin Bethel and District Attorney Larry Krasner have said explanations for the declines are elusive and could remain difficult to sort out for some time.

Staff writer Chris Palmer contributed to this article.

Correction: An earlier version of this article misstated the figures for the percent changes in overdose deaths and homicides among Philadelphians for 2023 compared to 2022.