In the midst of a state of disaster due to COVID-19, on Wednesday, Gov. Tom Wolf renewed another disaster declaration — the one over the opioid epidemic. First issued in January 2018, the 11th renewal of the 90-day disaster declaration allows the state to loosen regulations, such as allowing first responders to leave naloxone behind on the scene of overdoses.
Sadly, the disaster declaration is as relevant now as it was when it was first signed. According to preliminary data released at the end of July by the Pennsylvania Department of Health, overdose deaths decreased by only 1% in 2019 compared with 2018. In Philadelphia, overdose deaths increased by 3% over the same time period — killing 1,150 of the city’s residents.
According to the preliminary data from the Philadelphia Department of Public Health, fatal overdoses increased for the period of April through June. In addition, the proportion of Black people who died of overdose also increased — continuing the trend of the last few years. Emergency department visits in Philadelphia due to overdose have been significantly higher since March compared with the same period last year.
The increase in overdoses matches reports from all over the U.S. about spikes in overdoses since stay-at-home orders have been enacted.
Contributing factors include a growing sense of despair due to loss and economic recession and social distancing’s impact on outreach and recovery programs.
Other forces, such as President Donald Trump’s assault on the U.S. Postal Service, could also come into play. This week, Pennsylvania Health Secretary Rachel Levine allowed for organizations to mail the opioid antidote naloxone to overcome outreach difficulties due to COVID-19. Unfortunately, delays in mail could seriously undermine this important development.
One lifesaving tool that Philadelphia could have used at this moment, but is unlikely to have soon, is a supervised injection site. Last October, a federal judge sided with Safehouse, the nonprofit working to open a site, and rejected the argument of Trump-appointed prosecutor William M. McSwain that the sites violate federal law. However, in June, the judge issued a stay on his ruling, citing social and economic upheaval. The stay came in the midst of a pandemic and after a February effort by Safehouse to open a location in South Philadelphia that was met with protest. Now the case is pending at an appellate court — promising a long legal battle.
A recent New England Journal of Medicine evaluation of an unsanctioned supervised injection site in the United States found that since 2014, despite 10,534 injections, not a single person who used in the site died.
The coronavirus pandemic and recent Black Lives Matter protests in the wake of George Floyd’s killing have applied a magnifying glass on racial disparities in all aspects of life. The increase in overdose deaths, and shift in racial demographics of those dying away from predominantly white, demands similar scrutiny over addiction treatment and overdose prevention. In addition to continuing to pursue new solutions, the city and its partners must ensure that existing resources are accessible to all people who need them. That’s the path to preventing overdoses, not simply shifting them from one demographic to another.