Disaster emergencies used to be declared for extraordinary catastrophes like wildfires or terrorist attacks. Now they’re declared for out of control overdose deaths.
In Pennsylvania, where fatal overdoses are the fourth highest in the country, according to the Centers for Disease Control and Prevention (CDC), the opioid epidemic is precisely such an extraordinary catastrophe. Gov. Tom Wolf acknowledged this last week when he issued the first-ever Statewide Disaster Declaration for a public health crisis in Pennsylvania.
The disaster declaration signals a shift in how Pennsylvania views the way out of this epidemic. Immediately, restrictions will be loosened and resources shifted to improve coordination between health and public safety agencies and make it easier for people to access treatment. For example, no longer will doctors be required to meet with people face-to-face before admitting them to a treatment program, and hospitals will no longer be required to obtain a separate license to offer treatment.
I applaud the Governor’s commitment to combating the epidemic, which has killed more people in Pennsylvania than any other health crisis in the state’s modern history. Early data shared by Wolf shows that 5,260 people died from drug overdoses in 2017, a 15% increase from 2016.
We at CleanSlate Centers, a national medical group dedicated to treating people suffering from substance use disorders, agree with Gov. Wolf that increasing access to treatment is a critical component to saving lives. The appalling human toll in Pennsylvania is what has led CleanSlate to open four outpatient medication treatment centers in the state, with a fifth center to be added next month. Pennsylvania now follows seven other states that have declared the opioid epidemic a disaster emergency, including three states where CleanSlate operates medication-assisted treatment centers: Massachusetts, Arizona, and Florida.
Philadelphia is the epicenter of the crisis in Pennsylvania, rocked by more overdoses than anywhere else in the state, with an estimated 55,000 Philadelphians thought to be abusing opioids. Fentanyl, which flows heavily through the city, is the number one killer in this epidemic, largely responsible for the CDC’s recent report on the drop in American life expectancy. Sixty-four percent of fatal overdoses in Philadelphia are due to fentanyl, as reported by The Guardian. Last year, the DEA seized 40kg of fentanyl destined for the Philadelphia market; as the Guardian noted, a single kilo is enough to kill half the residents in the county.
In addition to fentanyl, some of the purest, cheapest and deadliest heroin in the country can be found in Philadelphia. “This is a very dangerous time for someone struggling with substance use disorder, with all of the fatal overdoses that are occurring in Philadelphia,” DEA agent Patrick Trainor told The Guardian.
The state disaster declaration follows on the heels of recommendations from Philadelphia Mayor Jim Kenney's Heroin Task Force last year, which noted that 80% of overdose deaths in Philadelphia were a result of opioids, and that opioid deaths in Philadelphia were three times the number of homicides. The task force’s recommendations include increasing access to medication treatment programs, such as CleanSlate Centers, which is opening an outpatient treatment center in South Philadelphia this week and another in North Philadelphia next month. The North Philadelphia center is adjacent to the Kensington area, which is ground zero of the city’s epidemic, with an open air heroin market that has become a magnet for people in the grips of this devastating addiction.
Given the gravity of the city’s crisis, and the massive amount of overdoses in Kensington in particular, officials are also considering a dramatic step: creating the nation's first safe-injection site, where users could take drugs in a monitored environment. It’s a controversial proposal which has proponents and critics throughout public agencies in the city, state and nation as a whole.
Those in favor argue that far from enabling drug use and criminal activity, supervised injection sites can offer a bridge to treatment. District attorney Larry Krasner has pledged not to prosecute users at the safe-injection site. "The only way to get people to turn their lives around," he told NPR, "is to keep them alive long enough so they can do that. And we're going to do that."
Whether or not the safe-injection site proposal is ultimately recommended by Mayor Kenney, what’s clear is that top officials at the city and state level in Pennsylvania are assessing and implementing innovative approaches to combating the opioid epidemic. Gov. Wolf’s disaster declaration is a deepening of his already evident commitment to fighting the crisis, including providing funding to create treatment centers of excellence, which CleanSlate was awarded last year.
We will not beat the disease of opioid use disorder without cooperation and coordination across each touchpoint of public health and treatment agencies, first responders, law enforcement, and all entities of government. Leadership from the top is essential to pave the path for this essential partnership, and we at CleanSlate are grateful for the increased opportunity that this disaster declaration affords to work in lockstep with the Pennsylvania community to save lives.