The opioid crisis has been national news for decades, and deaths from opioid overdoses have been rising dramatically since 1999. Synthetic opioids, in particular, have been driving these figures up. While every state has its challenges, Pennsylvania’s experience with the opioid crisis is shaped by unique factors in its rural areas and densely populated urban areas. Understanding the situation in Pennsylvania and local efforts to address the issue can provide valuable insights into the broader opioid crisis.
How opioids have affected Pennsylvania residents
The current opioid crisis in Pennsylvania didn’t appear out of nowhere. For years, opioids have presented a serious, ongoing public health concern in the state. Pennsylvania is one of the states with the highest rates of deaths from drug overdoses, and opioids are involved in the majority of those deaths. Between 2010 and 2019, the opioid-related mortality rate in Pennsylvania more than quadrupled from 5 to 23.7 per 100,000 residents. The COVID-19 pandemic made matters worse: In 2021, Pennsylvania experienced 5,449 drug-related overdose deaths. That’s almost 15 a day and more than 43 per 100,000 Pennsylvanians—twice the national average.
Fentanyl and heroin, specifically, have been the most significant threats contributing to the high rates of opioid overdoses and deaths. The influx of fentanyl is directly responsible for a spike in overdose deaths in Pennsylvania starting in 2015.
Kensington’s high-profile problem
Kensington, a neighborhood in northeast Philadelphia, is one of the communities that has suffered the most during the opioid epidemic. The neighborhood, which was once a thriving textile and leather manufacturing hub, has experienced growing poverty, drug use, and drug overdoses in recent years. Today, Kensington is home to the largest open-air drug market on the East Coast. It’s common to see drug deals and open opioid use in homeless encampments across the neighborhood. Recently, a new drug called tranq—the street name for xylazine, a non-opioid sedative for horses—has been further complicating the Philadelphia drug problem as it’s mixed into fentanyl and other street drugs.
The Kensington, Philadelphia drugs crisis has had far-reaching consequences, and systemic issues—like poverty and gentrification—only make the problem worse. The neighborhood consistently suffers the highest number of fatal overdoses in the city. Crime has also risen alongside opioid use. Violent crime is considerably higher in Kensington than in Philadelphia overall, and the total crime rate is also more than double the national average. This spike in crime has left Kensington residents fearful for their safety doing ordinary tasks, like walking down the street or using public transport.
In response to the Philadelphia drug epidemic, then-Mayor Jim Kenney declared a citywide emergency in 2018. The resulting Philadelphia Resilience Project did make some positive changes, such as creating more than 200 additional housing opportunities for vulnerable residents and conducting thousands of HIV tests in Kensington. Unfortunately, these victories were short-lived as the COVID-19 pandemic led to increased opioid use, homelessness, and overdose deaths again. Post-pandemic, the city is working toward improving access to medications for addiction treatment (MAT), food, housing, and employment opportunities as part of harm reduction in Philadelphia.
Opioids in rural PA
Urban areas aren’t the only communities affected by the opioid crisis, however. Between 1999 and 2015, overdose deaths in the nation’s rural counties more than tripled. The overdose death rate was even slightly higher in rural areas than in metropolitan areas in 2015. The pervasive belief that drug addiction is exclusively a problem within cities is wrong and contributes to the struggles rural communities have in dealing with the opioid crisis. Effectively addressing addiction in rural areas requires an honest look at what’s been happening in these communities and the unique challenges they face.
The primary challenge for rural communities dealing with the opioid crisis is that opioid treatment programs are less widely available in these areas. Medical facilities are generally more spread out in rural areas, and they may not all offer comprehensive treatment services. In other words, rural patients dealing with opioid use disorder (OUD) often have to travel greater distances to receive addiction care. And if their ability to travel is limited due to work or family care responsibilities, or a lack of reliable and affordable transportation, people may simply go without.
They may not even be able to find effective treatment programs—32% of insured PA patients reside in a ZIP code with no publicly listed buprenorphine provider, leaving them without convenient access to this life-changing medication for addiction treatment. Attitudes toward harm-reduction approaches also vary widely across the state and are not always accepted in rural areas compared to cities. These factors present barriers to effectively fighting the opioid crisis in rural communities.
Recent initiatives to combat the crisis
Pennsylvania officials, addiction treatment professionals, and community members have worked together to fight the opioid crisis in the state. After the setbacks connected to the COVID-19 pandemic, recent public health efforts have focused on bringing down opioid misuse and overdoses in a variety of ways.
Pennsylvania rules for administering naloxone
Act 139 of 2014 in Pennsylvania, also known as David’s Law, allows first responders to administer naloxone to patients experiencing opioid overdoses. EMS, law enforcement, and firefighters are all permitted to use the life-saving drug on those who need it. Between January 2018 and July 2023, EMS administered 89,360 doses of naloxone in Pennsylvania, potentially saving that many people from fatal overdoses. Over the same period, over 50,000 people visited the ER for opioid overdoses in Pennsylvania.
Act 139 also permits close friends and family members of people at risk of opioid-related overdoses to get a naloxone prescription. If they have the medication on hand, the hope is that these individuals will be able to save a loved one who is experiencing an opioid-related overdose. Even with this law in place, addiction treatment professionals still express concerns about insufficient funding for naloxone provision and inequitable administration of the drug.
Harm reduction facilities + programs
Beyond allowing naloxone administration, Pennsylvania has also implemented several other harm reduction programs and facilities to address the opioid crisis. In 2023, the state launched the Pennsylvania Overdose Prevention Program (POPP) to increase access to overdose prevention supplies. This program allows those who need them to receive naloxone and/or drug testing strips for free by filling out a simple request form.
Philadelphia has syringe service programs that provide clean syringes, a way to dispose of used needles safely, and HIV testing. Sharing used needs can lead to infections like HIV and hepatitis C, so these programs aim to reduce infections.
Public-private partnerships
There have also been a growing number of public-private partnerships where officials and organizations or community members come together to fight opioid addiction and its devastating effects. One example of such a partnership is the Task Force on Opiate Prescribing, convened by Partnership for Better Health and the Cumberland-Perry County Drug & Alcohol Commission. This task force included leaders from top healthcare providers and community centers to increase safe prescribing and implement best practices for opioid abuse prevention.
Ophelia’s role in helping Pennsylvania
Virtual care for patients
As an online MAT provider, Ophelia has a pivotal role to play in the efforts against opioid addiction and overdose. Telehealth makes addiction treatment accessible for many patients who otherwise would not have been able to get the treatment they need. Ophelia runs online campaigns highlighting the availability and convenience of telehealth treatment, so patients are aware of this option. Those who may not have a treatment provider close to their home can access treatment without traveling long distances through this service.
Our intake team gets to know each patient to make personalized recommendations for care, which may include Suboxone® or another buprenorphine-naloxone medication (important safety information). We’ll make sure the prescription gets to your local pharmacy and set up a meeting schedule with your care team.
UPenn training program for nurse practitioners
Ophelia has also partnered with the University of Pennsylvania School of Nursing to create a nurse practitioner training program that prepares Family Nurse Practitioner students to care for patients with OUD. The immersive program counts toward the educational requirements for becoming a buprenorphine prescriber and will equip participants to help turn the tide of the opioid epidemic as diligent, knowledgeable care professionals.
The long-term goal of both telehealth OUD treatment and updated healthcare provider education is to make gold-standard treatment as accessible as possible, no matter where a patient is located.
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