PHILADELPHIA — More than half of Philadelphians think that addressing the opioid crisis should be a top priority for the next mayor — and that city leaders should focus on offering mental health and addiction treatment instead of arresting drug users, according to a Lenfest Institute for Journalism/SSRS poll that surveyed more than 1,200 people.
Black and Latino poll respondents were more likely to say that addressing the city's opioid epidemic should be a top priority than their white counterparts.
In Philadelphia, fatal overdose rates among Black and Latino residents have risen for years, while overdose rates among white residents have fallen. Last year, as overdose deaths rose particularly sharply among Black Philadelphians, the city scrambled to get education and resources into neighborhoods with higher Black populations, like North Philadelphia's 19140 zip code, where overdose deaths increased 66% in three years.
Sam Rivera, 61, a disabled veteran and Red Cross volunteer from Northeast Philadelphia, said that he's been stunned by the open-air drug use and sales he's seen in Kensington, the majority Latino neighborhood at the epicenter of the city's overdose crisis. A former resident of Port Richmond, Rivera is Latino, but he said that everyone should be concerned about the opioid crisis, regardless of their race or neighborhood: "It's affecting everyone."
"People are dying," said Anita Plumer, 59, who is Black and listed opioid use as a top priority on the poll. Plumer, a Mount Airy resident who worked for the city's Sanitation Department before retiring, has been in recovery from addiction to alcohol and crack for seven years.
She's known several people who have overdosed in the last few years, and worries about the rise of pressed pills: fake pharmaceutical painkillers that contain illicit fentanyl. "It's one-time use that's killing some people, taking fentanyl and thinking it's something else," she said.
When asked which interventions were best to combat opioid addiction, 68% of poll respondents said the city should prioritize mental health treatment, and 62% said the city should offer more addiction treatment and recovery programs.
Alexis Roth, an associate professor in community health and medicine at Drexel University, said ensuring that Black residents receive equal access to addiction treatment is especially key as the demographics of the overdose crisis change. National studies show that Black patients are less likely than their white counterparts to be offered medication for opioid use disorder, which has been shown to be more effective to result in lasting recovery than abstinence from drugs.
Roth and other public health experts in the city said residents' poll responses show that Philadelphians are rejecting some war-on-drugs-era policies that criminalize people with addiction. More than half of the poll's respondents said the city should prioritize arresting drug dealers and educating people about drug use, but only 22% said city leaders should focus on arresting people who use drugs.
"There is clearly a widespread recognition that using classic tools from the war on drugs isn't the right approach to take," said Megan Reed, a research assistant professor in public health at Thomas Jefferson University. "We need a public health approach to the problem, and the mayor should realize this is a public health issue, not a law enforcement issue."
Zenovia Battle, 75, of Germantown, also ranked opioid use as a high priority for the next mayor. She said she's frightened when she encounters people openly using drugs on public transportation, and nervous about panhandling and robberies related to drug use. But arresting people with addiction isn't the answer, she said.
"They need help, professional help. They need another chance. And they need to be off the streets," Battle said. "Maybe that will extend the time they will stay off the drugs, if they have housing and get a chance to look at another way of life."
Nearly 67% of Philadelphians polled agreed, saying that providing more support to people with addiction and/or serious mental health issues should be a top priority in mayoral candidates' housing policy. Black Philadelphians were also more likely to believe that than white Philadelphians, the poll found.
"When your basic needs aren't being met, it's hard to prioritize anything about your health," said Roth. "Providing an opportunity for people to become stable through adequate housing gives people that opportunity to prioritize things beyond just survival."
Housing programs geared toward people in addiction do exist in the city; the nonprofit Pathways to Housing offers homes to clients without requiring sobriety, and many participants use that new stability to subsequently seek treatment.
Less than a third of poll respondents ranked supervised drug consumption sites as one of the best interventions to combat the crisis. "I don't think that's going to contribute to diminishing the problem. I think it would make it even worse," Rivera said. "Everyone has to share responsibility and open up more rehab centers."
Dozens of supervised consumption sites operate internationally, and research suggests they reduce overdose deaths. In 2018, Mayor Jim Kenney announced his support for opening a site in the city where people can use drugs under supervision and be revived if they overdose, but the effort has been mired in legal battles for years. In the meantime, two sites have opened in New York City, the first in the country. Since November 2021, clients have used the site more than 65,000 times and staff there have treated more than 800 overdoses.
Recently, Safehouse, the nonprofit working to open a site in Philadelphia, announced that it was discussing a settlement in a federal lawsuit that so far has blocked its opening. If the new mayor also decides to open one, public health experts say, they must consider the public's concerns.
"Evidence and popular opinion are not always aligned," said Rosie Frasso, the director of Jefferson's public health program. "We have to respect that concern, not just march in, which is why we haven't been able to pull it off."
