DV Journal

The opioid epidemic has extracted an immense toll on Pennsylvania’s communities. Now, with over $2 billion in settlement funds set to flow into the state over the next two decades from companies involved in the manufacturing, distribution, and sale of prescription opioids, we stand at a critical crossroads. This windfall presents an unprecedented opportunity to combat the opioid crisis, but Philadelphia’s controversial spending decisions threaten to undermine the entire initiative’s effectiveness.

While the city has received more than $20 million in settlement funds to date, its plan for the allocation of some of them within the Kensington neighborhood has raised serious concerns. Some believe the city runs the risk of falling prey to the kind of mission drift that plagued previous settlements, whereby money meant for specific public health crises ended up funding pet projects having little to do with the underlying issue the funds were meant to address. As the opioid crisis continues to claim lives on a daily basis, we cannot afford to make the same mistakes.

Kensington, home to what’s considered by Drug Enforcement Agency (DEA) officials to be the “East Coast’s largest open-air drug market,” certainly deserves substantial support. However, Philadelphia’s decision to spend settlement funds on home repairs and assistance for small businesses as part of a broader abatement plan for the community – albeit well-intentioned – strays too far from the settlement’s intended purpose of directly addressing the opioid crisis. That’s why the Pennsylvania Opioid Misuse and Addiction Abatement Trust (PAOT) stepped in to reject those aspects of the Kensington spending plan, ensuring that the terms of the settlement are strictly followed.

Philadelphia’s leaders argue that addressing root causes of addiction like poverty and neighborhood deterioration will help prevent future addiction cycles. While this argument has merit in theory, it misses the urgent reality of the current crisis. When there are immediate, proven interventions available, directing funds toward general community improvements feels like a dangerous gamble with lives at stake.

Other Pennsylvania counties offer compelling examples of how these funds could be better utilized. Neighboring Chester County’s implementation of Project Sticker Shock, which aims to help combat underage drinking, as well as its initiatives to expand access to medications to reverse overdoses and treat addiction, demonstrates focused, practical approaches to prevention and response. Other counties, including Perry, Cumberland, and Allegheny, have prioritized medication-assisted treatment in their prisons – a critical intervention point for individuals at high risk of relapse or overdose upon release.

Philadelphia has appealed the decision of the PAOT to the Commonwealth Court of Pennsylvania where this fundamental disagreement about how to best serve communities ravaged by opioid addiction will ultimately be settled. At stake is not only access to Philadelphia’s future settlement payments – which could be reduced or withheld by the PAOT if they lose and do not change their abatement spending plans – but that of the entire state as well. The terms of the settlement require that 85 percent of funds be spent on authorized uses. If this standard is not met, future payments to the state from the settlement could be jeopardized and previously divested funds could potentially be clawed back. Such an outcome would be catastrophic not just for Philadelphia, but for the entire state’s efforts to combat opioid abuse and must be avoided.

As Philadelphia awaits the court’s decision, the city should begin planning how to better utilize future settlement payments. While community development is vital, it shouldn’t come at the expense of direct interventions that can help curb the worst impacts of the opioid crisis. Its leaders would be wise to reconsider their approach and, instead, look to their neighbors for guidance on alternative applications of their funds.

The strategies employed by other Pennsylvania counties provide a clear roadmap: focused spending on proven interventions, direct support for at-risk populations, and careful adherence to settlement guidelines. Only through such disciplined, strategic allocation can we hope to maximize the impact of these historic settlements and make meaningful progress in combating the opioid crisis that has devastated so many of our communities.

The stakes are simply too high for anything less. Lives hang in the balance, and we cannot afford to squander this opportunity on well-meaning but misaligned initiatives when proven solutions to the opioid crisis are ready to be implemented.

The opioid epidemic is the one of most serious public health and safety challenges facing our commonwealth, as reflected by the fact that in 2021 we lost an average of 14 Pennsylvanians each day to an overdose.

Overcoming this crisis requires a multi-pronged approach to support those struggling with addiction. But the goal should always be to stop addiction before it takes root, and as a certified register nurse anesthetist, I believe that requires reevaluating our approach to pain management and looking at where we can lessen the use of opioids or prescribe alternatives where those exist.

Among the tools that could have a real impact on weaning patients off opioids are non-opioids. I know that sounds obvious, but the U.S. Food and Drug Administration is close to approving the first non-opioid pain treatment for managing serious pain.

Non-opioids address pain outside of the brain, eliminating the risk of a patient becoming addicted to the treatment. To-date, the drawback of non-opioids has been that they were not powerful enough to effectively treat severe pain. But successful Phase III trials have been really encouraging to many of us in the medical community.

Non-opioids for severe pain could significantly reduce the number of opioids that patients are prescribed, and in turn drastically cut down the rate of opioid addiction occurring across our country.

Such a monumental advancement in medicine warrants action, so it’s encouraging to see some lawmakers — including many in our region — are already taking steps to ensure these treatments are accessible to those who need them once they are granted final approval.

In Congress, the recently introduced Alternatives to PAIN Act would make non-opioids more accessible to seniors, a demographic which typically has a heightened reliance on pain management treatments, by ensuring that non-opioids are covered under Medicare, the federal program that tens of millions of seniors receive their health insurance coverage through.

Not only would non-opioids be covered under the Alternatives to PAIN Act, but the bill also would make sure they don’t cost more than generic opioids. This provision is necessary: No patient should be forced into using more harmful and addictive treatments because they’ve been priced out of accessing healthier alternatives.

State legislatures across the country are joining the effort to leverage non-opioids alternatives to their fullest potential. Some states are considering bills that would cover these alternatives under their state’s respective Medicaid program, while others are pursuing investments in educational materials that inform patients and doctors about the existence of non-opioids, as well as the dangers of opioids.

Pennsylvania’s General Assembly has yet to introduce legislation on non-opioid access or education, but there’s still time to do so. It’s urgent that our lawmakers in Harrisburg make this a priority.

Our commonwealth has been hit especially hard by this crisis, which is why it’s imperative that every Pennsylvanian dealing with severe pain has access to these groundbreaking new treatments once they become available to the public.

Each patient who can avoid an unnecessary reliance on opioids could be another Pennsylvanian spared from opioid addiction further down the road.

It’s crucial for Pennsylvania’s legislative leaders to proactively embrace these opportunities to make a lasting impact on saving lives within our commonwealth.

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Due to the high murder rate and increasing lawlessness, fewer and fewer people venture into Philadelphia from the surrounding suburbs, whether to dine, see a show or enjoy other attractions.

However, suburban addicts and those who want illegal drugs flock to areas like Kensington where they can score an easy high.

“The kids we’re treating, my friends on the street, they’re not from Philly. This is Delco, Bucks, Montco, York, Allentown. This is kids from all over the state (who) are comfy county kids that come to Kensington and get stuck,” Sarah Laurel of Savage Sisters Recovery, a nonprofit in Kensington, said during an interview with the Penn Capital Star.

When their families try to find them, Laurel will tell them that she knows they’re there on the city streets somewhere, but they are not ready to give up drugs yet.

Philadelphia City Councilman Jim Harrity, who lives in Kensington and has overcome an addiction to alcohol, told me taking away anything that enables an addict to put off getting clean is necessary. It is a major reason he opposes Safehouse, the principal organization in Philadelphia that wants to set up safe injection sites where addicts can inject illegal drugs and receive aid from doctors and nurses if they overdose.

Safehouse was in the news because they met with a few neighborhood leaders and the U.S. Attorney for the Eastern District of Pennsylvania to develop plans for sites in Kensington and South Philly. It outraged Harrity that he and other elected officials were shut out of the meeting. He saw it as a deliberate attempt to bypass objections so Safehouse could quickly set up these harmful sites.

People across Philadelphia think addressing the opioid crisis should be a top priority for the next mayor. However, a Lenfest Institute for Journalism poll surveyed 1,200 people; respondents rejected war–on–drugs era policies. Only 27 percent approved of safe injection sites.

Other findings reported in The Inquirer showed 68 percent wanted more free mental health services; 63 percent favored more drug treatment and recovery services.

The lack of public support will not stop the Safehouse activists who, I am told, would like to set up at least 10 safe injection sites across the city.

The media should question the mayoral candidates about safe injection sites at every forum or debate. Former Councilperson Cherelle Parker was the most adamant when she was a guest on my show, saying she would use either power available as mayor to block or shut down these sites.

Progressives behind these sites resort to fake compassion that shields them from criticism. They claim they have the moral high ground because they are trying to save lives. It’s time for prominent religious figures like Archbishop Nelson Perez to publicly attack this phony compassion as dehumanizing and morally bankrupt.

And, it’s time to revisit the practical arguments that were made three years ago when this Safehouse group tried to establish a site in the heart of South Philly. These sites will draw drug dealers to the immediate area and become a hub for all sorts of criminal activity. Police would be complicit in not enforcing laws that remain on the books.

Finally, as Councilman Jim Harrity told me, safe injection sites would enable addicts to postpone making the hard decision to quit. They will help to normalize public illegal drug usage further.

There is still time to prevent this. Safehouse canceled a Zoom meeting they had scheduled last week to wrap up the discussion. The rumor is a Philadelphia congressperson appealed to the Biden administration to slow this process down or halt it.

This can be stopped, and we must stop it.

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