What the Biden administration’s new drug strategy could mean for Philly

The Biden administration on Thursday released its first national drug strategy, aimed at curbing overdose deaths — which now exceed over 100,000 a year — and focusing on expanding services designed to reduce the harmful effects of opioid addiction.

The administration says it will work to enhance access to treatment and address long-standing racial inequities in drug investigations and arrests. President Joe Biden’s plan also pledged to expand harm reduction access and medication-assisted drug treatment in prisons, while targeting drug-trafficking organizations and “reducing the supply” of illicit drugs in the U.S. with requests for hundreds of millions of dollars in budget raises for border control agents and the Drug Enforcement Administration.

Philadelphia Mayor Jim Kenney said he would “urge Congress to implement this strategy.”

“Drug overdoses have taken a devastating toll on our city and nation,” he said in a Twitter post.

Philadelphia has one of the highest overdose death rates in the country, with most deaths involving the powerful synthetic opioid fentanyl. This week, a new report by the Pew Charitable Trusts estimated that 1,250 people died here of overdoses in 2021, which would be the highest death toll the city has ever seen.

Overdose deaths are also disproportionately affecting Black and Hispanic people in Philadelphia, an alarming demographic shift that has had city health officials scrambling to conduct more outreach in communities of color.

Federal officials touted the plan’s embrace of harm reduction measures — programs that can help drug users avoid serious injury, illness, and overdose before they’re ready to enter treatment. Though widely supported by evidence and medical professionals, harm reduction, which includes measures like syringe exchanges, remains controversial around the country.

The White House highlighted the need to help communities where such measures are hard to implement or banned outright.

That’s a category that includes Pennsylvania. While major cities like Philadelphia and Pittsburgh have long pioneered harm reduction strategies, state laws technically forbid syringe services programs like Prevention Point Philadelphia, one of the oldest and largest in the country.

Harm reduction advocates in Pennsylvania have been lobbying for legalized syringe access for years, and in recent months state lawmakers have advanced bills to permit syringe exchanges and possession of fentanyl testing strips, another cornerstone of the Biden plan.

“We applaud our current administration for taking steps to federally expand harm reduction services. [In Pennsylvania] there are over 150 organizations supporting harm reduction services, and grassroots advocates are kicking into high gear educating on the benefits of syringe services programs,” said Carla Sofronski, the cofounder of the Pennsylvania Harm Reduction Network. “We are excited to keep this momentum going. We will not stop.”

Fatal overdoses caused by fentanyl hit Pennsylvania early and hard; for years, it’s been behind most drug deaths in the state. More than 5,200 people died of overdoses in the state in 2021, Sofronski said.

City officials in Philadelphia have worked to expand access to naloxone, the opioid overdose-reversal drug, and fentanyl testing strips. Since fentanyl has replaced almost the entirety of the city’s opioid supply — its presence in anything sold as an opioid is almost a given for experienced drug users — testing strips are most urgently needed for drug users who aren’t familiar with opioids, but whose drugs may be contaminated with fentanyl anyway.

In recent years, fentanyl has made its way into stimulants like cocaine and methamphetamine, in some cases causing a rash of overdoses among people who didn’t know they were taking an opioid.

“Federal and/ or state restrictions on urgently needed supplies for harm reduction programs impair program effectiveness, impose unreasonable burdens on harm reduction programs, and limit their ability to serve a vital public health function,” federal officials said in the strategy document.

The plan does not mention supervised injection sites — spaces where people with addiction can use drugs under medical supervision, be revived if they overdose, and get connected to treatment.

Since 2018, when Kenney said the city would allow — but not financially support — the opening of a supervised injection site, the city’s efforts have been mired in legal battles. Shortly after the nonprofit Safehouse announced its plans to open a site, then-U.S. Attorney Bill McSwain, a Trump appointee, sued to block it. Now, McSwain is running in the Republican primary for Pennsylvania governor, and Kenney said his administration is engaged in talks with the Department of Justice about the operation of a site.

“The Biden Justice Department is much more realistic about conversations. They have not endorsed it, nor do I expect they’re going to endorse it, but they’re at least willing to talk to us about a set of guidelines and rules, from community standards to police strategy standards and how it would operate,” Kenney told the Washington Post in an interview Thursday.

Earlier this year, New York City opened the first supervised injection sites in the country; staff at the sites have since saved more than 100 people from overdose deaths.