Overdoses are spiking in North Philly. Here’s how help is finding communities left out of the opioid crisis response.

Every Wednesday afternoon, Dominique McQuade sets out to canvass the North Philadelphia neighborhood around Temple University Hospital with a backpack full of naloxone and fentanyl testing strips — and a stack of fliers printed with alarming statistics.

Here in zip code 19140, fatal overdoses have risen by 66% in just three years.

In 2021, 84 people died of an overdose here, second only to the 169 overdose deaths in the 19134 zip code encompassing the Kensington community, long at the center of the city’s opioid crisis.

Both communities showcase the need for more resources for drug users all around the city, especially after years of record-high overdoses. But Kensington has gotten more attention. That neighborhood is the only place in Philadelphia where people in addiction can find a brick-and-mortar clinic that exchanges used needles for new ones, and other services to reduce the harmful effects of drug use.

In North Philly, help for people in addiction is scarcer. So is knowledge about the tainted drug supply that is killing residents here.

Going street by street on foot, at least once a week, McQuade leads a team of health department outreach workers — all of whom live in the neighborhood — dispelling misinformation about drug use in North Philly.

On a recent Wednesday, in bitter cold, McQuade and coworkers Jarrel Boyd and Quadre Rivers walked up and down Broad Street, offering testing strips and naloxone to passersby and shop owners. Some turned them down. One man took a handful of strips, saying he planned to test a batch of pressed pills — counterfeit opioid painkillers that look similar to legitimate pharmaceutical drugs but that are often laced with the deadly synthetic opioid fentanyl.

“We use Kensington as the picture of the opioid crisis, and that’s really not what it is anymore,” McQuade said, referring to that neighborhood’s highly visible open-air drug market. “People are overdosing behind closed doors here. We have to make these connections and get more resources into communities that are ignored.”

Through months of outreach, the team from the Philadelphia Department of Public Health has learned which deli owners are happy to take naloxone for their customers and which neighbors prefer to have fentanyl testing strips dropped discreetly in their mailbox. The team has also made inroads with people who sell drugs in the neighborhood, many of whom also use drugs.

Everyone that McQuade talks to gets a flier the health department created to help North Philly residents learn about the overdose crisis in the 19140 zip code, which encompasses the Hunting Park, Nicetown-Tioga and Franklinville neighborhoods.

In this area, 51% of residents are Black, 42% are Latino, and 40% live under the poverty line. Health workers inform residents that overdoses are increasing dramatically in Philadelphia’s Black and Latino communities — a national trend that belies the long-standing stereotype of the opioid crisis as affecting mostly white Americans.

Most people who overdose in North Philly live here, and most die in private homes. In 2020, 76% of deaths in the area involved opioids — including fentanyl, which is far more powerful than heroin and present in most overdose deaths citywide.

In Kensington, the fact that fentanyl has replaced most of the city’s heroin supply is common knowledge. Many drug users have developed a tolerance for fentanyl and even seek it out on purpose.

But in North Philly, education and outreach have been so limited that many drug users don’t know that fentanyl can be found in other drugs, like cocaine. Or that pressed pills also usually contain fentanyl, unlike the pharmaceutical products they mimic.

» READ MORE: Struggling with an addiction, or know someone who is? Here are ways to get help.

These outreach efforts go beyond once-a-week flier drops. Boyd, who also lives in the community, became an activist in 2020 after several of his neighbors overdosed.

“I get asked by my neighbors to get fentanyl tests and naloxone,” said Boyd. “I don’t think they would do that if it was someone from City Hall.”

The credibility that comes with involving local faces in outreach has helped health officials to reach deeply into the community, even engaging with the dealers who are selling drugs.

Several say they use testing strips to screen for fentanyl in the drugs they sell — and the drugs they use themselves.

“It’s been able to help me, because I know what’s in my drugs to sell,” said one man, who wouldn’t give his name for fear of arrest. “At the end of the day, if I give this person something, and they die, I will be in a lot of trouble. And I don’t want nobody to die.”

The man said his customers often don’t know about the risks of fentanyl. He sometimes gives them testing strips himself.

“The awareness is not there at all. I see it in Kensington — they have outreach there for poverty and drug use, and safe, effective harm reduction,” he said. “But in North Philly, it’s not where it should be at all.”