Mayor Cherelle Parker’s administration will not allow opioid settlement cash to fund syringe exchange

Mayor Cherelle L. Parker’s administration is changing the city’s response to the opioid epidemic and will not fund any services that provide people with items to safely use drugs, such as clean syringes and pipes, out of the $180 million coming to Philadelphia from lawsuits settled with the manufacturers of opioid painkillers.

Dollars from the legal settlements may still fund services that provide items such as the overdose-reversal drug naloxone and drug testing kits, but “anything directly used in the consumption of illegal drugs” can no longer be supported, city spokesperson Sharon Gallagher said.

Philadelphia has long provided financial support for syringe exchange programs, which are not legal in Pennsylvania but have been allowed to operate in the city. The change “aligns with the Parker administration’s strategy to improve public health and public safety,” Gallagher said, adding that top leaders are “exploring all options and funding sources” to do so.

Philadelphia will receive $180 million over 18 years as the result of the settlement of several lawsuits against opioid painkiller manufacturers, largely blamed for fueling over-prescription of opioid pain pills that led to skyrocketing overdose deaths.

The city saw 1,413 fatal overdoses in 2022, the highest annual death toll on record.

The amount of money at stake is relatively small, but Parker’s decision marks another shift in policy from former Mayor Jim Kenney’s administration, which was supportive of syringe exchange programs, one of many services considered “harm reduction,” a philosophy that aims to keep people alive until they are ready to seek treatment.

It is the first time that Parker’s administration, in its third month, has taken a public stance on syringe exchanges, which have operated in Philadelphia for more than 30 years.

Decades of research show that syringe services effectively prevent the spread of HIV, hepatitis, and other blood-borne illnesses by allowing drug users to obtain sterile needles to inject their drugs instead of sharing needles with others.

The policy change will impact how the nonprofit Scattergood Foundation disburses funding from its Overdose Prevention and Community Healing Fund, the only part of the opioid settlement money that funded syringe services. Scattergood worked with the city administration to distribute $1.9 million in grants to 27 grassroots community organizations last June.

Three local groups received about $38,000 between them to distribute sterile syringes and other materials for safer drug use. A second round of Overdose Prevention and Community Healing Fund grants will be distributed in May.

Joe Pyle, Scattergood’s president, said the organization hopes the city will not pull back entirely from supporting syringe exchange efforts as part of the public health response to the opioid crisis.

“I’m optimistic that the mayor wants to drive a particular focus for the opioid settlement dollars, but that they have not excluded harm reduction strategies like syringe exchange in their broader public health approach to the opioid epidemic across the city,” Pyle said.

Asked to clarify the administration’s position on syringe exchange generally, Gallagher did not provide an explanation. The administration “is supportive of overdose prevention work and is further focusing the range of those activities funded through this grant program,” she said.

Public health researchers criticized the Parker administration’s decision not to dedicate settlement funds to syringe exchange or other safer drug use tools like sterile pipes.

Ayden Scheim, an assistant professor of epidemiology at Drexel University, questioned why opioid settlement money would not be used to support an intervention shown to be effective at stopping the spread of diseases associated with drug use.

“Given how little money is involved, it’s not a budgetary decision — it’s a decision about politics and optics,” he said. “It’s putting people who use drugs at risk to score political points.”

In 2019, researchers at George Washington University used mathematical modeling to estimate that the syringe exchange program at the nonprofit health organization Prevention Point had prevented more than 10,000 HIV cases among injection drug users in Philadelphia in the 10 years after it opened in 1992.

In recent years, Philadelphia has seen an uptick in HIV cases from injection drug use — likely because the deadly synthetic opioid fentanyl, which has replaced most of the heroin in the city, sends drug users into withdrawal more quickly, leading them to inject more often. That makes people more likely to share syringes or re-use old ones, increasing their risk of contracting blood-borne illnesses.

“We need more syringe distribution, not less,” Scheim said.

Syringe exchanges are illegal in Pennsylvania, but local prosecutors and politicians allow organizations to operate such programs in Pittsburgh, Philadelphia and some smaller cities.

State lawmakers have filed bills to legalize syringe exchanges statewide in recent years, and a committee in the state House of Representatives voted last month to move a legalization bill to the House floor. It will be the first time in at least 10 years that the full chamber votes on whether to legalize syringe exchanges, Spotlight PA reported.

Parker has made ending the open-air drug market in Kensington a key part of her early agenda, and she campaigned against some progressive approaches to drug policy, such as creating sites where people can consume drugs under supervision to reduce their risk of dying from an overdose.

Long the center of the city’s overdose crisis, Kensington sits within the 19134 zip code, which saw 193 overdose deaths in 2022, the highest of any zip code in the city.

It is unclear whether Parker’s administration will continue to support city funding for organizations such as Prevention Point, which has several contracts with the city for such services as providing health care and operating a homeless shelter. (The money Prevention Point receives from the city is separate from opioid settlement funding.)

The mayor is scheduled to unveil her first budget proposal next week.

The Parker administration does support some harm reduction services. Opioid settlement funds may still be used to fund services that provide items to people in addiction, such as naloxone, wound care supplies, hygiene materials, meals, and clothing, Gallagher said.

But City Councilmember Quetcy Lozada, who represents parts of Kensington, said last month that she has “serious concerns” about Prevention Point, a large organization in the neighborhood that provides a variety of harm reduction and public health services, including syringe exchange, and receives millions of dollars annually in city funding.

Lozada and a group of three other City Council members have sought to rein in some harm reduction services in Kensington beyond syringe exchanges. Last month, Savage Sisters, a small nonprofit that provides services such as showers and wound care to people in addiction, lost its lease after Lozada urged its landlord not to renew it.

Savage Sisters was also one of the three organizations that received opioid settlement funds from Scattergood for sterile syringes.