Overdose deaths in 2021 were the highest they’ve ever been in Philadelphia

Philadelphia saw its highest-ever number of fatal overdoses in 2021, with 1,276 people dying within city limits from drug use, city health officials said Wednesday.

In an annual report on overdose deaths, city officials attributed the staggering death toll in part to lasting harms from the COVID-19 pandemic, citing “the impact on mental health, social isolation, and access to health care, treatment, and harm reduction services.”

Overdoses increased across all racial groups in the city in 2021, with 59 more people dying, a rise of 5%.

The 2021 deaths also reflect a continued demographic shift, as reported by The Inquirer earlier this year, with overdose deaths among Black Philadelphians increasing much more rapidly than those of their white counterparts.

» READ MORE: At a tipping point: Decades into the opioid epidemic, Black Philadelphians are dying of overdoses at the same rates as white residents, and the death toll is breaking records.

Overdoses among white Philadelphians have been generally declining over the last several years, while overdoses among Black and Hispanic residents have increased. The city is now catching up with trends playing out nationally and statewide for several years.

The city report also highlighted grim statistics showing another changing aspect of the city’s overdose crisis: Deaths involving only opioids are decreasing, but deaths involving only stimulants like cocaine or methamphetamine, or a combination of opioids and stimulants, are on the rise.

Eighty-two percent of overdose deaths involved opioids. Fentanyl, the deadly synthetic opioid that has replaced most of Philadelphia’s heroin supply, was present in 94% of deaths involving opioids, and 77% of all unintentional overdose deaths.

Opioids and stimulants have opposite effects, and are sometimes mixed intentionally for a euphoric high. City officials have said it’s unclear whether the rising deaths from both classes of drugs are the result of fentanyl contaminating stimulants, dealers intentionally mixing the two together, or drug users using both at the same time.

» READ MORE: Tyreek Lewis, 35, died after seeking relief from back pain — and unknowingly buying a fentanyl pill

Black Philadelphians are particularly at risk of dying from unintentional overdoses, the report said — fatalities were highest among that demographic in 2021, and 73% of the deaths involved stimulants, both with and without opioids.

Another contaminant in the drug supply, the animal tranquilizer xylazine, was present in 34% of all overdose deaths in 2021 — a 39% increase from the year before. Xylazine is usually combined with fentanyl or heroin to produce a longer-lasting high, and doesn’t normally cause an overdose on its own.

However, combined with opioids, it can suppress breathing, making it more difficult to revive a person who is overdosing, and it’s suspected to cause severe wounds, creating new challenges for people with addiction and the providers who treat them.

The 19134 zip code in Kensington still sees the highest number of overdoses — 169 in 2021, a 23% increase from the year before.

While Kensington continues to be regarded by many Philadelphians as the heart of the city’s opioid crisis, health officials are increasingly concerned about some majority-Black neighborhoods in North Philadelphia that are recording more overdose deaths.

For example, overdoses have increased by more than 25% in a year in the 19140 zip code, which includes Nicetown, Tioga, and Hunting Park.

When Dominique McQuade, a community engagement and assessment specialist at the city health department, began handing out naloxone and fentanyl test strips in North Philadelphia this year, some residents would tell her to take the naloxone to Kensington.

“People are changing their view of what we call the ‘opioid crisis’ — it’s just a crisis. It’s not just heroin. And it’s about getting all that information into neighborhoods that didn’t think they needed it,” she said.

McQuade spends three days a week in North Philadelphia neighborhoods, where slowly she’s built relationships with drug users who now regularly test their drugs for fentanyl, and who tell her about how the resources she shares have helped them to save friends’ lives.

“It’s about making those small connections and letting them spiral out into larger community connections,” she said.