A dozen years ago, Madeleine Dean, a Congresswoman from outside Philadelphia, said she didn’t know how to help her son who was struggling with addiction. But he eventually hit a breaking point and admitted that he needed help.
She remembers asking him in the car on the way to treatment, “‘Did you ever think of asking us for help?”
And she remembers him responding, “You know, I never thought there was a good time. I mean, it was somebody's birthday. It was Christmas. It was Thanksgiving.”
“He literally thought the shame of telling us that he was an addict would be greater than if he had died of an overdose,” she said. “That's what addiction actually does to the brain.”
While Dean’s son has been sober for years now, a panel she spoke on Friday didn’t have a clear answer about how to turn around the opioid crisis more broadly, although there were a couple of hopeful signs. The number of people who have died of an overdose in Allegheny County and Pennsylvania, 717 and 5,343 deaths in 2021 respectively, has increased for three years in a row and is the second-highest total ever, just below the number of overdose deaths in 2017.
The Zoom panel included top drug treatment officials in Pennsylvania and the United States, as well as state politicians and medical experts from the University of Pittsburgh.
Dr. Rahul Gupta, the director of the Office of National Drug Control Policy for the Biden administration, who spoke on the panel, said early data shows a 2% decline in overdose deaths in 2022. His department has set a goal of reducing deaths 13% over the next three years. “That's exactly what keeps me up at night,” he said.
One cause of optimism, panel members agreed, was the billions of dollars pouring into states and treatment programs from legal settlements with opioid manufacturers. They also cited billions of dollars allocated in the American Rescue Plan. But these amounts are relatively small, they said, compared to a recent study, which showed that the opioid epidemic is costing the country $1.5 trillion annually.
Gupta described visiting jails in other states that have instituted harm reduction programs in their jails and prisons, including by allowing incarcerated people to take medicines, like buprenorphine and methadone, which reduce their likelihood of dying of an overdose.
“Death rates improve, their recidivism rates improve. And on top of that, the corrections officers are happy,” he said. “They're happy because they're not having the relationship with the people behind the walls changes.”
The Allegheny County Jail started and ramped up its programs to administer drugs like buprenorphine over the last two years. In 2021, there were only about 25 people in the jail receiving similar treatments, but that number has increased to around 125 this year, according to an email from Jesse Geleynse, a spokesperson for the county.
Jennifer Smith, the secretary of Pennsylvania’s drug and alcohol programs, said during the panel that the state has also seen a small decline in overdose deaths in 2022 but the state has not set a specific target for reducing overdose deaths.
While some parts of the country are still debating harm reduction approaches, like safe-injection sites, both Pittsburgh and Philadelphia already have significant harm-reduction programs and are still seeing a surge in overdose deaths. But Smith says many of the recent deaths have come from Black and Hispanic communities. She said the public health community needs to change what and how it offers addiction services to those communities.