Anthony walks the streets of Philadelphia's Kensington neighborhood looking for two competing things: His next heroin fix – and help in what he says is his struggle to end addiction.
He traces the habit to one fateful day.
“I shattered my leg and I was on oxycodone pain medication prescribed through my doctor,” recalls the 28-year-old, who asked for anonymity to share his story. “I withdrew so bad, a friend put me on heroin and it’s been a slippery slide for five years.”
He ended up in Kensington, a predominantly Hispanic neighborhood where drug users can find some of the cheapest and purest heroin in the country. The area is also home to unscrupulous healthcare providers who continue to over-prescribe opioid medications.
Open drug use occurs within easy view of storefronts. Teenagers riding their bikes pass addicts in zombie-like states on the sidewalks and porches. Kensington is a destination for heroin users from afar. Many end up staying to feed their addiction.
“We have not only people from other parts of the state, we have people from other parts of the country who come here,” said Drug Enforcement Administration (DEA), Special Agent Patrick Trainor. “Unfortunately, it’s sparked a heroin tourism industry,”
The drug epidemic is not a new phenomenon for Kensington. For decades, it’s contended with addicts. More than half the population lives below the poverty line, 2.5 times the rate of the rest of Philadelphia. The wide availability of prescription opioids from healthcare providers, along with the influx of individuals from outside the community, has made matters dramatically worse.
In 2017, a deal was reached by city officials to clear out an open air heroin market known as El Campamento, or “The Tracks.”
It existed beneath sunken train tracks, hidden from street level. The property was riddled with syringes and all kinds of drug paraphernalia.
People in the area regularly died from drug overdoses. At times, 75 to 125 opioid addicts lived there in makeshift homes.
“It was contained,” said Councilwoman Maria Quinones Sanchez, who represents the Philadelphia district that includes Kensington. “But now it’s out in the open and people are kind of struggling about dealing with the problem. What are we going to do with it? Because this problem is not going to go away in the next six months or in the next year,” said Sanchez.
Pure Heroin Fills the Streets of Kensington
The attraction of Kensington is simple: cheap and powerful heroin primarily piped in by Mexico’s Sinaloa cartel. And in the streets of Kensington, drug dealers compete with one another to sell heroin, some laced with fentanyl, a synthetic opioid.
“In order to compete, you have to have the purest stuff on the street, we've seen purity levels in Philadelphia around 93% at times, and that’s street purity level,” said (Drug Enforcement Administration) DEA Special Agent in Charge Gary Tuggle. “So in order to compete with that, many groups have started to adulterate that 50% [of heroin] or so with fentanyl. Often not recognizing the fact that fentanyl is 80 to 100 times more powerful than morphine, 50 to 80 times more powerful than heroin.”
Davey, a 31-year-old heroin addict knows firsthand how strong, and dangerous, the fentanyl laced drug can be. “I had a good friend, the bag was empty, I scraped an empty bag for him, some grains, and just a tiny amount and he overdosed,” Davey said. “That's just how powerful it is.”
Philadelphia recorded over 900 overdose deaths in 2016. Officials say the city is on track for at least 1,200 deaths in 2017. Overdoses are the number one cause of death in Philadelphia for every age group from 25 to 44, the number two cause from age 45 to 54, and the number three cause from age 55 to 64.
“It’s extraordinary to have an epidemic like this appear on leading causes of death,” said Dr. Thomas Farley, Philadelphia’s Health Commissioner. “The problem is not only not slowing down, but it’s accelerating. There are not enough beds for addicts he said.
“I lived through the worst drug epidemics in the country’s history. The post-Vietnam heroin epidemic, the crack cocaine epidemic of the ‘80s and early ‘90s and then there’s this particular opioid epidemic that dwarfs the other two,” Tuggle said.
“It has a feeder system to it that the others didn't have. And that’s the misuse and abuse of prescription opioids,” Tuggle said.
“We still have a major focus on the enforcement piece, but we also engage with the community in prevention and education to try to drive down that insatiable demand for opioids that exists in this country,” said Tuggle. The engagement includes non-traditional partnerships within the public health sector such as treatment providers and medical examiners where they analyze data to assist in explaining the drug epidemic trends.
Councilwoman Sanchez wants all sectors working together to ensure those who understand what is happening are the ones leading the fight. “We now have to have the political will to sit all of those actors at the table and say, 'OK, how do we work our way backwards,” she said.
The biggest obstacles are lack of treatment facilities and housing for addicts and others. Estimates suggest that 30,000 heroin addicts are in Philadelphia, currently, only half would have access to proper treatment.
“Not all people who are drug users have housing, and housing is often a part of treatment. It's hard for people to get treatment if they are living on the street,” said Dr. Farley.
A Community Connected beyond the Drug Epidemic
On a recent walk down Kensington Avenue, Sanchez recalls growing up in the neighborhood and her commitment to the people.
“All I see is people who survive despite circumstances that are sometimes created outside of their control, and those are the folks that I represent,” she said. “And so my job is to be the cheerleader for those folks who work really hard and despite all the situation, whether it’s the teacher, principal, the librarians, you know, the folks that are here.”
Convenience store owner Sam Kuttab said things have improved some. He plans to stay in Kensington.
“About 10 years ago we had a big fire here and the insurance company paid us good money,” Kuttab said. “We could have just taken the money and moved on. But we felt there is a community here, there’s a community here that really appreciated our services, and we appreciated them. So we put our money back into this neighborhood, and it’s paid off,” he said.
Officials recognize there are obstacles, but unless they do something impactful more people will die in Kensington and Philadelphia.