Interviews with community members about Philadelphia’s opioid epidemic
Interviews conducted and transcribed by Sharon Christner, Rebekah Christner, Jack Hostager, and Lena Leszinsky. Interviews have been edited for length and clarity.
Chris Marshall is a former addict and former Executive Director of Last Stop Sobriety, a recovery support center on Kensington Avenue.
Penn Political Review: Have you always lived here in Kensington?
Chris Marshall: I was a Northeast Philly kid, born and raised in the Greater Northeast. I didn’t know nothing about heroin and all that kind of stuff. So one day while working as an adult I hurt my back, and my grandmother – bless her heart – out of her kindness said, “here Chris, take one of these Percocets. They’ll make you feel better…”
A few weeks after that I hurt my back again, a real big hurt. I was like, “I don’t think one’s going to help. Let me take two.” And I took two and I’m like “ooh, what is this? This is a very cool feeling. I should have felt like this my whole life!…” And later on that night I was like “well if two feels that good, I wonder what three feels like.” Whew – there went my addiction.
From Percocets, I didn’t learn about heroin until I went to detox. Everybody was in there for heroin and I was there for pills, and they looked at me like I was crazy. The day I actually got out of detox for my prescription pill problem was the day I shot my first bag of heroin.
I didn’t get it at first. I wasn’t one of those people that got treatment and stayed sober. Like a lot of other people, I had to keep coming back and keep coming back. In fact, I came to Last Stop program when technically I think this was my fifth time. The first four times I couldn’t get more than a couple weeks sober. But something changed… and when I stayed here the last time, I stayed. And I haven’t been drunk or high since.
PPR: How much does it cost to sustain an addiction?
Marshall: When I was committing crimes to put me in federal prison, I was spending $700 a day minimum on dope. My tolerance went up real quick from like a one or two bag a day habit – $10 or $20 – to shooting a bundle at a time which costs about $140, to doing that about six or seven times a day. If you have the means to do it, the sky’s the limit if it doesn’t kill you… so it could be as little as $10, $15, $20, up to $1,000.
PPR: Per day?
Marshall: Per day. It’s unfortunate because there’s a lot of ladies working the Ave right now hopping in and out of cars… it’s harder to help females out then it is men because they have natural assets that they can continue to exploit to get money, where many men wouldn’t go that avenue. It’s a d*mn shame.
Judy Moore is a librarian at the McPherson Square Branch of the Free Library of Philadelphia, where she has worked for 28 years. The library gained national attention this spring for regularly administering Narcan to overdose victims.
PPR: How have you encountered the drug problem at the library?
Judy Moore: Last summer – even a little bit before that – we started noticing people trying to live in [McPherson Square] Park. We started noticing middle-class suburban kids coming here, that was new to us. People from the Main Line, from New Jersey and then it just got more and more spread out. We started seeing people from Nebraska, Wyoming… we never saw that before. And we also started seeing more overdoses. We have not had an overdose inside the library in over a year, but that’s because we took measures. But outside, it’s crazy.
One particular week Chera [another librarian] administered Narcan to like five people.
Right after Thanksgiving there were a whole lot of overdoses. Kids will go home just a couple days and their tolerance is less, and then they’ll come back and take what they normally took and then they’ll overdose because they’ve lost their tolerance. That was the week there were 30 deaths or something… One time Chera gave Narcan to a guy while a kid was out here watching. I said, “I’m sorry you had to see that.” She said, “Oh, I’ve seen that before.” So blasé. She’s like ten. The woman from NBC was so shaken up, but this little girl didn’t care, she’d seen it before.
Then there were kids playing out here in the snow one day and I said, “Oh, be careful of the needles.” They said, “We know, Miss Judy.” It’s good that they know it, but it’s horrible that they have to.
[Some Kensington residents] resent it, which is understandable. Some will say, “We should just let them die. It’s useless. Don’t Narcan them, we should let them die and that will solve the problem.” It’s horrible, but that’s their anger coming out. There have been heroin addicts for years. Now all of a sudden it’s white kids and now we’re talking about it. But, we do need to talk about it now because it’s so much worse than before.
PPR: What is the best way Penn students can help in Kensington?
JM: I feel like everyone should get Narcan training – you just never know when you can use it. Students could volunteer at Prevention Point or other clinics because users and non-users have medical needs. We’d love to have students volunteer to tutor kids with homework.
Father Murphy and Sister Ann Raymond
Father Liam Murphy and Sister Ann Raymond, along with Fr. Joseph Devlin, run a Catholic Mission called the Mother of Mercy House on Allegheny Avenue.
Father Liam Murphy: We’re a very small place. We’re not going to solve all the drug issues. What we want people to know is that if they come here… we’ll do everything we can. We have connections where we can get them help and get them into detox. Sometimes, quite frankly, they just stop by, and they’re not ready to get the help they need, but they want water, juice, or food…
Sister Ann Raymond: Or just somebody to bless them. People ask for a blessing all the time. I mean, they do have that sense that they know they’re in trouble but they don’t know how to get out of it.
LM: Yeah, and for lack of a better term, the “secular world” doesn’t get it, but I have to tell you, I was surprised at how much they ask for a blessing. When they’re in that state where they know they’ve messed up, if there is a God they want to know that God still loves them…
We actually walked all the way over [to Hope Park] one day, and I wasn’t out of my car for 30 seconds and there were like ten [drug dealers] around me and they were like, “What are you doing here, what are you doing here, what are you doing here?” And I was like, “Oh we’re going to have mass in the park!”… We ended up having it, and the cops came just to be there and keep us safe, and one of them said to us, “You know, I hope you guys know that you’re interrupting a million-dollar a day business right here.”… But it was just kind of interesting because a lot of the people are Hispanic, which means if not still, they at least were Catholic, so they see this Catholic mass going on. Some came over, a lot sat on their steps at a distance and watched as if it was a little too dangerous to come over. But you would see them praying along – it was kind of neat, neat and sad everything at the same time.
Dr. Priya Mammen
Dr. Priya Mammen is an emergency room physician at Thomas Jefferson University Hospital and a member of the Mayor’s Opioid Task Force.
PPR: How long does someone usually stay with you if they come in for an overdose?
Dr. Priya Mammen: A lot of people who are reversed want to leave immediately. If we are reversing them in the emergency room, if they haven’t been reversed in the field, we try to do it gently, making sure they’re breathing, and then giving them Narcan more slowly so they don’t go into immediate withdrawal and we can watch them longer. We try to watch them at least 90 minutes, because as the Narcan wears off, depending what is on board, they could go back under… so ideally you can watch them for that long. We also use that time to try to engage them in terms of their opioid use disorder, or any kind of treatment options they have done already or seek out. It doesn’t always happen.
PPR: What percentage of people are open to treatment when they come in from an overdose?
PM: It’s a pretty small percentage, honestly. We try to have a discussion with everybody. A lot of people deny it’s a true problem, even though they’ve just been reversed from a near fatal overdose. Some people feel they can just stop on their own. As a rough estimate, 20-25% will say in the moment, “Yes, I want something.” The key point of warm handoff is that someone is going to engage the patient even after they leave, because in that space, they’re not really thinking right… what we want is to be able to make that connection and then be able to re-engage that same patient in a couple days when they’re not in this same intense experience in the emergency room.
PPR: Is the crisis getting better or worse right now?
PM: What’s getting better is that people are coming in reversed. Increased availability of Naloxone and Narcan in the community is huge. EMS has it, police in the highest risk areas of the city all carry it. And we’ve done a concerted effort to prescribe Narcan for people, to have it very easily available… So the fact that they can be revived in the field and arrive with some degree of being awake, or at least not in a life-threatening situation immediately, has helped a lot. In terms of sheer numbers…I can’t say in terms of specific numbers, but it pretty much has been the same if not a tiny bit worse.
Representative Gene DiGirolamo
Gene DiGirolamo has served since 1995 as State Representative for Pennsylvania’s 18th District, encompassing Bucks County. He is Republican chair of the House Human Services Committee.
PPR: Can you tell us a little bit about your background?
Rep. Gene DiGirolamo: I took an issue in this addiction and treatment because of my oldest son Gene’s heroin addiction about 20 years ago… it’s just a terrible thing for a family to go through. My son is one of the lucky ones, he was able to get into treatment.
PPR: What should happen at the state level to address this issue?
GD: I believe, like a lot of other people, that the drug companies had a campaign for years to increase the sales of these opiates, and misrepresented the dangers of addiction to these opiates. I would like to see the Attorney General in Pennsylvania… file a civil suit against these drug companies… I foresee it as happening much like what happened with the tobacco settlement, where many states got together and filed a lawsuit, which I think since then has generated about $250 billion in payments from the tobacco companies that they’ve paid out to the states.
PPR: What should the state be doing to expand addiction treatment?
GD: We have a lot of empty state buildings around the state of Pennsylvania… I would like to see the state get involved and partner with treatment facilities to maybe open up some of these buildings that are closed and abandoned, and use them for treatment… One of the other things I want to point out is what’s going on down in Washington with this health care debate. These bills that passed out of the House, and then what the Senate was talking about doing also… Medicaid is the insurance people get, and a lot of people are really getting drug and alcohol treatment from Medicaid. And there was part of the Affordable Care Act which expanded Medicaid, which Pennsylvania decided to opt into. I think there are 725,000 people in Pennsylvania who have health insurance with this expanded Medicaid, and have access to drug and alcohol treatment. If they make changes [in Washington] to the states and their Medicaid, traditional and expanded, it is going to be disastrous for our state.
Representative Angel Cruz
Angel Cruz is a Democratic Ward leader has served since 2001 as State Representative for District 180, encompassing Kensington.
PPR: How have you seen Kensington change in your 30 years here?
AC: There’s been drugs in this community, in every community, for years. When I first moved here, I could count how many Hispanics and blacks lived in this community. I was one of the first to live around here. You started just seeing people pick up and leaving abandoned houses and you saw more trash, more and more abandoned cars, graffiti everywhere, and you have areas where you have the drug kings and the drug lords in those areas that chased good people out and they inhabited their properties…
This issue with the open drug sales, this issue with the drugs under the bridge isn’t going to take a year. This is been done through many years of neglect. I’ve been around for a long time and I’ve dealt with many mayors, but it fell on deaf ears. But now we have a mayor who said, “let’s roll up our sleeves and be ready to work.” This is the first mayor that listened, heard our cry, who says Kensington is Kensington, and is a neighborhood just like any other neighborhood in the city of Philadelphia and it has to get priority and attention. Kudos to Mayor Kenney, he’s done a wonderful job of taking care of this issue.
JH: What is the solution to solving the heroin crisis?
AC: I think that we’re so far off right now that it’s going to take years to clean this up. I was asked the other day by [Mike] Newall, a reporter for The Inquirer, “do you support an institution where people come in to get high?” And I told him at the moment you’re asking me this, yes. We need a site because they’re doing it out on the street publicly. They’re throwing the syringes everywhere else. People walk through there, people could get sticked. So while we look for a solution to this problem, why don’t we have a center where they can go, to keep them out of the streets, keep them out of the public eye, keep them out of everywhere? Until we can find a solution for where we can put these people… You got to remember that these people have an addiction, have a disease and it’s killing them, which is drugs, but these are human beings that have families that care for these people and we should do the same.
JH: What is going on at the state level to address this crisis?
AC: I see the Governor trying to spend money on Narcan and all these issues. But one of the things that we need to do if we’re going to have the needle exchange program, I think it has to be in Outreach and with services where they can get counseling, give them a place to lay their head, give them a place where they can eat, shower, give them the dignity as human beings. Right now all you do is just take the free needles no questions asked. That’s not the way you solve this issue. It prolongs it because you’re giving them the tools they need to keep using drugs, then we’re going to have to spend more money on Narcan and other stuff to help people that overdose. So those are the issues that we have to address. If we’re going to do stuff like give needles, it has to be with Outreach and services…. I hosted three public hearings about the opiate crisis On Gurney Street. We had some pieces of legislation that we’re passing — Rep. Gene DeGirolamo from Bucks County has a piece where any pharmaceutical that sells opiates will have a 10% or 20% tax that they will have to pay. And the money that is generated will be used for homes in counseling centers for people with opiate problems… So there’s stuff that we’ve done that is heading in the right direction, but it’s going to take time. Even Rome wasn’t built in a day. It’s a long haul, but we got to start somewhere.
Inspector Ray Convery
Philadelphia Police Inspector Ray Convery oversees 700 officers in the 24th, 25th, and 26th police districts, encompassing Kensington.
PPR: What is the police department doing to address this epidemic?
Ray Convery: The drug dealers are in the business to sell drugs. The police department is in the business to have them stop selling drugs. It’s a daunting task, because of the magnitude of the people that are here. The best way to explain it is in a business model – there’s a supply and a demand. Apparently, right now, there is a large demand for the heroin market, which makes for a supply to match that demand. Some of the supply exceeds the demand, which is why we have very cheap prices around Philadelphia… If we can get the constituents from the area the help that they need – which we’re working on with my partners in the city, to help outreach to the homeless and the drug-addicted people – and fewer people have that demand, then the supply goes away because if [drug dealers] can’t make any money, then they’re gonna find some other enterprise to keep themselves involved in.
PPR: Someone from the community told us that sometimes the police don’t target the right people. What would you say to that?
RC: I don’t know what he meant by targeting. I understand that the neighborhood, whenever there’s an influx of new officers to come down here… there’s officers that are eager to go out and do the job. They’ll go into the areas where some of the veteran officers are just getting used to it, but the newer officers will go into those areas, and try to make it up – try to make a difference in the neighborhood.
And they’re very successful, especially with these 30 bike officers, they’re covering twice as much ground as the foot beats were, so I’m getting all kinds of positive things from the neighborhoods.
PPR: What would you say if a student asked, “What can I do to be part of this solution?”
RC: Community service. I mean it sounds like it’s nothing, but it’s a wonderful thing when you go out there on a Saturday or Sunday, and there’s forty-five volunteers walking down the street, cleaning up the street. Then we bring in the mural arts program, and then they come in and paint up the abandoned buildings and make them look like regular houses. And once you make the neighborhood better, it tends to chase the unwanted people out of those neighborhoods.
Joe Pyle is President and CEO of Thomas Scattergood Behavioral Health Foundation, a nonprofit dedicated to expanding and enhancing behavioral health in Philadelphia.
PPR: What is your approach to solving problems in Kensington?
Joe Pyle: What’s really important, and what needs to be a part of the solution in Kensington, is a focus not on what’s wrong with people but what’s happened to people. What are the things that have happened in people’s lives that have led them to make the choices they have made? It’s not that there’s something wrong with them, but there have been experiences in their lives that have changed them… and I think that’s where the failure has been in the last decade or so in Kensington – we’re not meeting people where they are. We’re not listening to their voices and having them drive the change. We are being overly prescriptive about what we think should be happening.
PPR: What is the biggest barrier to solving these problems right now?
JP: I don’t think that first and foremost this is a funding issue. I think this is about how we address the issue, how we frame it. Going back to, “Are we listening to the community? What do they need?” This is not a problem that we get ourselves out of in a quarter. In this country sometimes we think about how quickly we can solve a problem – this really takes a long view. You have to look at what’s happening in our education system, what’s happening in our employment system, in assisted housing. All the social determinants are going to play huge roles in this.
Elvis Rosado is a former addict and current Education and Community Outreach Coordinator at Prevention Point, a nonprofit medical group in Kensington.
PPR: Do you do a lot of general health work, or primarily focus on addiction?
Elvis Rosado: We have a nucleus, which is the actively-using, homeless individual. We also work with people who are getting into treatment. But the idea of harm reduction is [taking into account] anything and everything that impacts this individual. What is the best way to make quality of life better for them? Is it helping them get an ID, get a shower, get some food or clothing? Is it getting into treatment? Is it making it to an appointment?… It could be anything, from buying them a sandwich to buying them a bus ticket.
PPR: What are the biggest gaps in medical and other resources right now?
ER: I can tell you this: the gap is financial, the gap is in treatment for certain populations. There’s a gap that’s a moral deficiency. When I say that, I mean that we live in a society where people look at this population with disgust. And these are somebody’s kids – somebody’s mother, brother, father, sister. And we have to remember at the end of the day, they’re still human beings. I know people that will go above and beyond for a dog or a cat, but they look at a human being and say “Ugh, I’m not helping you.” One of the key pieces is remembering that these individuals are human beings. And a little bit of compassion and love never hurt anybody.
Casey O’Donnell is president and CEO of Impact Services Corporation, a community development organization in Kensington.
PPR: We read the op-ed you wrote called, “Don’t Call Kensington a Hellscape.” Do you think the media attention Kensington has received has been fair?
O’Donnell: That was a reaction to the narrative that has been told by the media that really ignores the resilience and the strength of this community, and how adaptive and industrious the people are who live here… there is a component of voyeurism, to tell the same story over and over again. I think it is disgraceful that Dr. Oz came out here, and you can absolutely publish that. He is a physician that has taken an oath to do no harm. Having somebody inject heroin on camera… to let people know what’s going on? That story’s already been told. So this idea that you’re going to use a term like “hellscape” I think is really sensationalistic.
PPR: What is happening in Kensington that you’re excited about?
CO: One opportunity in Kensington that’s really exciting is this concept of equitable development. So instead of gentrifying the neighborhood, we make room for people to create opportunities for themselves… Part of what I’m excited about is the opportunity to bring change to a neighborhood that provides for the current residents, the people who are not part of the current narrative. They’re working hard, they’re raising kids here, they want educational opportunities… [We’re thinking about] how we can make it so those people can stay, and how we can have diversity, socioeconomically and racially… If you’re in the business of creating opportunities for people, or making room for them to create options for themselves, it’s an exciting time.