There is no corner in Philadelphia that remains untouched by the overdose crisis. In 2021, Philadelphia experienced the highest number of drug overdose deaths on record, with 1,276 deaths from drug overdoses, a 5% increase from 2020. Of the counties associated with the 10 largest U.S. cities, Philadelphia had more than double the rate of drug overdose deaths in 2020. Over 82% of overdose fatalities in Philadelphia involve an opioid and 67% involve a stimulant. The City of Philadelphia has taken major steps to address the substance use and overdose crisis, including developing prevention programs that increase access to care, expand harm reduction services and programs, enhance community engagement, and improve understanding of the crisis through routine surveillance and prevention activities. Yet the crisis is getting worse as overdoses increase and structurally disadvantaged communities are becoming disproportionately burdened by the harms of substance use.
Purpose: Funding from the CDC National Center for Injury Prevention and Control’s Overdose Data to Action: LOCAL grant, CDC-RFA-CE-23-0003, will allow the Philadelphia Department of Public Health (PDPH) to develop, implement and measure several initiatives that reflect key priorities of both the CDC and the City of Philadelphia, reducing substance use-related morbidity and mortality. PDPH is applying for the required Component A funding, as well as the optional Surveillance Component B funding and Surveillance Component C funding. With these funds, PDPH will support linkage and retention in care activities and overdose prevention activities by expanding naloxone and fentanyl test strips across community, public safety, and health care settings (1A). In addition to naloxone and fentanyl test strip distribution, harm reduction activities will include conducting regular drug user health surveys, providing point-of-care drug testing, and establishing a community advisory board (2A). PDPH will also develop stigma communication materials that are incorporated into clinician education and community engagement activities (3A). Clinician education will consist of launching a webinar series, sustaining a citywide hospital workgroup, and supporting the Substance Use Response, Guidance and Education program (4A). Surveillance activities will monitor mortality and morbidity related to substance use disorder and analyze data across demographic, clinical, and geographic characteristics to inform prevention activities. A bimonthly “data to action” meeting between PDPH epidemiology staff, OD2A strategy leads, key partners, and community advisory board members will integrate the data to action framework into surveillance and prevention activities (6A). Lastly, PDPH will expand surveillance to develop a SUD continuum of care surveillance system to monitor linkage and retention in care (Component C), expand drug checking services to community, public safety, and healthcare settings, a
nd support the Medical Examiner's Office to provide PDPH with timely and comprehensive forensic toxicology data (Component B).