The Bronx’s quiet war with opioids
La crise des opioïdes aux Etats-Unis.
Aux Etats-Unis, plus de deux millions de personnes sont dépendantes aux opiacés. Héroïne, fentanyl, médicaments délivrés sur ordonnance… L’épidémie d’overdoses liée à ces substances est telle que Donald Trump l’a qualifiée d’ « urgence de santé publique ». Direction New York, où les habitants du Bronx se battent contre ce fléau, mais aussi contre les clichés.
The bodies turn up in public restrooms, in parks and under bridges, skin tone ashen or shades of blue. Terrell Jones, a longtime resident of the Bronx, was pointing to the locations where overdoses occurred as he drove through the East Tremont neighborhood.
2.“This is sometimes where people are being found, in their houses, dead,” said Jones, 61, 1. to turn up apparaître; ici, être retrouvé / restrooms (US) toilettes / skin tone teint / ashen blême (aussi, cendreux) / shade nuance, teinte / longtime depuis longtemps / to point to montrer (du doigt), indiquer, désigner / location endroit / to occur survenir, avoir lieu / to drive, drove, driven through traverser/ sillonner/circuler dans (en voiture) / neighborhood quartier. looking toward a housing project along 180th Street. “Especially in the South Bronx, you have so many people in housing who overdose. To actually sit there and witness this whole thing? You’re watching this person turn all different colors. You know what I’m saying?”
3.The dramatic rise in opioid-related deaths has devastated communities around the United States in recent years, and has stirred concern among law enforcement and public health officials alike in New York City.
4.Here, the reports about the epidemic and its ravages have mostly centered on Staten Island, where the rate of deaths per person is the highest of the five boroughs. But perhaps nowhere in the city has the trajectory of opioid addiction been as complex as in the Bronx, where more residents are lost to overdoses than anywhere else in the city. On Bronx streets, the epidemic’s devastation is next door, down the street, all around.
5.The increase in deaths — now at the highest levels since the city began collecting the data in 2000 — has been fueled by social forces that have left some Bronx residents especially vulnerable: a history of high drug use in the area; a growing supply of cheap heroin on the streets; and the proliferation of a deadly synthetic opioid, fentanyl.
6.Jones said he never leaves his apartment in Hunts Point without a dose of naloxone, a medication that can be used to reverse opioid overdoses. The antidote has become a necessary stopgap to prevent deaths that happen in public spaces. Jones, who has himself struggled with drug addiction in the past, now works with the New York Harm Reduction Educators to help drug users.
7.“Regardless of how they died, it wasn’t an intentional death. Nobody woke up and said,
‘Today I want to die of an overdose,'” he said. “People have issues and reasons they’re using drugs, and it’s not for us to judge.”
8.In 2016, 1,374 people died from overdoses in New York City, up from 937 in 2015. The vast majority of those lethal overdoses involved opioids, a drug classification comprising prescription painkillers like Oxycodone and Percocet, morphine, and the illegal street counterpart, heroin.
CHEAPER AND STRONGER
9.The crisis in the Bronx stems, at least in part, from a surge of opioids in a place where some residents have long struggled with addiction. Heroin has become much cheaper in recent years as the supply in the United States has grown. It has also become significantly more potent.
10.The cheaper, stronger heroin has been made even more dangerous by the proliferation of fentanyl, which is 50 times more powerful than heroin. Narcotic experts say the drug is likely being mixed into heroin batches, often without the dealers themselves knowing, let alone users.
11.An illegal prescription painkiller market also thrived in the Bronx. In one high-profile case, a physician who owned several medical clinics in the Bronx was convicted of illegally distributing millions of prescription painkillers between 2011 and 2014.
STATEN ISLAND
12.In Staten Island, the proliferation of prescription painkillers — often acquired illicitly — led to an explosion in overdose deaths earlier this decade. Eventually Staten Island itself developed a market for heroin dealers.
13.The ensuing rise in opioid-related deaths among white, middle-class men and women has helped change popular conceptions about who is susceptible to drug addiction. 14.Given the significantly larger overall numbers of deaths in the Bronx, Dr. Chinazo Cunningham, a primary care physician who has worked in the Bronx for decades, lamented that opioid-related deaths in the borough have not received more attention. She said the interest in Staten Island likely stems from its relatively new addiction crisis and the fact that white middle-class residents are being affected.
15.Cunningham, who is certified in addiction medicine, said it is important to balance medical data against stereotypes “portraying everyone in the Bronx as a drug user, or suggesting that all brown people are drug users.” Such assumptions are partially to blame for apathy in the overdose death crisis in the borough, she said.
16.In fact, in 2016, the highest rate of overdose deaths in the Bronx was among white residents, followed by Hispanics, and then African-Americans.
Heroin has become much cheaper in recent years as the supply in the US has grown.