Philly to Fayette: Opioid woes a symptom of mental health crisis
Second in a three-part series
PHILADELPHIA — Malcolm Kenyatta loses his composure discussing the corner of Somerset and Kensington Avenue in his beloved hometown,a place that has become an open-air bazaar for anyonelooking for an opioid fix.
On any given hour of any given day, the corner is dottedwith people making deals, smoking meth or injecting heroin. Some of the users sit listless on the sidewalk, the stareof the dead in their eyes.
“My childhood church was at the intersection of Kensington and Somerset,” said Mr. Kenyatta, a current Democratic state representative and candidate for his party’s nomination for U.S. Senate.
Mr. Kenyatta, who began preaching at the age of 14, grew up in the public housing projects right across the street from Temple University.
“They shut down the entire Somerset [Elevated Rail] Station because of how dramatic and intense the opioid crisis has become there,” he said of the station that locals refer to on social media as #Heroinexpress.
“This is where so many of my friends live, and it’s terrifying for them; they feel too scaredto leave their homes to go out — and they are too poor to move out,” he said of the neighborhood that is disintegrating right before his eyes.
Drive 286 miles west to Fayette County and the city of Uniontown, which is experiencing the same anguish as Philadelphia. While there isn’t the same obvious openair market, walk along Main Street or into one of the alleys that spill off to the side of the county courthouse, and you will find the same vacanteyed ghosts slumped against theside of a building.
A car pulls up; items are exchanged; the car pulls away.
It looks both different and yet exactly the same as the corner of Kensington and Somerset.
This second installment in athree-part series examining theshared experiences of two counties in Pennsylvania with high poverty rates — Fayette County, which is predominantly white and isolated, and Philadelphia, a dense,minority-majority city — focuses on the opioid crisis devastatingboth.
“Drug addiction is colorblind,” said Mr. Kenyatta. “It doesn’t care where you come from, what your color is or how much or little you grew up with — and it is killing those with the least power and influence, with very little attentionin the press.”
In Uniontown a few months ago, a mother who lived a half a mile from the courthouse was arrested and charged with her 11-year-old son’s death after he was found unresponsive in her home; an autopsy showed he had fentanyl, heroin and morphine in his system. Drug paraphernalia was found throughout the residence after the woman allowed officers to search her home.
The cause of death of her son was determined to be acute combined drug toxicity.
The mother is in the county jail, just a few yards from where Warden John Lenkey sits with Fayette County Commissioner Scott Dunnand Sheriff Jim Custer. It’sone of those wood-paneled courtrooms that looks like it came straight out of a 1940s film. Most of the inmates in the jail, Mr. Lenkey explains, are there because of drug-related offenses: “Property crimes, theft, burglaries — once in a while it’ll lead over to maybe armed robberies and assaults — most of the time, it’s just your petty thefts, break-ins, criminal mischief, anything that they can grab to turn a dime to go supportthe habit.”
Most of them have a drug problem: “I would say, unfortunately,85 to 90 percent of all the incarcerated people have some type of dependency … whether it would be opioids or alcohol. It’s really, really sad,”said Mr. Lenkey.
For the past decade, opioid addiction has been depicted in the media primarily as a white Appalachian problem, associated with post-industrial areas like coal-rich Fayette that have been left behind by automation. As jobs left, so did people and opportunity,and despair set in.
Aches and pains from former labor jobs or unchecked mental health issues soon led to an explosion of addiction, as folks tried to ease their pain, first by prescription then — when that ran out — with whatever they could findon the streets.
Yet it is Philadelphia County that has one the highest overdose rates in the country, according to data compiledby the Pew CharitableTrust.
Last summer, Philadelphia’s Department of Health reported there were 1,214 unintentionaldrug overdoses in Philadelphia in 2020, an increase of 9% and 6% from 2018 and 2019, respectively. The vast majority, 86%, of those fatal overdoses involved opioids, a class of drugs that include many prescription painkillers, heroin and fentanyl, a strong synthetic opioid that is the main driverof fatal overdoses.
Just 10 years earlier, fentanyl was involved in less than 10% of drug overdose deaths in Philadelphia; in 2020 that numberskyrocketed to 81%.
Prior to 2020, unintentional overdose deaths were highest among whites, but by 2020, the number of overdoses among Black residents increasedby 29%.
Sheriff Custer said Fayette County didn’t have its 2020 overdose numbers posted yet, “but I don’t even have to look to know that they have increased.”
Sheriff Custer — like Commissioner Dunn, Mr. Kenyatta and Mr. Lenkey — has lived in the county he serves his entire life. All these men are invested professionally — and personally — in turning the opioid tide, and all agree that the lack of proper attention to mental health is atthe heart of the problem.
“The isolation and instability of the pandemic only made matters worse in communities that already had tragic circumstances prior to the pandemic,” Sheriff Custer said, pointing to declining life expectancies, limited access to health care and the cultural stigma of mental healthdisorders.
Mr. Dunn said he’s not alone in thinking the mental health aspect should be the toppriority: “I just came back from the annual county commissioners meeting in Harrisburg, and hands-down the top priority across the state for all of us is to appropriate money for our crumbling mentalhealth system.”
“This isn’t just a Fayette County problem, this is a problem that’s happening all over our state,” said Mr. Dunn. “Mental health beds, as a result of the budget, have been taken away — and with the opioid crisis, with the drug addiction, with COVID and all the things that are going on right now, we need to step up our game when it comesto mental health.”
Mr. Kenyata agrees. In 2020, he and Republican Rep. Wendi Thomas of Bucks County introduced legislation to increase the number of mental health professionalsin schools.
“We have to start with our young people who are coming to school with unaddressed mental health situations,”said Mr. Kenyatta.
Mr. Dunn admits that despite all of the effort they put into making sure the already addicted receive treatment, addressing the root of the problem is easier said than done — no matter which communityone’s in.
“The stigma over mental health issues is there; it is in the families, the community, our young people and in our culture,” he said, “and that is our biggest obstacle to overcome.”
Mr. Kenyatta echoed this sentiment: “And it begins with our youth. The fact that we don’t even know how many mental health professionals are in our schools is a problem because a counselor could mean a bunch of things and not inherently mean mentalhealth professional.
“We have to start somewhere in our communities; if we aren’t stigmatizing it when they are young, well maybewe have a chance.”