Faced with authorities overwhelmed by extremely powerful and deadly synthetic drugs, associations are trying to reduce the effects of this crisis which goes far beyond the borders of the Pennsylvania city.
At the wheel of his truck, Hawaiian shirt on his shoulders, Tom Freye starts his tour with a smile on his lips, this Friday October 25. But a warning quickly contrasts with his relaxed demeanor. “It's better if you don't wear your seat belt, in case there's a shooting”slides the solid fifty-year-old. There are gunshots “almost every day” in the Kensington district of Philadelphia (United States), he assures, “for territorial issues or drug-related debts.”
In the north of the economic capital of Pennsylvania, Kensington Avenue is painful to see. Under the arches of the elevated metro, alongside businesses that have been closed for a long time, thousands of people are surviving as best they can in this “open-air cam supermarket”. That's what Tom, executive of the association The Everywhere Project, which offers “a whole bunch of services” for street people and drug addicts. On the sidewalk, there are few who do not have a twisted body, a haggard look and an uncertain gait, the result of drugs and nights spent outside.
“This is what fentanyl can do to an entire neighborhood”plagues Tom, who is delivering foodstuffs that day for a large meal distribution planned for the next day. Since the 2010s, this painkiller 50 times more powerful than heroin – and 100 times more than morphine – has become the nightmare of American health authorities. “On the streets, this stuff has quickly replaced heroin, because it's much cheaper and incredibly strong”traces Tom. Unlike heroin, which is of plant origin, fentanyl is a synthetic opioid that is easily manufactured in the laboratory. It has flooded the black market in the form of powder, tablets or liquid for injection.
Even more worrying for the public authorities: fentanyl is now cut with xylazine, “a veterinary sedative nicknamed 'tranq'”, explains Tom, having to jerk the wheel to let an ambulance pass. “Probably another overdose”grumbles the one who says he has several times “resurrected” intoxicated users in the middle of the street. As the University of Pittsburgh (Pennsylvania) explained at the end of July, tranq causes a sudden drop in blood pressure and greatly hampers the management of overdoses. Narcan, a nasal spray developed for this purpose, may be much less effective in the presence of this product.
Because of these synthetic drugs, Philadelphia has become one of the American capitals for fatal overdoses: at least 1,122 people lost their lives in this way in 2023, and these incidents concerned “80% of fentanyl users”explains to franceinfo the local public health department, which only counts residents of the city. “The number of deaths is therefore certainly much higher”warns Tom Freye, who mentions the presence of numerous “drug tourists from other states”.
At the top of the list of cities most affected by fentanyl, we also find Baltimore (Maryland), Cleveland (Ohio) and San Francisco (California). Nationally, these opioid overdoses caused nearly 75,000 deaths in 2023, according to the CDC, the American health agency, or almost 70% of all fatal overdoses.
“Besides that, xylazine also causes really serious injuries on a daily basis”adds Tom, supporting photos. On his phone, he keeps photos of open wounds, sometimes very infected, which are side effects of the product. “This causes significant abscesses all over the body, not necessarily at the site of the injection, which can lead to amputations due to lack of treatment”he laments.
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Despite its scale, the fentanyl crisis has been “relatively little discussed” during the presidential campaign, judge Tom Freye. During the only presidential debate, the word was uttered twice, by Kamala Harris only, and in connection with border controls. In her program, the Democratic candidate promises to uncover and stop the clandestine supply chains of fentanyl, which comes mainly from China and Mexico. As vice president, she also supported the distribution of anti-overdose treatments. For his part, Donald Trump insists on “training and employment” former drug addicts, while wanting to fund more help and treatment programs, only if they are run by religious organizations.
“The candidates are using the fentanyl crisis to attack each other. But they are proposing absolutely nothing concrete, apart from the same approach that is 50 years old. It's a shame, because everyone can fall for it, but no one don't really talk about it.”
Tom Freye, Director of Operations at The Everywhere Projectat franceinfo
In this case, the American government is accused of having favored the emergence of the opioid epidemic by authorizing, in the 1990s, the sale of powerful and highly addictive painkillers, such as oxycodone. “A young sportswoman recovering from a fall, a worker injured at work… No one is safe from this scenario”warns Tom, who suffered from a heroin addiction until 2001. “For me, it all started with an accident in an elevator, says the former plumber. Five years in a wheelchair, very strong medication and then nothing, that's when I found 'the hero'.” Sober for 23 years, he remains marked by this “terrible passage” of his life. “A few weeks ago, doctors found a foreign body in my right arm: it was a piece of needle from that time!”he wonders again, pointing to a radio with his elbow.
In Philadelphia, most associations have decided to adopt another approach: harm reduction. This is the case with Savage Sisters, a support group made up largely of former drug addicts. “We must agree to see drugs as part of life, it is too dangerous to ignore this problem or simply condemn it”asks Sarah Laurel, director of the association, who herself experienced addiction and life on the street. For four years, the association has distributed meals and hygiene kits, offered mobile showers using a truck and managed seven accommodations for drug addicts. “It’s important that there is a change in mentality, that we no longer criminalize people and that we finally start helping them,” she demands.
If they allow “visible results”assures Savage Sisters, the association's methods are not always to the taste of the neighborhood or even the authorities. Under pressure from the municipality, the day center located in Kensington had to close its doors. In the street, relations with the police have become “very complicated”affirms its director. “No one wants to deal with this problem, because it's not a pretty sight, she laments. But it's not by closing your eyes that all this will disappear.”
“If I had the candidates in front of me, I would ask them to improve access to treatment and housing. I would ask them for showers, toilets, and the analysis of drugs in circulation so that we can better responding to overdoses.”
Sarah Laurel, director of the Savage Sisters associationat franceinfo
While roaming the South Philadelphia neighborhoods, Charlie, Amy and Victoria, three Savage Sisters employees, share this observation. “We do not see drug addicts, but people who are hungry, thirsty, who have wounds and need to wash, explains Charlie, orange hat screwed on his head. Fentanyl and tranq are not a criminal problem, but primarily a public health problem.”
In front of a grocery store, they come across a small group of men. “You want some water, some deodorant?”says Charlie, to make contact. After a quick discussion, he also offers “tools”. Understand: syringes. Some refuse, others happily accept this clean material, which helps reduce the transmission of diseases such as hepatitis or HIV. Distribution is done out of sight, “because it’s still very frowned upon in the street”says Charlie.
When we talk to them about the presidential election of November 5, the marauders we meet confide that they only have “little hope”. “The government is not waging war against drugs, but against drug addicts, tranche Amy. It destroys people’s lives even more.” Everyone would like to be able to provide help under better conditions, and to receive federal funding. “We expect a lot from the president, but that won’t change much for us”estimated Charlie, who stays “determined” to support drug addicts. “On the morning of November 6, no matter the outcome, I will be there to help on the streets.”he says, pulling his cart onto the sidewalk.
