Editing Opioid Crisis (section)

== Origins ==

Philadelphia's opioid crisis has roots extending back decades. Heroin addiction existed in the city long before the current epidemic—Kensington has had a drug market since at least the 1970s. What changed was scale. The crisis accelerated after pharmaceutical companies aggressively marketed prescription opioids like OxyContin beginning in the late 1990s, creating addiction in patients who had never sought drugs. When prescription opioids became harder to obtain or more expensive, users transitioned to heroin, which was cheaper and more available. Philadelphia's location on Interstate 95, the East Coast's major drug trafficking corridor, ensured abundant supply. The user population expanded from traditional demographics to include suburban users who traveled to Kensington to purchase drugs.<ref name="macy">{{cite book |last=Macy |first=Beth |title=Dopesick: Dealers, Doctors, and the Drug Company That Addicted America |year=2018 |publisher=Little, Brown |location=New York}}</ref>

Fentanyl transformed the crisis from serious to catastrophic. This synthetic opioid, fifty times more potent than heroin, began appearing in Philadelphia's drug supply around 2015. Drug dealers mixed fentanyl into heroin to increase potency, but the mixing was inconsistent—users never knew how much fentanyl they were getting. Overdoses spiked dramatically. In 2017, Philadelphia recorded over 1,200 drug overdose deaths; by 2020, the number exceeded 1,200 annually even as the [[COVID-19 Pandemic in Philadelphia|COVID-19 pandemic]] complicated response. Fentanyl made every use potentially lethal, transforming addiction from a chronic condition to an immediate survival crisis.<ref name="quinones"/>