Editing Opioid Crisis in Philadelphia (section)

== Background ==

The opioid crisis in Philadelphia followed national patterns while exhibiting local characteristics. Prescription opioid overprescribing during the 1990s and 2000s created addiction among patients who transitioned to illicit opioids when prescriptions became restricted. Heroin had long been available in Philadelphia, with Kensington's drug markets operating for decades, but the influx of users addicted through the medical system expanded demand.<ref name="opioid"/>

Fentanyl's arrival transformed the crisis beginning around 2015. The synthetic opioid, far more potent than heroin, was mixed into the drug supply, making every use potentially lethal. Overdose deaths spiked as users encountered fentanyl unexpectedly or underestimated its potency. Philadelphia's overdose deaths approximately doubled between 2015 and 2017, reaching levels that exceeded the city's homicide rate.<ref name="opioid"/>

The crisis reflected and exacerbated social conditions including poverty, trauma, homelessness, and mental illness. Many people using drugs had experienced childhood trauma, untreated mental illness, or economic desperation before addiction. These underlying conditions complicated treatment and recovery while the drug use itself generated additional trauma, housing instability, and health problems.<ref name="opioid"/>