Latest news with #PhiladelphiaDepartmentofPublicHealth
CBS News
11-04-2025
- Health
- CBS News
Philadelphia warns of possible measles exposure at 2 local hospitals
Philadelphia health officials are warning of a potential measles exposure at two hospitals in the region but say the case is not connected to the outbreak in western states . The Philadelphia Department of Public Health announced Friday that the possible exposure to the highly infectious virus happened over the last weeks at a hospital in the city and another in Montgomery County. According to the health department, the first potential exposure was in Penn Hospital's emergency department on Sunday, April 6, between 3:55 p.m. and 11:55 p.m. The second exposure was days later at the Holy Redeemer Hospital's emergency department in Meadowbrook on Tuesday, April 8, between 6:05 p.m. and 9:45 p.m. The Philadelphia health commissioner said the patient was exposed to the measles virus while they traveled abroad. "We believe there is no threat to the general public," Health Commissioner Dr. Palak Raval-Nelson said in a statement. Raval-Nelson said that with vaccination rates dropping in the United States, the risk of people who cannot be vaccinated against measles being exposed to the virus is increasing. She added that she was hopeful the measles case wouldn't spread further in Philadelphia due to the high rates of immunity against the virus in the city. The health commissioner pleaded for anyone who isn't vaccinated to get the MMR vaccine . Research shows one dose of the vaccine is 93% effective against measles, and the recommended two doses are 97% effective. In an interview with CBS News earlier this week, Health and Human Services Secretary Robert F. Kennedy Jr. encouraged people to get the vaccine amid an outbreak primarily in West Texas, where measles has killed two children and infected more than 500 people. It was the first time since becoming HHS secretary that Kennedy publicly urged people to get the vaccine.
Yahoo
26-03-2025
- Health
- Yahoo
Medetomidine is replacing xylazine in Philly street fentanyl − creating new hurdles for health care providers and drug users
Philadelphia's street opioid supply – or 'dope' market – is constantly changing. As health care workers and researchers who care for people who use drugs in our community, we have witnessed these shifts firsthand. New adulterants are frequently added to the mix. They bring additional and often uncertain risks for people who use drugs, and new challenges for the health care providers and systems who treat them. The latest adulterant to dominate the supply is medetomidine. Medetomidine, pronounced meh-deh-TOH-muh-deen, is a drug used in veterinary medicine for sedation, muscle relaxation and pain relief, often during surgery. It is an alpha-2 adrenergic agonist, which essentially means it works by slowing the release of adrenaline in the brain and body. In May 2024, the Philadelphia Medical Examiner's Office began testing for medetomidine in people who died from fatal overdoses. By the end of the year, 46 of the deceased had tested positive for the substance, in addition to fentanyl and other known chemicals. In fact, medetomidine is quickly becoming more common in Philadelphia's street opioid supply than even xylazine, a non-FDA-approved sedative linked to skin ulceration, chronic wounds and amputation. Xylazine was first detected in Philadelphia street drugs in 2006 and became increasingly common starting in 2015. By early 2023, xylazine was detected in 98% of tested dope samples in the city. However, its presence is steadily dropping, according to local drug-checking program data. The Philadelphia Department of Public Health says medetomidine has emerged as a primary adulterant and is now twice as common as xylazine in drug-checked samples. Recent studies show even more unusual substances entering the street fentanyl supply, such as the industrial solvent BTMPS. At the same time, hospital and behavioral health providers are reporting more common presentations of severe withdrawal symptoms among people who use drugs in Philadelphia. While medetomidine's sedating effects are similar in mechanism to xylazine, it is upward of 10-20 times more potent. It suppresses brain signals in the central nervous system, leading to deep sedation. Since medetomidine is so powerful and does not act on opioid receptors, a person who overdoses on it often does not respond to the opioid-reversal drug naloxone, which goes by the brand name Narcan, in the manner we commonly expect from people who appear to have overdosed on opioids. When patients overdose on a combination of opioids and medetomidine, providing naloxone will help individuals start breathing again but does not reverse the sedation caused by the medetomidine. From our clinical experience, after patients start to breathe normally, providing additional doses of naloxone does not seem to help and even risks prompting opioid withdrawal symptoms. Additionally, medetomidine presents serious clinical challenges for health care workers treating patients in withdrawal. These patients often experience symptoms such as rapid heart rate, severe spikes in blood pressure, restlessness, disorientation and confusion, and severe vomiting. While many of these symptoms were similar, if less intense, for those withdrawing from opioids and xylazine, the number of patients we are seeing is unprecedented – as is the severity of their symptoms. While published data on humans' withdrawal from medetomidine is limited, clinicians are drawing comparisons to dexmedetomidine, a related drug used in humans that has shown similar features when withdrawn too quickly. Researchers and clinicians in Philadelphia's hospitals, including us at Thomas Jefferson University, are analyzing emerging clinical data. This data suggests that existing protocols that effectively controlled withdrawal symptoms in the era when xylazine was common are no longer adequate in the era of medetomidine. New protocols have been developed based on the guidance of local experts and are being tested. The rise in severe withdrawal symptoms has prompted expanded testing for adulterants such as medetomidine in Jefferson's emergency departments. Currently, drug testing involves two primary approaches. Qualitative analysis determines the presence or absence of substances. For example, fentanyl and xylazine test strips are commonly used by harm reduction groups and people who use drugs. Unfortunately, they can be unreliable and prone to user error, expiration, misinterpretation and false positives or negatives. This technology is also commonly used in urine drug-testing kits sold over the counter. Quantitative analysis, on the other hand, is a more sophisticated approach to drug testing. It uses complex technology such as liquid-phase chromatography and mass spectrometry to separate the individual components of a sample and determine their concentration. This form of testing is more expensive and requires specialized equipment and analysts to perform the tests and interpret the results. Hospitals in the city have begun selectively testing urine and blood samples from patients who present with suspected medetomidine exposure. The labs are looking for the presence of certain drugs and their related byproducts, and also trying to identify distinct concentrations that might be associated with overdose, intoxication and withdrawal. We believe Philadelphians should be aware of these recent changes in the street drug supply and how people in their communities may react to exposure to medetomidine. Naloxone is still recommended for a person showing signs of opioid overdose – such as excess sedation, shallow or absent breathing and small pupils. Narcan is freely available at pharmacies around the city. But if the patient starts breathing but does not immediately wake up, additional doses of naloxone should be avoided. As always, contact 911 for expert assistance and to get patients to an emergency department to complete their care. Patients who use large amounts of drugs may suffer from severe withdrawal symptoms. Typical medications given to those in opioid withdrawal, such as buprenorphine or methadone, may not be sufficient to treat this constellation of symptoms. Even medications and regimens tailored for xylazine may not be effective. Patients with severe withdrawal symptoms need to be seen in the emergency department, given the risk of undertreating this emerging condition. Read more of our stories about Philadelphia. This article is republished from The Conversation, a nonprofit, independent news organization bringing you facts and trustworthy analysis to help you make sense of our complex world. It was written by: Kory London, Thomas Jefferson University and Karen Alexander, Thomas Jefferson University Read more: Philly hospitals test new strategy for 'tranq dope' withdrawal – and it keeps patients from walking out before their treatment is done Philly's street fentanyl contains an industrial chemical called BTMPS that's an ingredient in plastic How opioid deaths tripled in Philly over a decade − and what may be behind a recent downturn Kory London receives funding from The Sheller Family Foundation. Karen Alexander receives funding from the National Institutes on Drug Abuse (NIDA).
Yahoo
11-02-2025
- Health
- Yahoo
How opioid deaths tripled in Philly over a decade − and what may be behind a recent downturn
After nearly a decade of almost year-over-year increases in overdose deaths, the tide may finally be turning in Philadelphia. The Centers for Disease Control and Prevention announced in May 2024 an estimated 3% decrease in overdose deaths in the U.S. in 2023 compared with 2022. Shortly after, data from the Philadelphia Department of Public Health showed a similar trend: Fatal overdoses across the city decreased 7% in 2023, from 1,207 to 1,122. The city is expected to release its 2024 data in the spring of 2025. While these declines are notable, the city's 2023 fatal overdose numbers are three times higher than they were in 2013. Still, if 2024 numbers confirm the downward trend, it allows a little hope into an otherwise bleak epidemic that is killing more Philadelphians than homicides, car accidents and diabetes combined. Something may finally be working. But what? If over a decade spent treating and researching substance use disorders has taught me anything, it's that the overdose epidemic is what researchers and policymakers refer to as a wicked problem. Wicked problems are constantly changing, complex, interconnected knots of other problems with no clear solution. But let's look at what we do know about how overdose deaths in Philadelphia spiked in the first place – and why they may finally be decreasing. The first wave of the overdose epidemic began in the late 1990s and is attributed to overprescription of opioid pain medicines. But the largest acceleration in deaths didn't occur until after the government and health insurers implemented prescribing controls in the early 2010s. These controls led many people who were no longer able to get prescribed opioids to turn to illicit heroin. In a phenomenon known as the 'iron law of prohibition,' stricter drug law enforcement led drug-trafficking organizations to shift from heroin toward more powerful synthetic opioids that are easier to produce, conceal and distribute. Gram for gram, pure fentanyl is over 50 times stronger than pure heroin. But street-obtained fentanyl has proven to be anything but pure. Local drug-testing efforts found as much as a fiftyfold difference in potency between bags of fentanyl that appear identical. This unpredictable potency is considered to be the chief contributor to the deadliness of street fentanyl. It's like cracking a beer and not knowing whether drinking it will get you mildly buzzed or send you to the graveyard. Research suggests drug busts, though touted as improving public safety, can lead to more inconsistency and unpredictability in the potency of illicit opioids. An analysis of 14 studies conducted in the U.S. demonstrated a marked increase in fatal overdoses following the supply disruptions that result from drug seizures. There's also some evidence that the heightened economic insecurity and despair caused by the COVID-19 pandemic may have intensified the fatal overdose epidemic. Just as economic insecurity was associated with rising deaths, the subsequent economic recovery as the U.S. emerged from the pandemic may have contributed to the 2023 drop in overdose fatalities nationwide. However, the unequal distribution of that recovery seems to track with worsening racial disparities in overdose rates in the late 2010s to early 2020s. Another possible explanation for the reduction in overdose deaths is the increasing availability of buprenorphine. Buprenorphine, an FDA-approved medication for opioid use disorder, reduces withdrawal and cravings for fentanyl. What's more, it decreases overdose risk by more than 50%. However, efforts to increase access to this medication have stagnated. National prescribing rates for buprenorphine were relatively stable from 2019 to 2023, and the CDC estimates that only a quarter of those who need treatment are getting it. Efforts to make buprenorphine available without a prescription have not yet gained traction. Access to and education around naloxone, a lifesaving drug used to reverse opioid overdoses, has also increased, and the drug is increasingly being administered by bystanders. Over 1.3 million doses were distributed in Pennsylvania since 2017. National research suggests these distribution efforts, often spearheaded by local harm-reduction organizations, have led to quicker administration of naloxone. This saves lives while also decreasing reliance on emergency medical services. Finally, the consequences of a seemingly minor characteristic of fentanyl's pharmacology might also be reducing the overdose death rate in Philadelphia. Fentanyl's effects last only a third as long as heroin. This shorter duration led drug traffickers to add the animal tranquilizer xylazine – also called 'tranq' – and the veterinary anesthetic medetomidine into Philadelphia's street drug supply. In 2019, two-thirds of heroin or fentanyl sampled in Philadelphia had xylazine in it. By 2021 all of it did. These additives lengthen the duration of the effect, mitigate withdrawal symptoms and possibly reduce the amount of fentanyl needed per dose. Some evidence from animal studies shows that xylazine reduces fentanyl intake by suppressing fentanyl withdrawal, thereby lengthening the time before a person uses again. What's more, the skin wounds and sedative effects that are associated with xylazine may be motivating some people to avoid using street fentanyl. The opioid settlement, a multibillion-dollar payment from the pharmaceutical industry to resolve legal actions against them, has led to increased funding in Philadelphia for naloxone and medications such as buprenorphine to treat opioid use disorder. However, in the past year the city eliminated funding for needle exchanges and implemented compulsory treatment strategies, which research suggests often do not reduce drug use or criminal recidividism. Meanwhile, at the federal level, Republican members of Congress have proposed cuts to Medicaid, the health insurance program for low-income Americans. Whether new data, when it's released, will show overdose deaths in Philly have continued to decline or are back on the rise is anybody's guess. But I do know that harm-reduction advocates, medical providers and communities of people who use drugs will continue to fight this epidemic as if their lives depend on it. For many, it does. This article is republished from The Conversation, a nonprofit, independent news organization bringing you facts and trustworthy analysis to help you make sense of our complex world. It was written by: Ben Cocchiaro, Drexel University Read more: Philly hospitals test new strategy for 'tranq dope' withdrawal – and it keeps patients from walking out before their treatment is done Philly residents with opioid addiction get medication from the 'bupe bus' − creating a path for treatment Xylazine wounds are a growing crisis among drug users in Philly − a nurse explains potential causes and proper treatment Ben Cocchiaro is affiliated with Prevention Point Philadelphia but his opinions are his own. He served on the Data Analysis and Sharing Subcommittee of the Philadelphia Mayor's Task Force to Combat the Opiate Epidemic from 2016-2017.
