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Political tension around harm reduction and a toxic drug supply

Philadelphia Inquirer - 4/10/2024

Apr. 10—Good morning and welcome to the second edition of Philly Health Insider, the Inquirer's subscriber-exclusive newsletter on our area's health-care industry and burgeoning eds and meds sector.

Today, we're bringing you news on the citywide conversation around harm reduction and addiction outreach, an architectural review of Jefferson's new Center City location, and a data dive into how popular area hospitals are with patients.

Got tips, questions, or suggestions? For a chance to be featured in this newsletter, email us here.

If someone forwarded you this newsletter, sign up here.

— Aubrey Whelan and Abraham Gutman, Inquirer health reporters, @aubreywhelan and @abrahamgutman.

The big story: Tensions over harm reduction in Manayunk, and a deadly addition to Philadelphia's volatile drug supply

Aubrey here: Our big story this week is actually two stories detailing how the opioid crisis in Philly is getting deadlier and more unpredictable, and political tensions are growing over how to solve it.

I've been leading The Inquirer's coverage of the opioid crisis since 2018. When I started writing about this epidemic, overdose deaths were at a record high, a new, toxic additive (fentanyl) was contaminating the city's drug supply, and politicians were trying to allow the nation's first supervised injection site to open in Philly.

Fast forward to 2024: Deaths are still setting record highs, even more toxic additives (xylazine, nitazenes) are contaminating the city's drug supply, and politicians are proposing to pull city funds for syringe exchanges.

In my latest story, I examine how tensions are expanding beyond Kensington, the epicenter of the city's opioid crisis. In Manayunk, staffers at the addiction support organization Unity Recovery say heightened political rhetoric around harm reduction is causing friction with local business owners who believe the organization is attracting drug users to the neighborhood.

At the same time, a new danger — a class of drugs called nitazene analogues — has emerged in our city's volatile drug market, causing problems for people in addiction and those hoping to get them treatment.

Nitazene analogues are opioids up to 40 times more potent than fentanyl. The city health department has been tracking nitazenes and recently announced that they turned up in the toxicology results of at least five overdose victims and two people who died from other "traumatic causes of death." And officials suspect nitazene analogues were present in at least a dozen more overdose cases.

From years of reporting on this beat, I know that getting help for addiction can be difficult enough. The emergence of more potent drugs may contribute to what health officials call a "vicious cycle" keeping people out of treatment and driving skyrocketing overdoses. Read more about nitazenes and how the city is tracking them here.

The latest news to watch

1.

Would this Biden administration proposal to reduce the cost of prescription drugs stifle innovation in drug research? Penn, University City Science Center, and other local innovation centers think so. Harold Brubaker explains the proposal, the opposition, and why it would only impact a couple dozen medications.

2.

Nurses at Temple's Jeanes Hospital voted on Monday to approve a new three-year contract that includes wage increases. The roughly 375 nurses have been negotiating since the fall, and earlier this spring threatened to go on strike.

3.

The Inquirer's architecture critic Inga Saffron thinks Jefferson's new Honickman Center in Center City is a "dazzling" building, but also pans "Jefferson's self-inflicted blight" on the streets surrounding the new gleaming glass tower for outpatient services. Check out her review.

Data dive

Abraham here: This week, I want to break down a telling patient satisfaction metric from one of my favorite surveys. (Fellow data nerds, tell me your favorite surveys!)

Let's get into it.

This week's number: 92%.

That's the number of patients who would be willing to recommend their Philly-area hospital to friends and family. (So much for our grouchy reputation ...)

Having so many would-be promoters in the community can have big benefits. Studies show that patients take recommendations from friends and family into account they know when choosing where to seek health care.

Which general hospitals have the most patients singing their praises? Hospital of the University of Pennsylvania, Chester County Hospital, and Doylestown Hospital. Nearly all patients who participated in the survey would recommend these hospitals.

The acute care hospitals with the fewest patients who would recommend them are St. Francis Hospital, Lansdale Hospital, and Nazareth Hospital.

The survey is from the Centers for Medicare & Medicaid Services' most recent update of the Hospital Consumer Assessment of Healthcare Providers and Systems.

Check out what percentage of patients would recommend your hospital here.

Hospital inspections

For a few hours last summer, Lankenau Medical Center got slapped with an "immediate jeopardy" citation, the state's most serious warning. The Wynnewood hospital earned the label after a nurse gave a patient 3 mg of hydromorphone instead of the 1.5 mg prescribed. The patient overdosed, and ultimately was revived with naloxone and treated in the ICU.

Lankenau provided the state with a plan to prevent mistakes like this from happening again. Since then, state inspectors have investigated two additional complaints, both times finding that the hospital was in compliance.

If you're interested, here's the full roundup of Lankenau's inspections between August and January.

Q&A with the new president-elect of the American Psychiatric Association

Theresa Miskimen wants to embed psychiatrists in primary care practices and use telemedicine to expand access to mental health care.

The Rutgers professor, newly elected to lead her professional society and head of the psychiatry department at Hunterdon Medical Center, believes that these steps can help offset a shortage of psychiatrists.

"It is clear that we just don't have enough psychiatrists to provide for the necessary mental health needs of the nation," Miskimen said.

Read our colleague Sarah Gantz's full Q&A with Miskimen here.

Making moves

AI might make some jobs obsolete one day — but it is also creating jobs at Penn. Well, at least one job.

Penn's Perelman School of Medicine named Marylyn Ritchie the first vice dean of artificial intelligence and computing.

Ritchie, who's also the director of Penn's Institute for Biomedical Informatics, will be responsible for developing a plan to incorporate AI into medical school education.

We asked ChatGPT to write a short limerick congratulating Ritchie on her appointment:

Congratulations to Marylyn Ritchie, so bright,

As Penn's AI vice dean, it's just right!

In the realm of computing, Her leadership's a-rooting,

For innovation in healthcare's new height!

A Philly first

Penn gene-therapy innovator Jim Wilson's start up, iECURE, got FDA approval to test a method of gene editing in babies.

Wilson continues his efforts to help children with OTC deficiency, whose livers are unable to make a crucial enzyme.

This is the same disease that Wilson was trying to treat 20 years ago in a clinical trial that ended in a patient death and congressional hearing. Jesse Gelsinger, who was born with a mild form of the condition, died at age 18 when his body rejected the virus that Wilson used to deliver an experimental treatment.

The new clinical trial uses a different virus that is already used in other treatments and doesn't trigger an immune response.

We're impressed

The last thing a patient undergoing a vasectomy would want is for the earth to start shaking. It also strikes us as a surgeon's nightmare.

Steven Hirshberg, a urologist at Midlantic Urology in Huntingdon Valley, held steady as he performed a vasectomy on Justin Allen of Horsham during Friday morning's earthquake.

"The room was shaking — I wasn't shaking," Hirshberg said.

Were you in the middle of a vasectomy, inserting an IUD, or performing open surgery during the earthquake? Send us an email with your story — and our kudos for keeping your cool!

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