PHILADELPHIA—The Philadelphia Department of Public Health is announcing the publication of the latest version of the OD Stat Annual Report providing a comprehensive review of a selection of overdose deaths in the city of Philadelphia in the hope of identifying possible situations where it was possible to have interrupted the chain of events leading to a fatality. Based on such data, this report includes policy and programmatic recommendations with the sole purpose of reducing death due to unintentional overdose.

According to Dr. Roy Hoffman, Medical Director, Mortality Review Program, “We expect OD Stat to provide the City of Philadelphia with a unique understanding and insight into the circumstances that can contribute to unintentional overdose deaths, which can then help our agencies focus their efforts to prevent future such deaths.”

Every neighborhood in the city is being hit hard by an epidemic of opioid use and overdose. Across all racial and ethnic groups, the number of deaths from drug overdose is higher than the number of deaths from homicide. To provide useful insight into these deaths, this year’s report provides some notable obstacles to overcome.

• From April 2020 to April 2021, there was a 29% increase in fatal overdoses nationwide, compared with an 8.7% increase in Philadelphia.
• Fatal overdoses among Black (non-Hispanic) individuals continue to rise in Philadelphia. Stimulants were noted more frequently among the toxicology of Black (non-Hispanic) overdose decedents, meaning they may be more likely to encounter fentanyl unknowingly in the stimulant supply. Fentanyl can lead to overdose for anyone, but people who do not typically use fentanyl or other opioids, and who may not be aware that fentanyl is in their drugs, are particularly at risk for overdose.
• 8 out of the 9 OD Stat decedents with cocaine in their toxicology were Black (non-Hispanic).
• Drug use occurs on a spectrum and efforts were made to review the cases of individuals who represent the many ways people use drugs in Philadelphia. In 2021, 32% of deaths involved an opioid only, down from 50% in 2020. 59% of decedents reviewed in OD Stat had both an opioid and stimulant present in their toxicology.
• 24% of decedents reviewed in OD Stat used drugs recreationally and often sought out non-opioid substances.

Many individuals who use substances or have a use disorder are diagnosed with behavioral health conditions and have experienced a trauma. 53% of descendants reviewed in OD Stat experienced suicidal ideation. 47% of decedents reviewed in OD Stat experienced a childhood trauma. These are likely undercounts as the team relies only on available data.

OD Stat team is part of the Health Department’s Substance Use and Harm Reduction program. Their process involves two groups of people. The OD Stat staff group is comprised of staff from the Health Department and the Department of Behavioral Health and Intellectual Disability Services. This group reviews the details of select overdose fatalities and consolidates the information presented at quarterly meetings.

The larger OD Stat team attends the quarterly meetings to hear the decedents’ stories and discuss areas for improvement in services or missed opportunities that might have prevented the death. This team includes City leadership as well as non-City representation from hospitals, community-based organizations, treatment providers, and community members.

Every three months, this team investigates a sampling of four to five Philadelphia residents who died due to drug overdose to learn what could be done to prevent future fatalities. They not only look at the circumstances involving the fatality, but also the victims’ interaction with City systems such as prisons, arrests, homeless services, substance use treatment, behavioral health services, infectious disease testing, and emergency medical services. They also receive data from community-based organizations, hospitals, as well as interviews with the next-of-kin of those died. This information is then used to assemble an anonymous summary of the individual’s life and the circumstances of their death.

For more information, read the 2021 OD Stat annual report.