Substance Use Treatment

The following section features service utilization and medication use data of Medicaid beneficiaries in Philadelphia diagnosed in the behavioral health service system. The treatment data is provided by the Community Behavioral Health Division of Philadelphia’s Department of Behavioral Health and Intellectual DisAbility Services.

Behavioral health services include any mental health or substance use disorder (SUD) treatment services. This includes, but is not limited to, Medications for Opioid Use Disorder (MOUD), outpatient, intensive outpatient, partial hospitalization, case management, halfway house, residential rehabilitation, and detoxification.

Residential rehabilitation services include hospital and non-hospital-based, short and long-term residential rehabilitation and specialty programs such as Journey of Hope and Women with Children. Service includes 24-hour professionally directed evaluation, care, and treatment for individuals with substance use disorder in acute or chronic distress.

Outpatient services are non-residential treatment services providing structured psychotherapy. Services can include assessments for evaluations using the American Society for Addiction Medicine (ASAM) or Pennsylvania Client Placement Criteria (PCPC), testing by a psychologist, therapy with a counselor, psychologist, or psychiatrist; individual, group, couple, or family therapy; medication administration, evaluation, or management; case management, peer support, co-occurring partial hospitalization, and collateral services. For outpatient services, regularly scheduled treatment sessions occur at least three days per week for at most five hours per week.

Medication for Opioid Use Disorder (MOUD) includes methadone maintenance (daily administration or take-home dosage), buprenorphine prescriptions, and naltrexone prescriptions. Prescription claims are provided by Physical Health Managed Care Organizations (PHMCO).

Naloxone is a lifesaving prescription medicine that reverses an opioid overdose. It temporarily blocks the effects of opioids and helps a person start breathing again.

Drug Groups

Opioids include: fentanyl and fentanyl analogs, heroin, and prescription opioids. Stimulants include: cocaine, methamphetamine, and pharmaceutical amphetamine.

Historically, most unintentional overdose deaths involved opioids without stimulants. However, deaths involving stimulants, including those with and without the presence of opioids, have largely attributed to the rise of overdose deaths in Philadelphia since 2017. Deaths involving both opioids and stimulants made up 55% of overdose deaths in Philadelphia in 2023.

Drug Involved

Drug involvement is not mutually exclusive; one decedent may have had more than one drug detected in toxicology.

Fentanyl

Of note, fentanyl has nearly replaced heroin in Philadelphia's illicit drug market.

Xylazine

Xylazine is an adulterant often detected with fentanyl which has been associated with wounds and soft tissue infections.

Race / Ethnicity

Calculation of rates includes Philadelphia residents only. Individuals of other race/ethnicity groups are excluded from this graph due to low counts.

Unintentional overdose deaths have historically been highest among non-Hispanic White individuals. In 2021, the number of overdose deaths among non-Hispanic Black individuals surpassed the number of overdose deaths among non-Hispanic White individuals. This trend has continued into 2023.

Age Group

Calculation of rates includes Philadelphia residents only.

Unintentional overdose deaths are most common among individuals aged 45-64, with 47% of deaths occurring among this age group in 2023. The increase in overdose deaths among those 45+ may be attributed to stimulant-involved deaths, particularly among non-Hispanic Black Male decedents.

Birth Sex

Calculation of rates includes Philadelphia residents only. Philadelphia's Medical Examiner's Office categorizes decedents by sex at birth, not gender.

Zip Code

Calculation of rates includes Philadelphia residents only. Counts are displayed by Incident Zip Code, which is the Zip Code where overdoses occurred.

In 2023, the highest number of overdose deaths occurred in the 19134 Zip Code with 191 deaths. Other Philadelphia Zip Codes with a high number of overdose fatalities in 2023 include 19124 (n=85), 19133 (n=74), 19140 (n=74), 19132 (n=49), and 19139 (n=45).