The Legacy of Northeast Philly’s “Redlining” Against Methadone Clinics

Protesting residents of the mostly white, working-class neighborhoods of Holmesburg and Mayfair in Northeast Philadelphia accepted back in 2013 that methadone clinics were needed to help people with opioid use disorders. The caveat, according to them, was that they didn’t belong near churches, daycares or schools—or anywhere near the residential zones and revitalizing business centers where people in Northeast Philly live and work.

The harmful consequences of that campaign—resonant amid current South Philly community opposition to Safehouse’s proposed first-in-the-nation safe consumption site—persist to this day.

“[It’s] a bad idea at a terrible location,” said Rep. Brendan Boyle to a crowd of protestors in 2013. Boyle, who at the time was a state legislator, was one of several local politicians and civic leaders at the helm of a losing battle against what would become The Healing Way methadone clinic in the predominantly Irish-Catholic section of Northeast Philly. He told the 300-plus people gathered that day that methadone causes deaths and has unknown side effects.

Although the fight against the clinic was portrayed as an issue of neighborhood safety by politicians and media, activists with lived experience who’ve battled both stigma and the cultural divide that segregates Philadelphia’s districts offer a different perspective.

“That was definitely redlining,” said Andre Reid, an African American methadone expert in the city who’s the founder of both Phila Nama, the Philadelphia chapter of the National Alliance of Medically Assisted Treatment, and Lived Experience LLC. Reid, a transplant from Baltimore, focuses on addiction issues in black communities. He credits methadone with saving his life.

In 2013, Northeast Philly was “definitely redlining what they didn’t want in their community,” he told Filter. For him, the effort not only stigmatized drug use, but also spoke to how white America frames the narrative around neighborhoods where black people live. “I remember saying, it’s okay to send these kids from this community into our community, it’s okay for them to nod out, it’s okay for them to urinate on our lawn.”

Brooke Feldman, a longtime harm reduction activist and former Northeast Philly resident, recalled that toxic conflict over the clinic. As a person with lived experience who worked in Philly’s Office of Addiction Services during the scrum, Feldman was warned not to attend the public meetings.

“City officials were basically blasted, and the stigma was kind of loud and present,” she told Filter. “I was told that I shouldn’t go because it would be really painful to hear things that are being said.”

Residents wore T-shirts proclaiming themselves to be “100% family/ 100% drug-free.” The local $10 Buck Cuts barbershop displayed a large sign that read “Don’t Let the Methadone Clinic Kill Our Community,” complete with an image of the grim reaper. Residents doxxed the local realtor who leased the building, publicly displaying his home phone number and address at a protest with city politicians in attendance. And when Common Pleas Court Judge Idee C. Fox sustained a Zoning Board appeal to allow the clinic to open, the neighborhood voted her out of office.

And then there was City Councilman Bobby Henon, who, according to Feldman, “led the fight to keep services out of Northeast Philadelphia.”

When efforts to stop The Healing Way from opening proved unsuccessful, Henon, a Democrat, reached across the aisle to Republican Councilman Brian O’Neill to push through BILL NO. 130770, which created the Northeast Overlay District. This shock-and-awe piece of legislation did not ban methadone clinics outright—which the council knew would never pass a legal challenge—but instead placed a zoning variance on all medical, dental and health practitioners in Northeast Philadelphia.

In other words, the healthcare community no longer had the right to simply set up shop or expand offices in the neighborhood. Local civic associations and the Zoning Board of Adjustment now had to grant approval, which, in the case of methadone clinics, would be unlikely to happen.

Henon and O’Neill found a way to effectively ban what they deemed “for-profit” methadone clinics, and also made it more difficult for healthcare providers in general to operate in those neighborhoods. 

Then-Mayor Michael Nutter’s veto of the bill was overridden by all but one member of City Council, including current Mayor Jim Kenney.

The law, which covers Philadelphia’s sixth and tenth districts—and was later extended by Councilman Mark Squilla to the city’s first district—was adopted through an archaic process called councilmanic prerogative, a city tradition that lacks transparency. Passed at the onset of the overdose crisis, in a city that outpaces most others in overdose deaths, the shameful consequences of the Northeast Overlay District continue.

Feldman noted that Henon escaped significant criticism for what she considers his role in preventing access to treatment at a critical time, when overdoses were just beginning to hit crisis level.

“If there was more access in Northeast Philadelphia to quality treatment where people didn’t have to travel, [if] it was convenient within their own community, would we see as many overdose deaths as we see in Northeast Philly?” she asked.

Rather than address this self-inflicted problem, most Northeast Philly officials prefer to turn their alarmist focus on the highly visible drug use of Kensington Avenue. They stereotype that diverse neighborhood and segregate their own, ignoring what should be a city-wide concern.

Around 4,000 Philadelphians have died an opioid-related death since the advent of the Northeast Overlay District in 2013. Between 2017 and 2018 alone, almost 500 people died of an overdose in the area covered by Henon and O’Neil’s bill. Methadone is shown to reduce mortality for people with opioid use disorder by about 50 percent. Although it would be unfair to say the bill caused all of those deaths, it sure didn’t help.

As of 2018, there were roughly 10,000 people taking advantage of medication-assisted treatment (MAT) services in Philadelphia—not including private or cash-pay programs—of whom around 5,000 were prescribed methadone. But according to a report by the Pew Trusts, most licensed MAT providers were clustered in Kensington and further south, with about eight scattered across Northeast Philly. Of those, just two offer methadone (not including The Healing Way, which is a private clinic).

“We cannot think that there aren’t people with drug problems in Northeast Philly, because there are,” said Devin Reaves, executive director of the Pennsylvania Harm Reduction Coalition. “And there are people that are in recovery in Northeast Philly and we want to make it as easy as possible for them to begin and sustain their recovery journey and access medications for opioid use disorder.”

“We have this small window of time when somebody says I’m willing to get help,” he told Filter, noting how burdensome it is to have to drive to the other side of town or hop on three buses to make a daily methadone appointment. “It becomes boundaries or barriers that are too hard to navigate, and then maybe people won’t consistently stay in that service.”

Both Reaves and Feldman were quick to point out that, even in the age of qualified doctors being able to prescribe Suboxone, methadone remains a lifesaver for many—whether because it works better for some patients, or because of factors such as insurance coverage or personal preference.

These days, Mayor Jim Kenney is calling for more MAT services across Philadelphia, a result of the Opioid Taskforce he coalesced a few years ago. But even as the city government promotes more access to treatment, pockets of resistance remain in Northeast Philadelphia, with local groups organizing against clinicsrecovery houses and, yes, Safehouse.

The disparities are partially a product of a growing racial divide in Northeast Philly, which was originally home to white-flight settlers in the 1960s and 70s, but has in recent times experienced an uptick in immigrant populations and communities of color. In 1990, the area was 92 percent white, according to a report by the Pew Trusts. By 2010, that number fell to just under 60 percent, as white people migrated out and African American, Asian and Hispanic communities grew.

Despite its growing diversity, Northeast Philadelphia can still feel segregated from the rest of the city. In 2012 a local swim club made national headlines when management used racially charged rhetoric to bar scores of black children from entering. When Wilson Goode was elected Philadelphia’s first black mayor in 1983, racial animus stoked a movement led by local politicians in which the area attempted to secede from the rest of the city. The ultimately failed proposal would have made Northeast Philadelphia an independent municipality called Liberty County. And every four years, populist mayor Frank Rizzo, the city’s own version of Donald Trump, receives a few write-in votes in the mayoral election, even though he’s been dead since 1991.

As Andre Reid observed, the movement to limit treatment options in Holmesburg and Mayfair not only succeeded in further segregating the city, but also helped to widen health disparities in black neighborhoods. White residents dying in communities of color caught the attention of local officials, at least while the cameras were rolling; black people slipped under the radar.

“It came back to bite them,” he said of the communities that pushed against local methadone clinics. If they hadn’t done so, “Now, you wouldn’t have to ride down Kensington on Christmas with a trunk full of gifts looking for your child. You would have been able to go and drop them off around the corner and meet their therapist, and the methadone program would have become part of the community. But you didn’t want to address the issue. You said, ‘We don’t want it here. It could be anywhere else but here.’”

He also called for more significant investment in the black community around this issue. “We’ve got to start looking at disparities in African American communities,” said Reid. “We’ve got to start looking at these young black boys messing with these perc 30s. We’ve got to start looking at the counterfeit drugs that when the doctors are slowing up more counterfeits are making it to the street.”

Things may finally be changing, however slowly.

Following the 2018 appointment of pro-reform District Attorney Larry Krasner, activist groups from across the city came together to form the Alliance for a Just Philadelphia. The initiative resulted in the People’s Platform—a document that outlines a bold, progressive vision for the city’s future on everything from criminal justice to income inequality to housing affordability and more.

The Platform strongly supports harm reduction, including Safehouse’s proposed safe consumption site in South Philly. And it calls for an end to the ban on methadone clinics in Philadelphia’s first, sixth and tenth districts.

It’s potentially a winning proposition, too. Last year Alliance member and Working Families Party candidate Kendra Brooks adopted the Platform when she became the first-ever third-party nominee elected to a City Council seat. As Brooke Feldman noted, the city needs elected officials to care about this issue. However, politicians are only part of the solution.

“Not only should Northeast Philadelphia be held accountable for being supportive of its residents,” said Feldman, “and that includes offering treatment resources right there in the community, but Northeast Philly should also be accountable for not pushing its problems on the poorer parts of the city.”

Image is a detail from a 2010 graphic, representing the predominant racial populations in Philadelphia (blue = black; red = white; orange = Hispanic; green = Asian) based on 2000 census data, by Eric Fischer via Flickr/Creative Commons 2.0.

Originally published in Filter March 10, 2020