LEFT
Fernando Irizarry’s
addiction began with
pain medications he
took after an acci-
dent. He invited me
to observe his life on
Kensington Avenue,
and I spent two days
with him. Unable to find
a usable vein in his arm,
bruised from repeated
injections, he asked an
acquaintance to inject
a slurry of discarded
drugs into his neck.
On the street, addicts
often look out for each
other, administering
narcotics but also sav-
ing lives with Narcan,
an overdose-reversal
nasal spray.
RIGHT
Those I met could tell
me exactly how many
lives they’d saved with
Narcan. I would witness
an overdose, they
said, and I did. I found
this woman collapsed,
unresponsive, and
turning blue. A security
guard called 911, and
emergency medical
personnel revived her.
O
ne thing you should know,” one man advised me. “No one on this street
imagined they would end up like this. Every person here thought they had
it under control.” That street could be anywhere in addicted America. This
one is Kensington Avenue, a bleak stretch that runs beneath the elevated
tracks in Philadelphia. I went there to witness the opioid crisis, to under-
stand how people seeking relief from pain had ended up on the street.
I’ve seen extreme misery in wars and natural disasters, but I was stunned by
what I found in my own country. The rules of society seemed to have vanished.
What remained was a raw struggle for one thing: the rush of relief from pain.
In Philadelphia 1,116 people died from a drug overdose in 2018, more than twice
the number five years earlier, and eight out of 10 of those deaths involved opioids.
Hundreds of people live on the street. High, or searching for a high, they slump against
storefronts, they drift through parking lots. Many are emaciated, weak, scarred from
shooting up. Desperate, they pierce their arms, ankles, necks with needles.
Fernando Irizarry (far left) lives on this street. He is 33, small and thin, with a dark
beard. He walks with difficulty, shuffling on atrophied legs. He is funny, thoughtful,
and kind, but distracted, searching constantly for discarded bottle caps used to mix
drugs. When he collects enough of them, he scrapes together the dregs for his next shot.
On September 11, 2005, he hit the back of a car on his motorbike. As a kid, he’d loved
school. The strongest substance he’d tried was chewing tobacco. After months in rehab,
he was discharged on Percocet. When his family physician passed away, his new doctor
refused to renew his prescription. He found the pills on the street. But there, he could
pay $10 for two or $5 for a shot of stronger heroin. “That was the choice I made.”
At first I was intimidated, unsure how to approach people. When I did, though, their
stories were familiar. Stories about their pain, but also about college days, fulfilling jobs,
loving families, plans for the future. On cracked screens of mobile phones, I saw evidence
of their former lives. And I saw them cling to the vestiges. Recalling her days as a dancer,
a young woman, bone thin, took off a boot and performed an en demi-pointe pirouette.
The opioid addicts I met are our children. They are our mothers and fathers. They
are college students and professionals. Enduring a chronic illness or striving to recover
from an accident, they could be any one of us.