A Symposium to Address Infections and Healthcare Related to Shifting Opioid Use

In 2023, US drug overdose deaths exceeded homicides by 338.6% and suicides by 103.0%. And opioids accounted for 76% of overdose deaths overall.¹

The opioid crisis continues to ravage communities across the country, and no where is that more acutely seen than in the Kensington neighborhood of Philadelphia. Along Kensington Avenue, there is an open drug market that has operated for a number of years. There were 747 overdose deaths in Philadelphia in 2025. The previous year, there were approximately 1,100 deaths.²

Although overall deaths are trending down in the city, with intravenous drug use comes a host of health issues, including skin wounds, bacterial infections, and cardiovascular disease. Compounding this issue are the differing types of drugs being used by people with SUD and how that affects the infections and health issues that clinicians are seeing according to Stephanie Spivack, MD, associate program director of the fellowship program and assistant professor of clinical medicine at Lewis Katz School of Medicine at Temple University.

“We have been seeing this crisis evolve over the past decade or so, and we've seen the shift here in Philadelphia in the drug supply, from heroin to fentanyl to xylazine to now medetomidine being our major contaminant,” Spivack said. “And each of these changes has come along with its own set of challenges, both from the addiction medicine perspective, but also from the infectious disease perspective. For example, when we were seeing a lot of xylazine in our supply, we saw a lot of wounds related to that…from the infection standpoint, we've seen a lot of shifts in infectious complications over the years. We recently saw a big outbreak of Shigella in our homeless population that was using substances. So we've been trying to adapt and keep up with these changes that we've been seeing.”

These changing patterns of drug use by people with SUD has seen increases in veterinary sedative overdoses such as carfentanil and medetomidine, which was detected in roughly 78%-80% of drug samples tested in 2025 in Philadelphia.²

As a way to address these shifting drug use patterns and related infections, Spivack and other Philadelphia-area clinicians across different institutions, have been collaborating on treatment plans for individuals who are suffering from these infections.

After years of informally working together, they have taken these collaborations and developed their first INSPIIRE (INFECTIONS IN SUBSTANCE USE: PREVENTION, INTERVENTION/IMPLEMENTATION, RESEARCH, AND EDUCATION) Symposium. This event will bring together healthcare professionals and other interested stakeholders in discussing treatment for people with SUD, as well as addressing the healthcare disparities associated with this population.

The symposium is a 1-day event being held May 29 in Philadelphia, and they are running a variety of educational sessions including treatment on HIV, hepatitis C, endocarditis, bloodstream infections, skin and soft tissue infections, musculoskeletal infections, and wound care.

In addition to the infectious disease clinical sessions, they will have social workers coming in to share more information about the resources that are out there for this vulnerable population. Former patients will also provide their first-hand experiences dealing with these infections and issues related to substance use.

The symposium has seen a great deal of interest and it has been moved to a bigger space. Although there is not enough room for any further attendees, Spivack says it is possible to recreate this type of event at other institutions.

“This started as just a group of infectious disease doctors talking amongst ourselves. And then we were all able to draw in our own connections, so we relied on each other…we were able to reach out to our institutions to get a little bit of funding and support for this conference,” Spivack said.

References
1.Drug Overdose Death Rates.National Center for Drug Abuse Statistics. Accessed May 12, 2026.
https://drugabusestatistics.org/drug-overdose-deaths/

2.Whelan A. Overdose deaths in Philly on track to be the lowest in nearly 10 years. Pa. deaths are also declining dramatically. Philadelphia Inquirer. December 30, 2025. Accessed May 12, 2026.
https://www.inquirer.com/health/overdose-deaths-philadelphia-pennsylvania-2025-20251230.html