Lots of big American cities have a “skid row,” an impoverished part of town where the homeless and drug addicted often gather. San Francisco’s Tenderloin and the original Skid Row in Los Angeles are two of the best-known examples, but Philadelphia’s Kensington neighborhood is just as bad -- and it’s getting worse.

Kensington, which is just north along the El train from the gentrified Fishtown neighborhood, has long been a rough part of town. It began, writes Philadelphia Inquirer columnist Alfred Lubrano, as an industrial neighborhood full of factories making Stetson hats and Disston saws. Since the 1960s, when the factories shut down and the jobs left, the area has become known as a place to score heroin.

Things have gotten worse there as the opioid epidemic has morphed into a broader crisis. In the past year, Kensington’s homeless population, which has been linked to the epidemic, has more than doubled, from 271 to 700 people. In 2017, the area saw a 23 percent spike in homicides -- a trend that appeared to continue last year.

To address the growing problem, the Philadelphia Police Department (PPD) has been targeting the dealers, especially the “middle managers” who drive into the area with large drug quantities and distribute them to so-called corner boys. PPD has recently conducted several large-scale drug ring busts, arresting dozens of people at a time and seizing millions in cash or drug quantities. In a 12-month period, there were over 700 arrests in a four-block radius within Kensington.

Yet it doesn’t seem to be enough. With the homeless population and homicide rate rising, residents have complained that drug dealing and prostitution in the neighborhood seem to go unchecked by the police. On a recent visit to Kensington, I saw cop cars parked on side streets, even as dealers whispered out to passersby on the sidewalks. Similar complaints have been made about other skid rows -- that they function like contained areas where the police tolerate crime.

Ray Convery, a PPD inspector who has spent years on the Kensington beat, takes issue with that characterization. He argues that it’s difficult for officers to bust dealers, since they sell drugs out of sight. Convery adds that PPD frequently goes undercover and makes lots of arrests, but that the department still struggles to tackle the problem. “There’s an endless supply of people willing to sell,” says Convery. “I can lock you up, taking two police officers off the street to go process the paperwork, and before they hit the building here, there’s someone else on that corner dealing.”

Convery says policing alone won’t clean up skid rows. There needs to be an understanding that the users themselves are addicts -- often mentally ill -- rather than hardcore criminals. Locking them up en masse, he says, is neither humane nor effective. They instead need help from beyond the PPD’s domain, such as drug counseling.

Whether or not that’s true, the problems associated with skid rows are starting to affect cities at large. Worsening conditions in San Francisco, for instance, have led to an increase in complaints from tourists, according to S.F. Travel, the city’s visitor’s bureau, and the Hotel Council of San Francisco, which represents 110 hotels. “The streets are filthy,” Joe D’Alessandro, president of S.F. Travel, told The San Francisco Chronicle. “I’ve never seen any other city like this -- the homelessness, dirty streets, drug use on the streets, smash-and-grabs.”

Police and city officials need to find some way to clean up skid rows before their problems are no longer largely contained to a single neighborhood.