Cook County has confirmed a record number of fatal overdoses in 2021 during an opioid-fueled crisis that is weighing most heavily on middle-aged Black men, according to a WBEZ analysis of medical examiner’s data.
By last Thursday, the analysis found, the county had confirmed 1,920 opioid-related deaths last year, up 4.0% from 2020, the first year of the COVID-19 pandemic. The overdose fatalities trended up through 2021 and, with another 77 deaths during that year still being processed, the toll is all but certain to increase.
Since the start of 2021, the WBEZ analysis found, fatal overdose victims have averaged 47 years old. More than 76% have been male and about 54% have been Black in a county whose population is less than 24% Black.
“Wherever there are Black communities in the city of Chicago, you can get heroin laced with fentanyl, or just fentanyl, when you walk out your door,” said state Rep. La Shawn Ford, D-Chicago, referring to a synthetic opioid that is lethal in small amounts.
Ford has helped expand outreach to addicted people on the West Side, the epicenter of the county’s overdose crisis. He and other advocates for them are applauding recent government efforts against the overdoses but say much more needs to be done, including the establishment of safe places to consume the drugs.
Fatal overdoses have been rising across the country for more than two decades. In the 1990s, many of the deaths resulted from opioid painkillers. Later increases involved heroin and, more recently, fentanyl and other synthetic opioids.
Experts say a Cook County overdose spike in May 2020, which had 230 deaths tied to opioids, owes to lockdowns and other restrictions that isolated people with drug addictions and made treatment harder to get.
The fatal-overdose spike did not last long but, according to the WBEZ analysis, opioid-related deaths climbed again in 2021.
Suzanne Carlberg-Racich, a DePaul University associate professor of public health, says that the incline may have stemmed from pandemic-related mental health issues tied to isolation, job losses and falling incomes.
“We also had a rise in suicides,” said Carlberg-Racich, who heads research for the Chicago Recovery Alliance, a nonprofit that distributes clean needles, drug test strips, and overdose-reversing naloxone on the West and South sides.
As the overdose numbers have increased, local and state agencies have taken some steps to tackle the problem.
Since October, Chicago Mayor Lori Lightfoot’s administration has distributed thousands of test kits to help opioid consumers detect fentanyl in their drug supply. In January, the city announced it would start distributing naloxone, often branded as Narcan, at 14 public library branches.
And, this month, the administrations of Lightfoot and Illinois Gov. J.B. Pritzker launched a program that offers Chicagoans free and immediately available medication that helps people reduce their reliance on opioids. The program includes a hotline for a same-day phone appointment to get a prescription for medicines including methadone, buprenorphine and naltrexone. To fill the prescription, the program provides transportation to a pharmacy or clinic.
The medication program takes advantage of COVID-era federal regulatory changes allowing patients to begin treatment at home after an initial phone appointment with a provider.
“More people die each year in the city from opioid overdose than from gun-related homicides and traffic accidents combined,” Lightfoot said in a statement about the effort. “Addressing this crisis requires us to prioritize harm reduction, lower barriers to treatment and invest in innovative public health programs.”
Cook County, meantime, has supplied dozens of suburban police departments with naloxone.
In January, County Board President Toni Preckwinkle announced receiving a federal grant to set up a “rapid-access, low-barrier and high-capacity bridge clinic” in the Illinois Medical District on the city’s West Side. The clinic, according to a county statement, will serve addicted people “who are in between care settings,” including recently released detainees of the massive jail nearby, where the Preckwinkle administration runs the infirmary.
In March, the Pritzker administration released a 58-page overdose action plan that takes credit for training more than 110,000 people on how to use naloxone and recommends increasing the number of mobile vans to provide “medication-assisted recovery” wherever addicted people can be found.
Illinois Chief Behavioral Health Officer David Jones, speaking on the WBEZ show Reset, said overdose deaths are surging not just in Chicago but in rural areas, small cities and suburbs. Jones said Pritzker’s plan differs from the state’s past approaches to opioid addiction by using a “social equity lens” and embracing “harm reduction” steps such as the naloxone training.
At the federal level, the Centers for Disease Control and Prevention this month estimated that a record 107,000 Americans died of drug overdoses last year. The White House is promoting a 150-page drug control strategy in which President Joe Biden asks Congress to support “evidence-based prevention, harm reduction, treatment and recovery services.” The document calls for expanded access to naloxone, more connections to treatment, and steps to disrupt drug trafficking.
But many people battling the crisis say government efforts must go further.
Luther Syas, who heads outreach for a task force of West Side health-care providers and social service groups that Ford organized, said an urgent need of that collaboration is real-time data from first responders about where people are overdosing and what happens to them.
“Do those people go to the hospital? Do they get into treatment? How many of them actually die? If they walk away, is there any tracking of them?” Syas asked. “A lot of the suburbanites who come in and overdose, we don’t get that data. If they go back to the suburban area and die, we need to know.”
Another problem, according to advocates, is that Chicago still lacks safe-consumption sites where people can inject or snort illegal drugs in the presence of a health care worker. More than 100 such sites are running in more than a dozen countries, they say.
New York City opened two last fall. Rhode Island has approved others. And California lawmakers are debating a bill that would allow more.
“People who want to get help, or just want a safe place to do drugs, simply go to the safe-consumption sites and they get clean needles,” Ford said. “Now guess what? We’ve stopped the spread of hepatitis. And there’s no longer this nuisance of a lot of people shooting drugs [outdoors] with needles and drug bags on the street.”
A bill sponsored by Ford to allow safe-consumption sites in Illinois got support from Pritzker’s administration but the Preckwinkle and Lightfoot administrations did not take a position, the lawmaker said. When the bill reached the House floor last year, it fell 17 votes short of passing.
“We’d rather see people die than to allow them to have a program with the help that they need,” said Ford, who vowed to revive the bill after this November’s election.
Lightfoot’s administration, asked last week whether it supports safe-consumption sites, did not answer.
“We still have a climate of extraordinary stigma toward people who use opioids,” said Carlberg-Racich, the DePaul professor.
Carlberg-Racich criticized Chicago police Supt. David Brown for deploying tough rhetoric about “gangs, guns and drugs” that some of his predecessors used.
“We’re framing the opioid crisis as a criminal issue instead of a public health issue or a human issue,” Carlberg-Racich said. “The more we talk about criminal approaches, the more we will see mass deaths.”