CHICAGO — Opioid overdose deaths in and around Chicago continued at near-record high levels in 2023, as experts said more work still needs to be done to prevent tragedies.
The Cook County Medical Examiner’s office recorded 1,540 deaths from opioid overdose in 2023, and is still reviewing more than 400 cases that it expects will show a person died from opioid toxicity. That means 2023 is expected to record about the same number of opioid overdose deaths as 2022, when the county saw a record 2,001 recorded deaths.
Leaders from community organizations like the Chicago Recovery Alliance — which works on addiction treatment, health care, education and laws related to drug use — said it’s not surprising.
“Illinois as a whole has just not invested its money appropriately in harm reduction programming and interventions that actually work, as opposed to funneling money at treatment and 12-step programming that works for a very small population,” said John Werning, executive director of the Chicago Recovery Alliance.
Werning said that the city of Chicago is making advances in funding overdose prevention programs like the Recovery Alliance, but there is still more that needs to be done.
“There are evidence-based, very well-documented, very well-researched interventions, including syringe exchange programming, naloxone distribution. But things like overdose prevention sites and drug checking are just in the infancy now in the state or in the city of Chicago,” Werning said.
Harold Pollack, a public health researcher at the University of Chicago, said that one of the difficulties with tackling the opioid crisis has been that it is a very complex issue that doesn’t have one simple solution.
“While there’s a number of harm reduction interventions that are helpful, and linking people to addiction treatment is very helpful, this is a much more difficult problem,” Pollack said.
Pollack said that these types of interventions need to be expanded, which people in the public health community knows needs to be done.
“Making sure that everyone has access to Narcan, that everyone has access to addiction treatment and that a lot of the mundane obstacles to people getting access to the services that they need are addressed,” Pollack said.
Fanya Burford-Berry, director of the West Side Heroin/Opioid Task Force, said Illinois has responded well to the crisis by expanding access to Narcan — a drug that can reduce the effects of overdoses — but more needs to change.
“Our providers want better, more robust services, but because our hands are tied through the methods that we are funded by, we can’t do the work that needs to be done properly for the population of people who use drugs,” Burford-Berry said.
Of the confirmed opioid overdose deaths in the county last year, over 80 percent were men, with African Americans making up 56 percent of deaths, according to the Medical Examiner’s Office. The proportion of African American overdose deaths in Cook County was also disproportionately high at 56 percent in 2022, according to the Medical Examiner’s Office.
In 2020, Gov. JB Pritzker signed an executive order to prioritize racial equity in response to the opioid crisis. In 2022, Illinois launched the Overdose Action Plan to increase funding to programs that are working on addressing these issues.
Some of these disparities are caused by many people associating the opioid epidemic mostly with white rural communities, which has led to not as much focus being put on African-American communities being affected by it, Pollack said.
“What’s interesting about the opioid epidemic is, in a lot of ways, it hasn’t been quite as racialized in the public mind,” Pollack said. “At times, that correction does lead us in a little bit of a way to overcorrect and to forget about the fact that there’s a lot of people who are in communities of color who are really at risk from this thing. Many of them are older men, and they’ve had long-term chronic substance use issues, and now they’re at high risk of overdose.”
The health care system often doesn’t take into account how people of color may have been impacted by the justice system or different environments, which can lead to people not getting treatment, Burford-Berry said.
“We need to have really more evidence-based practices around people of color so that they can stay in programs that will help them figure out how to work with their substance use disorder,” Burford-Berry said.
The West Side Heroin/Opioid Task Force received funding to work on some of these issues. The task force tables in communities in East and West Garfield Park, North Lawndale and Humboldt Park to hand out Narcan, speak with people about safe substance use and provide information about services.
Burford-Berry said preliminary data the task force received from the city health department in August showed there was a downward trend in EMS calls for opioid-related issues on the West Side, but fatality data usually lags. She said she thinks Narcan distribution has helped with possible reductions in the area.
Overdose prevention sites — where people can use drugs safely under the monitoring of medical professionals — are also needed, Werning said.
“If we actually want to curb the overdose rates, these are the types of out-of-the-box interventions that we really need, and we needed them 10 years ago. So, the urgency of this is now,” Werning said.
Advocates and 18 Illinois lawmakers have been trying to get a bill passed in the state Legislature that would allow overdose prevention sites to operate in Chicago.
One of the other obstacles to tackling the opioid crisis is many of the people at highest risk are precariously housed or unhoused, and not all services are easily accessible to them, Pollack said.
“A lot of addiction treatment, the mentality in the public is often ‘this person should go to treatment,’ and yeah, they should, but a lot of times you really have to go out and go to them because given their life circ*mstance, they’re not going to come into the clinic right away because they’re facing a number of life challenges,” Pollack said.
Housing-first options and services that help to meet people’s basic needs would help address some of the problems, Pollack said.
Burford-Berry said that it’s not adequate to try to address substance abuse without also addressing issues people may be dealing with, like family trauma, loss or homelessness.
“What we need is easy access, what we need is kindness, what we need is hospitality, before we begin any of the deep diving that our treatments call for,” Burford-Berry said.
Conversations should be had with all communities about how issues people may perceive to be caused by drugs, like crime or addiction, are often caused by these larger issues, which need to be addressed first, Pollack said.
The Chicago Recovery Alliance would also like to see better in-school drug education that doesn’t focus on abstinence-only or “just say no,” Werning said.
“That type of education doesn’t work for most people,” Werning said. “If you’re going to use [drugs], you should know the risks, you should know the effect on your body, and you should be making that decision for yourself and you should be empowered with information.”
Evidence-based research has shown focusing on getting people to abstain from drug use is not effective, Pollack said. He said interventions like harm reduction, public health education and medical options like methadone treatment are more effective ways of reducing overdoses and should be more accessible.
Programs that deal with substance use also need to be more long-term because it can take years to deal with the root causes, but a lot of investment has been in one-month programs, Burford-Berry said.
“What harm reduction is saying is, ‘You know what? Let’s deal with one issue at a time,’” Burford-Berry said.
Another issue Burford-Berry has seen is that when people are treated for non-fatal overdoses, there isn’t enough follow-up with medical treatment options, and people end up overdosing again.
“We release people after they had overdosed back into the streets and with no follow-up care, and that is problematic, and that’s our health care system,” Burford-Berry said.
Organizations like Chicago Recovery Alliance want to see more people learning about and asking for action to address overdoses.
“I think people need to wake up, shake off their apathy and really recognize that these are human beings we’re talking about. Two thousand plus people in this county dying per year is obscene, and every human being in Illinois should be appalled that this is happening,” Werning said.
Block Club Chicago is celebrating six years of neighborhood news. We’re asking you to help us reach our goal of 600 supporters to keep us going.
As a thank-you, when you subscribe, donate, upgrade your subscription or gift a subscription during Block Club’s birthday week, we’ll send you a special coupon to pick out a free T-shirt, hat, tote or print from our merch store! Choose from over 15 of our most popular items by Chicago artists, including our lovebirds, Gator Watch and Chicago-style pizza merch.
