Gail Richardson is saving lives at the corner of Cicero and Madison.
It’s a hot August morning on the West Side, and Richardson is armed with a hefty supply of Narcan, medication that reverses the effects of opioid overdose. As people walk by, sometimes on the phone or with groceries in their arms, she tries to get their attention.
“Do you want Narcan?” she asks.
She’s met with some interest. People also approach her asking if she has water, masks or if she can help them get an ID.
Richardson works with the West Side Opioid and Heroin Task Force, a project started by Rep. LaShawn Ford in 2016 to prevent and respond to overdoses. The task force trains people to use Narcan and connects them with health care providers and other essential services, like getting an ID.
The task force’s work — often carried out by locals like Richardson — is focused on the West Side, the epicenter of Chicago’s opioid crisis. The area, like all of Chicago, saw a surge in people dying from opioid use last year. In all, 573 Chicagoans died from opioid-related causes during the first half of 2020. Throughout Cook County, opioid fatalities reached record levels.
The surge has largely continued this year, with at least 467 people dying from opioid-related causes in Chicago through June.
The city’s struggle with opioids was detailed in a report released last week by the Chicago Department of Public Health. The report found opioid-related deaths in Chicago were down 18 percent in the first six months of 2021 compared to last year.
But the data is preliminary, as the morgue is still determining the cause of death for 788 people in Cook County — and officials estimate 70-80 percent of those cases will be ruled opioid-related.
That means 550-630 cases are expected to be added to Cook County’s opioid death roll for the first half of this year. That could push the number of deaths in Chicago to be on par with or past last year’s levels.
Much of the 2020 surge and high death toll this year is linked to the impacts of the coronavirus pandemic on people’s social and economic livelihoods, officials said.
Chicagoans have struggled with job and food insecurity during the pandemic, as well as the mental and emotional toll of living around COVID-19 and heightened levels of gun violence. And many support groups and care providers were unable to meet with patients in person, disrupting people’s treatment.
“In 2020, COVID-19 wiped out a lot of people’s social support networks,” said Dr. Wilnise Jasmin, medical director of Behavioral Health at the city’s health department. “People often turn to drugs as a coping mechanism.
“It was stressful to be anyone, no matter where you lived, during 2020.”
Fatal overdoses continue to hit Black Chicagoans on the West Side particularly hard, according to a Block Club analysis of county medical examiner data.
The Austin community area had the most overdose deaths in the first six months of 2021, followed by West Garfield Park and Humboldt Park, according to the city’s report. Black people made up more than 60 percent of those dying from opioid-related causes in Chicago.
Ford said many of the issues driving drug use and overdoses on the West Side have existed for years — but the pandemic exacerbated them.
“If you have all of the trauma that people are going through in that community, and you don’t have enough mental health support to deal with it, you’re going to see people fall prey to substances,” Ford said. “People need help dealing with underlying problems. You can’t just tell them to stop using; you have to figure out why they even started.
“We have to open up more behavioral health centers and safe spots for people to feel comfortable coming to for help.”
Reaching out to save lives
Community groups responded to the surge of opioid-related deaths in 2020 by heightening their outreach efforts, Jasmin said.
“I think that after what we saw in 2020, overdoses were really at the forefront of people’s minds,” she said. “Our community partners have flooded communities with Narcan, and I think that people are more likely now to stop and engage with outreach workers.”
The West Side Opioid and Heroin Task Force approaches substance use disorder by trying to reduce harm. This means trained members of community outreach teams — many of them West Siders or people who once used drugs themselves — show up in the community and equip people with life-saving medications such as Narcan and Naloxone.
Richardson is a lifelong West Sider and has been recovering from opioid use disorder for 18 years. She works with the Task Force doing outreach, which often entails setting up a table in “hot spots” for opioid use, handing out care kits and training people how to use Narcan and Naloxone.
“What I see out in these streets is sad,” Richardson said.
About 18 months ago, Richardson used Narcan and Naloxone to save someone who was having an overdose near Cicero and Madison — the same spot where the Task Force often sets up their outreach station.
“When you’re dealing with heroin, you really are fighting a demon,” she said. “And we need to help these people.”
Richardson said the problem in 2020 and, now, 2021, is “much different” from when she used drugs 20 years ago, primarily due to fentanyl.
This is reflected in the report from the city’s health department, which found almost 90 percent of overdoses in Chicago involved fentanyl.
Educating people who use drugs about testing their supply is part of the work that harm reduction groups such as the Task Force do as well, and it is something that can contribute to a decline in overdoses, Jasmin said.
Jasmin said the Chicago Recovery Alliance has vans in which people who use drugs can access on-the-spot treatment, educational materials, clean injection supplies, fentanyl test strips and other harm reduction services, no questions asked.
Stopping deaths in the future
Preventing opioid deaths can’t just be the work of community groups, officials said.
Ford, a Democrat who represents the West Side, said tackling the opioid crisis requires a multi-step approach: There needs to be more accessible treatment for substance abuse disorder, and officials must address the systemic issues that perpetuate opioid-related issues on the West Side.
“I would love to see the state getting out there and enrolling more people in Medicaid so that we can make sure everyone is covered” for health care, he said.
Ford also advocates for creating spaces where people can test their drugs, get clean needles, work with health providers and be provided with Narcan and Naloxone, as that can decrease the number of people dying from opioid use.
These spaces are called “safe consumption sites,” and legalizing them in Illinois is a focus of Ford’s policy in the coming months, he said.
“The studies show that if you can get safe consumption sites in communities where overdoses are high, you have a great chance of reducing the nuisance of drug use on the streets, reducing the number of people dying of overdoses and reducing the number of people using drugs,” he said. “They not only provide a safe place to use, but a place to access support if people are looking for help.”
Jasmin said safe consumption sites can often provide a space for positive social interaction and community building, creating a healthy support network that is needed by people struggling with substance use disorder.
“They can be places where people have a sense of camaraderie, of belonging,” she said. “It’s much more nuanced than a place to use drugs.”
Jasmin and Ford said it’s difficult gaining political and community support for programs like this, as there is still heavy stigma around drug use.
“The concept is sticky: You are allowing people to come into a place and use illegal drugs,” Ford said. “But we know it’s safer if they’re not shooting up in an alley on the West Side of Chicago. And we know that we’re going to eliminate the dangers to kids by removing the amount of needles in places like sidewalks and parks.
“… Law enforcement has to recognize that this is the best harm reduction we can provide. But they’re not happy with it.”
On July 27, the state also announced it was investing $13 million in making Narcan more available to hospitals and community health organizations.
“Community health sites can and should sign up for that program,” Jasmin said.
Another policy that Jasmin said could make a difference for treating substance use disorder is doing away with the patient limit that exists for providers of medication-assisted treatment in their first year. Medication-assisted treatment is a way of treating opioid use disorder by providing people with medications, like methadone, along with counseling and behavioral health therapy.
The Biden administration recently expanded the program, so providers can offer medication-assisted treatment to 100 patients for a year and then expand to apply the treatment to up to 275 patients per year.
“It’s important to make sure providers know about this,” Jasmin said. “But doing away with the limit entirely would help more people get care.”
Ford said the state needs to “get everyone covered” under health insurance while continuing to increase investment in community health initiatives — like the task force — to save lives and help people get treatment for substance use disorder.
“The more we get street outreach teams on the West Side, the more that people know there is a way to get health, the better,” Ford said.