Correction: This story has been updated to clarify the name of the University of Illinois Chicago, previously identified as the University of Chicago. We apologize for the error.
Vincent Lee saved a person’s life a few months ago.
He was at the intersection of West Van Buren Street and South Pulaski Road when he saw a man on the ground. The man was unconscious and his breathing was shallow.
He recognized the symptoms: A drug overdose. So he and some coworkers rushed to the person to administer Narcan.
“We had to apply two doses,” Lee said.
It worked. The person lived.
To be sure, Lee’s job is to recognize such symptoms. He’s an outreach worker for a mobile van that provides harm reduction services for people who use drugs.
He’s out there with medical students and volunteers from the University of Illinois Chicago several days a week as part of the school’s community health outreach prevention program. He had naloxone, known as Narcan, on hand.
His experience – and the fact the team is out there – illustrates not only how the national opioid crisis plays out in Chicago, but also ways to reduce the harm caused by opioid use.
Statistics from the Cook County Medical Examiner’s Office show that 1,407 people in Chicago died from opioid overdoses last year. That’s a startling 330% increase from eight years ago, when 426 lives were lost citywide.
West Side communities are disproportionately affected by opioid use. Last year, the area spanning Austin, East Garfield Park, West Garfield Park, Humboldt Park and North Lawndale accounted for about 36% of the city’s emergency response calls to opioid overdose emergencies.
Out of 11,419 incidents citywide, 4,155 originated on the West Side, according to data from the Chicago Fire Department.
The problem is compounded when opioids are mixed with other substances. In 2022, more than 91% of overdose deaths in Cook County involved fentanyl, county figures showed.
Xylazine, known as “tranq,” is making its way into the drug supply. According to the Chicago Recovery Alliance, the veterinary tranquilizer that decreases heart and respiration rates showed up in 20% of the drug tests they conducted as part of their harm prevention program on the West Side last month.
Narcan does not counteract the effects of xylazine. However, because xylazine is often found in drugs that also contain fentanyl, it is still recommended to use Narcan if a person experiences an overdose.
Context is key
Understanding where these emergencies occur is important to respond to an overdose and save lives.
“There’s no harm in giving [Narcan] to somebody who’s unconscious and who’s unresponsive,” said Chris Torlone, a medical student and volunteer from the University of Illinois Chicago. “It’s never going to hurt anybody. It’s never going to cause any bad effect. Other than like, it’ll sometimes put somebody into withdrawal. But it’ll save their life if they’re overdosing.”
Location is key. On Chicago’s West Side, nearly 60% of opioid overdose emergencies happened on public streets and roads, a figure consistent with the rest of the city, where 52% of opioid overdose emergencies happened on public streets.
On the West Side, only 22% of opioid overdose emergencies originated from private residences and 6% on public transportation. These figures, experts caution, may be underestimated because individuals or their families often refuse to call for medical care.
“Not everyone’s on the same page as far as harm reduction and destigmatizing drugs,” Torlone said, adding some people who experienced an overdose have had traumatic experiences. Some of the people they help have shared they were arrested for the possession of drugs at the emergency room or did not receive “compassionate care” from emergency personnel.
Data from the fire department’s emergency management system shows that certain West Side areas see a higher number of overdose-related emergencies.
In West Garfield Park, the blocks on South Pulaski Road from West Lake Street to I-290 concentrated some of the highest number of emergency calls early this summer. Humboldt Park also saw some of the highest number of emergency calls, especially on several blocks of Chicago Avenue, from Pulaski Road to Kedzie Avenue.
From January to July this year, the city responded to more than 2,200 opioid-related emergencies in Chicago’s West Side, 28% of them in Austin. That is 5% less than the number of opioid-related emergencies on the West Side compared to the same period in 2022, yet every emergency means a person’s life was at risk.
The presence of harm reduction outreach workers like Lee in West Side streets is critical to saving lives. At the community outreach mobile van, Lee and medical staff “meet people where they are.” They provide medical services and harm reduction services without stigmatizing people with substance use disorders. They can obtain free Narcan, test strips and clean needles, receive wound care and medical care or start medication-assisted recovery to manage their substance use disorder.
“They feel comfortable when they come around,” said Albert Murphy, coordinator of the Austin community outreach intervention program. “They feel welcome. They can talk, they can communicate with us and share whatever’s going on.”
This approach, known as “warm-handoff,” helps build trust, encouraging people who use drugs to seek help if they need it, knowing they will receive it.
Every minute counts
A person experiencing an overdose requires immediate medical attention, but does not need to wait until emergency medical personnel arrive.
That’s where the boxes of Narcan one sees at dispensaries, aldermen’s offices and even churches come in.
They are part of a statewide strategy to prevent overdose deaths by providing free and immediate access to Narcan and training to community members. The idea is that anyone who witnesses an overdose will know how to respond and will have naloxone readily available.
But it may not be clear for even those with the best intentions how to use it.
If you suspect someone needs help, first check for signs of an overdose. Note not all signs may be present.
- A person is unresponsive and/or unconscious and does not respond to loud calling or shaking.
- A person’s lips and fingernails look blue or grey.
- A person’s face looks pale and skin feels cold and clammy.
- A person is breathing slowly, erratically or not breathing. If the person only breathes once every 5 to 10 seconds or is not breathing at all, provide rescue breathing.
- A person’s heartbeat is reduced, resulting in a longer pause.
- Snoring or gurgling sounds are present.
- Vomiting.
- A person’s pupils are contracted, appearing smaller than normal.
If any of these symptoms are present and the person is unresponsive, call 911 and administer naloxone.
When calling 911, experts say, stay calm and provide specific information about the person’s state. Describe their symptoms and provide information about their location as clearly and specifically as possible.
Then administer naloxone
Naloxone is available as an injectable substance and a nasal spray. Most free dispensers citywide distribute the nasal spray because it is easier to use.
The Illinois Department of Public Health recommends these steps:
- Be sure the person is unresponsive by loudly calling them or shaking them. You can also rub the person’s sternum hard with your knuckles to see if they react.
- Lay the person on their back.
- Hold the nasal spray with your thumb on the bottom of the plunger and your first and middle fingers on either side of the nozzle.
- Insert the tip of the nozzle into one nostril until your fingers on either side of the nozzle are against the bottom of the person’s nose. Push the bottom of the plunger to release one dose of the nasal spray.
- Tilt the person’s head back to ensure their airway is clear and make sure there is no vomit to prevent choking.
- Place the person in a safe recovery position by rolling them to one side and placing their hands under their head. Place the knee of the top leg in a 90-degree angle. This will prevent the person from rolling onto their stomach.
- Wait two to three minutes. If the person is still not breathing or unresponsive, apply a second dose of Narcan.
- Stay with the person as long as possible or until medical personnel arrives. This is important because Narcan’s effects only last 30 to 90 minutes and the person could overdose again.
- Finally, when the person wakes up, they may be confused. Orient them to the situation and keep them calm.
Doing this does not bring legal consequences.
The Illinois Drug Overdose Prevention Program Law empowers people, even if they are not medically trained, to administer naloxone to prevent a fatal overdose without being at risk of civil or criminal liabilities.
In addition, the Illinois Good Samaritan Act protects people from being criminally charged if they possess drugs while seeking emergency medical care for an overdose. The law protects people who in good faith seek to obtain emergency medical assistance for a person experiencing an overdose – by calling 911 or taking the person to emergency care. It also protects people experiencing an overdose who seek emergency medical assistance and possess drugs. The law states they cannot be arrested, charged or prosecuted for possession of drugs under a specific threshold.
The law protection applies only if they call 911 or seek medical attention while the person experiencing an overdose is alive and if the caller did not sell the person drugs. The law offers immunity for the person who helps or the person who experiences an overdose from possession charges for up to 3 grams of heroin, cocaine, morphine and peyote.
Where to find naloxone
Naloxone, known as Narcan, is available for free at all Chicago Public Library branches.
Dispensers that offer free Narcan, resembling the look of traditional newsstands, are available at the following locations:
- AIDS Foundation of Chicago, 200 W. Monroe St.
- Thresholds Health, 5801 Corcoran Pl.
- Polish American Association, 3834 N. Cicero Ave.
- Ruth M. Rothstein CORE Center, 2020 W. Harrison St.
- Rush Hospital, 1722 W. Harrison St.
- A Safe Haven, 2750 W. Roosevelt Rd.
- Chicago Recovering Communities Coalition, 4628 W. Washington Blvd.
- Phoenix Recovery Services, 501 N. Central Ave.
- Edna’s Circle, 4000 W. Jackson Blvd.
- Community Outreach Intervention Programs, 4756 W. Madison St.
The city’s Department of Public Health also distributes free Narcan through wall-mounted boxes located in different buildings and sites across the city. To find the nearest location, residents can use an interactive map available at the City of Chicago’s website.
To find other locations where Narcan is available, visit bit.ly/FindNarcan
To get more information about drug overdose prevention programs near you, call the Illinois Helpline at 833-234-6343 or text “HELP” to 833234.
