Editorial: The frustration of ever-increasing opioid deaths

The annals of this newspaper have been filled for years with tales of people whose lives were destroyed, or nearly destroyed, by opioids; and by chronicling the relentless suffering endured by both addicts and the people who love them. We have told the stories of addicts who precariously survive day to day and still others who have somehow broken the yoke of addiction.

But over all these years and through all the human tragedy, one question still looms: Why does the opioid crisis seem to defy all the attempts to get a handle on it?

This week, Cook County Board President Toni Preckwinkle's office reported that the county will have had more opioid deaths in 2021 than in 2020, by a relatively wide margin.

The Cook County Medical Examiner's Office recorded 1,840 opioid-related deaths in 2020. Based on past rates, they estimate the final 2021 count will surpass 2,100 cases, including, as of Tuesday, 1,602 confirmed opioid-related deaths and 717 cases still under review so far.

What is especially frustrating is that the numbers are rising despite a host of efforts by people and institutions to change the narrative: Police and others who routinely save lives using Naloxone; the health care professionals, mental health experts and policymakers who are making good faith efforts to deal with the crisis; and the grass-roots organizations staffed with experts (many of whom gained their expertise because of personal tragedy), who have done as much as anyone to push our understanding of opioid addiction forward.

Despite all this, the numbers of opioid deaths keep rising. Apparently, something more is needed.

There's plenty of evidence the pandemic has made a bad situation worse. Pandemics raise the uncertainty levels in people's lives and drive us indoors, often alone and separated from loved ones and support systems. Lockdowns, while combating the spread of disease, raise the risk levels for people who become lonely and isolated, and tend to use drugs alone.

As Cook County Health CEO Israel Rocha Jr. said, the pandemic has caused a great deal of stress and isolation, "exacerbating mental health challenges and substance use disorders."

An April 2021 article in the Journal of the American Medical Association looked at opioid deaths in Cook County over three years, from January 2018 to December 2020. They found OD-related deaths in Cook County were spiking for two years prior to the pandemic, with a "disturbing" increase in late 2019 and early 2020.

Still, JAMA said, the pandemic exacerbated the use of opioids, particularly among people whose treatment was interrupted by the 11-week stay-at-home order, and among those who lost jobs and economic security. Deaths are also attributed to the use of illicit fentanyl, which gained popularity when less dangerous drugs became harder to get.

Ultimately, policymakers who are dedicated to preventing addiction at its source, need to understand why opioids are so attractive during pandemics and other isolating circumstances, and take that into consideration.

Meanwhile, we must be grateful to the first responders, authorities, volunteers and policymakers who steadfastly keep battling a discouraging crisis. May we somehow find the elusive key that will honor their efforts and bring hope of an end to decades of misery and death.