Why the pandemic is leading to more opioid overdoses

Opioid overdose deaths could reach record levels this year in Cook, Lake and DuPage counties as the COVID-19 pandemic adds several factors that contribute to drug-related fatalities.

Drug prevention advocates were uneasy when overdose deaths across the six-county region, excluding Chicago, rose to 769 last year from 707 in 2018.

Now the toll appears on track to be even worse, two suburban coroners and Cook County public health officials say.

Suburban Cook County has seen 204 confirmed opioid overdose deaths through July 1, according to the medical examiner's online case archive, putting it on pace for 408 total deaths this year.

Last year's death toll was a record 376 in Cook County communities excluding Chicago. And medical examiner's figures show there are 148 pending cases that could make those numbers even worse.

Chief Medical Examiner Ponni Arunkumar said in a news release that 70% to 80% of pending cases are expected to be confirmed as overdoses, meaning there already have been roughly 307 to 322 overdose deaths in Cook County suburbs.

Countywide, Cook has recorded 773 opioid overdose deaths so far this year, compared to 605 during the same period last year.

Including 70% to 80% of 508 total pending cases countywide, Cook County already has seen roughly 1,200 opioid toxicity deaths, Arunkumar estimates.

Last year's total countywide was 1,267.

Officials also are troubled by the fact that 63% of the 773 people who have died this year from confirmed opioid overdoses are Black or Latino.

Suburban officials in Lake and DuPage counties are expressing similar concerns about rising overdose totals.

Lake County already has recorded 42 confirmed opioid overdose deaths, Coroner Howard Cooper said, and is on pace to reach 84 - topping last year's record of 77.

That's without including 23 cases that were pending as of July 1. Cooper said many of those likely will prove to be overdoses as well.

"We're way ahead of where we were last year," he said.

DuPage County has recorded 52 overdose deaths, with about 47 involving opioids, Coroner Richard Jorgensen said.

The pace would put the county at 94 deaths for the year, but that's without roughly 25 pending cases, many of which Jorgensen said could prove to be overdoses.

There were 96 opioid overdose deaths in the county last year - only two below its peak of 98 in 2018.

"If we keep on this track, we're way ahead of last year's numbers," Jorgensen said.

The news is slightly better elsewhere. McHenry County is roughly in line with last year's pace, while counts in Will and Kane counties could drop, depending on the number and outcome of pending cases.

Experts caution that several factors related to the COVID-19 pandemic have the potential to increase the number of people who fall victim to overdoses.

"The situation is dire," said Chelsea Laliberte Barnes, founder and executive director of Live4Lali, which works to reduce stigma and prevent substance use disorder. "The fallout of what happened with the quarantine is going to be pretty bad ... for people's mental health and people's livelihoods, and that is not a good recipe."

One key factor is isolation and all the ripple effects it causes. In isolation, experts with Linden Oaks Behavioral Health in Naperville say, people who use opioids are more likely to use alone. That means they're less likely to be in the presence of anyone who could step in with a dose of the antidote Narcan or naloxone.

"When you think about people with addiction, you don't want them isolated," Lake County's Cooper said. "They need people's help to get through this."

In isolation, people in recovery are unable to access the communal groups they form to help maintain sobriety, at least in the in-person manner many say is most effective.

The alumni network from Gateway Foundation treatment centers is seeing many people worried about falling back into old habits, said Jim Wright, director of alumni services.

He called the pandemic "a big roadblock to staying sober."

Coroners agree.

"The COVID crisis has taken away all of those options and really put people that are in treatment, in rehab or in recovery at tremendous risk," DuPage's Jorgensen said.

Stimulus cash brought another risk, Linden Oaks experts said, because "having a large amount of money can be a dangerous temptation."

And then there's the issue of supply. Laliberte Barnes said some users might have to turn to unfamiliar dealers because their regular suppliers got sick. A new dealer might sell street drugs like heroin at a stronger potency, which could cause an overdose if used in a typical amount.

"We, as a state, have to recognize that drug use is not an uncommon action and we need to be getting ahead of it when it comes to educating people on how to use safely," Laliberte Barnes said.

The overarching problem with the pandemic's effects on the opioid crisis is one of priorities, experts say.

The public health field has shifted so much of its muscle toward decreasing the spread of the virus and ramping up contact tracing that little remains to battle opioid overdoses.

"I feel, as always, we can do a lot more," Laliberte Barnes said. "We can't just give up on it because we have other priorities."

Her organization has restarted its mobile outreach with a purple truck called the Stigma Crusher available weekly in McHenry and Waukegan.

The truck provides safe use supplies including clean syringes, tourniquets and snorting kits, naloxone, fentanyl test strips and pill disposal equipment, as well as toiletries, bottled water, masks, nonperishable food, hand sanitizer, bags and safe sex supplies - all free of cost and questions.

Live4Lali also offers a delivery service for safe use supplies to anyone in suburban Cook, DuPage, Lake and McHenry counties, available nearly 24 hours a day by texting (224) 297-4393.

To Jorgensen, the best way anyone can help in the fight against the pandemic's effects on opioid overdoses is to reach out. He said the majority of people who died from overdoses confirmed during a spike in DuPage this spring were suffering from isolation, depression or a history of addiction and relapses.

"The only thing I say we can do is to reach out to people that we know are hurting," Jorgensen said, "and try to help these people during this critical time."

Fentanyl, latest drug of choice, adds to death toll

Why it's costing more to investigate suburban overdose deaths

Heroin overdose deaths, rescues both on the rise in suburbs

How fentanyl test strips help drug users 'be safe and survive'

'Right to a safe place': Program targets gap between hospital, addiction help for opioid patients

Opioid death toll rises in suburbs, but nonprofit warns 'urgency has died'

Officials hope decrease in opioid deaths continues in McHenry, suburban Cook

DuPage opioid deaths decrease by 2, but coroner still calls numbers 'not good'

At two suburban hospitals, opioids aren't the go-to painkillers