'The perfect storm': How the COVID-19 pandemic has exacerbated the suburbs' opioid crisis
Nicole Caceres fell to her knees in disbelief, feeling as if someone hit her in the chest and stole the air from her lungs.
It had been three months since she learned her 24-year-old son, Mathew LeBlanc, had been using heroin. A month and a half since he got out of rehab. A day after he moved out of a sober living house in Minnesota. He had been on the road to recovery, ready to start a new life and eager to find a job that blended his passion for art with his love of teaching.
But on May 19, 2020, Caceres found herself on the floor of her West Dundee home, reeling from the devastating phone call she had just received from LeBlanc's father: “We lost Matt.”
Everything beyond that moment is a blur.
“When you hear those words, it doesn't even really register,” Caceres said. “I can't even describe it. It's awful. You don't expect your children to go before you do.”
LeBlanc's death from fentanyl poisoning was among a record number of fatal drug overdoses nationwide - a dire situation experts say has been exacerbated and yet overshadowed by the COVID-19 pandemic.
The opioid crisis has intensified in the suburbs, too, with Cook, Lake, DuPage, Kane and McHenry counties all reporting a spike in 2020 overdose deaths compared to the previous year, according to data released this month. In the six-county region, including Will County but excluding Chicago, opioid-related fatalities rose from 781 to 922, with some cases still pending.
Local drug prevention advocates say the sheer nature of the pandemic and the subsequent lockdown has been a significant contributor.
Support meetings shifted from in-person to online. Face-to-face interactions with recovery coaches and loved ones became scarce. And people battling substance use disorder found themselves vulnerable to loneliness, mental health issues, economic insecurity, job loss, boredom and the disruption of daily routines, said Laura Fry, executive director of Arlington Heights-based Live4Lali.
“Substance use disorder is a disease of isolation,” she said. “COVID is the perfect storm.”
DuPage County Coroner Richard Jorgensen noticed new themes emerging as he examined each of the record 112 opioid overdoses that came through his office last year.
Suburban leaders have long been seeking solutions to combat an already growing number of drug-related deaths, largely due to the strength and abundance of fentanyl in the black-market drug supply, among other factors.
But the “alarming increase” in fatalities when the stay-at-home order took effect last spring was unlike anything Jorgensen had seen before, he said. In most cases, the person had a history of prior mental illness, depression, financial issues or drug use.
The correlation is no coincidence, he said.
“This is very COVID-related,” Jorgensen said. “I don't think there's any question that this pandemic is causing a long-term effect on our society.”
In 2020, opioid overdose deaths in DuPage County rose 17% over the 96 reported in 2019, according to a news release.
Coroners in other counties reported similar spikes. Fatal opioid overdoses increased from 32 to 43 in McHenry County and 79 to 97 in Lake, according to preliminary results with a handful of cases still pending. In Kane County, data shows opioids were involved in 97 deaths - 69 of which listed opioids as the primary cause - compared to 90 related fatalities in 2019.
Cook County saw a jump from 381 to 496 opioid-related deaths in suburban communities alone, with more than 100 cases still pending, according to the medical examiner's case archive. Adding Chicago, that number rises to 1,768 in 2020, compared to 1,276 in 2019.
Only Will County experienced a drop in fatal heroin and fentanyl overdoses, with 77 cases reported last year compared to 103 the year before, according to the most recent data from the coroner's office.
The Chicago-area data largely mirrors a national trend identified by the Centers for Disease Control and Prevention. A record 81,000 drug-related deaths were reported in a 12-month period ending last May, primarily driven by a 38.4% increase in synthetic opioid cases, according to a December news release. The coronavirus crisis accelerated that scourge.
“As we continue the fight to end this pandemic, it's important to not lose sight of different groups being affected in other ways,” CDC Director Robert Redfield said in a statement. “We need to take care of people suffering from unintended consequences.”
Flipping through her son's artist notebook, Caceres notices his lighthearted, whimsical drawings become increasingly dark and ominous.
It was an indication, she realized in retrospect, that LeBlanc was in the throes of addiction. “But hindsight is always 20/20,” she said.
After graduating from Harry D. Jacobs High School in Algonquin, LeBlanc moved to North Carolina and earned an art education degree from Appalachian State University in 2018, his mom said. It was there that he started using heroin, she later learned, though his family was completely unaware for years until his dad found his needle kit on Feb. 13, 2020.
Two days later, LeBlanc was admitted to a rehab facility in Texas, where he was living at the time, Caceres said. When he got out 45 days later and moved to Minneapolis, he found himself in a new world overthrown by the COVID-19 virus.
Living in a sober house with about 10 other men during a lockdown proved to be difficult for LeBlanc, his mom said, noting his family was in touch with him frequently. He had to attend daily narcotics anonymous meetings online, and he struggled to find constructive ways to fill his time.
More than anything, she said, LeBlanc longed to find a permanent job in his new town doing what he loved: teaching art. But at the height of the pandemic, schools were shut down and districts weren't hiring, prompting him to settle for a menial job at FedEx.
“Matt was a hard worker, and he just accelerated when he had something good to do,” Caceres said. “His passion was teaching and art, and he wasn't able to do those things when he got out of rehab.”
A sudden abundance of free time, a loss of connection and the unmanageability of events like those experienced in 2020 can be detrimental to people battling substance use disorder, said Brad Gerke, a member of the DuPage County HOPE Taskforce and co-founder of the 516 Light Foundation.
“People in recovery need structure,” Gerke said. Without it, some may be tempted to return to their former vices, he says. “Idle hands are the devil's playground.”
Other ripple effects from the pandemic may have contributed to an increase in opioid deaths, including a disruption in the supply chain prompting individuals to seek illicit drugs from unreliable sources, said Dr. Gregory Teas, chief medical officer for Amita Health Alexian Brothers Behavioral Health Hospital in Hoffman Estates.
Forced isolation has been another factor, he said, causing more people to use opioids when they're alone, with nobody around to call for help or administer naloxone in the event of an overdose.
On the flip side, Gerke said, treatment centers have had to limit capacity or institute new COVID-19 requirements, creating another barrier for someone seeking help.
“Is COVID a scary thing? Yes,” he said. “But so is addiction.”
Reducing the stigma
The day before LeBlanc died, he was kicked out of his sober living facility for drinking a beer, Caceres said.
He assured his family that he would be just fine. He had a job, he had a car, and he found a safe place to stay. That night, he texted his mom the address and said, “I'm here. I'm good.”
The next morning, LeBlanc was found with a needle in the bathroom of the Airbnb.
The pandemic made everything about the grieving process more difficult, from not having a proper memorial service to only being able to attend bereavement group meetings remotely, Caceres said. But it has not stopped LeBlanc's family from trying to honor his memory.
“That's going to be my life's work now,” his mom says, “Bringing awareness, letting people know about the effects of addiction and that it can happen to anybody.”
Reducing the stigma of substance use disorder has been a key focus for suburban organizations like Live4Lali and Point to Point Kane County. Both distribute free and safe supplies - clean needles, fentanyl test strips, naloxone, safe-sex kits, and personal care products - as part of their harm reduction programs.
Initiatives aimed at battling the opioid crisis have also been ongoing at the state and county levels. The Cook County Department of Public Health, for example, has partnered with nonprofits to prevent fatal overdoses and increase access to evidence-based treatment programs, thanks to a $4.7 million grant awarded in 2019.
An opioid mortality report released Thursday determined 82.9% of overdose deaths in suburban Cook County from 2016 to mid-2020 involved heroin, fentanyl or both. Other trends and potential blind spots will be used to “inform our activities and customize intervention programs,” said Dr. Kiran Joshi, who is colead and senior medical officer of the department.
Drug prevention advocates say they fear the opioid crisis has taken a back seat to the COVID-19 pandemic in terms of awareness and public health resources. They want to bring the issue back to the forefront.
“Education and the understanding of the disease of addiction is so important,” Gerke said. “The No. 1 thing I'd want people to know is, there's hope. But you have to take the action and be willing to change.”
Suburban Cook2019: 3812020: 496 (More than 100 cases pending)
DuPage2019: 962020: 112
Kane2019: 90 opioid-related (60 direct cause of death)2020: 97 opioid-related (69 direct cause of death)
Lake2019: 792020: 97 (five pending cases)
McHenry2019: 322020: 43 (three pending cases)
Will2019: 103 (heroin and fentanyl)2020: 77 (heroin and fentanyl, as of Jan. 20)Source: County coroners and Cook County medical examiner