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Heroin, Fentanyl Overdoses Kill More in Two Ill. Counties Than Car Crashes
June 29--Will County Coroner Patrick O'Neil has been tracking heroin deaths for a long time, and sounded the alarm several years ago when he believed the problem was reaching epidemic proportions.
Initially, he saw five or six deaths in a year, but then he saw those numbers double, triple and quadruple.
This year, the county could have its worst year ever as far as deaths due to heroin and opiate overdoses. The reason? Fentanyl -- a powerful synthetic opiate, blamed in the recent death of musician Prince, that is cheaper than heroin and is often mixed with it, or offered to an unsuspecting buyer in the guise of being heroin.
Last year, Will County recorded 53 overdose deaths linked to heroin and fentanyl -- more than the 51 deaths caused by traffic accidents in the county. The numbers were even worse in Cook County, where the 526 heroin and fentanyl deaths last year were more than double the 240 traffic fatalities.
Also, local and national statistics show, the misuse or abuse of prescription opioid painkillers such as hydrocodone and oxycodone has grown to become as frightening of a health problem as heroin.
Like other opiates, heroin is a depressant that slows the body's central nervous system, affecting heart rate and respiration. Paramedics responding to overdose emergencies can administer naloxone, which can revive someone suffering an overdose. The state's Heroin Crisis Act, which took effect Jan. 1, will, in part, increase access to naloxone, which local police departments and paramedics have credited with saving lives.
Without the access to naloxone -- the new law also requires it be made available at pharmacies -- Will County could "easily have over 300" heroin related deaths, O'Neil said.
"That's crazy," he added.
Southland agencies, which years ago were treating people who primarily abused alcohol, now are more often treating people who've become dependent on heroin or prescription painkillers. At the same time, reduced funding from the state is making it harder for them to make a dent in the problem, where the pull of the drugs too often overwhelms any efforts to wean users off of them.
Michael Schofield calls heroin "an equal-opportunity drug."
"It doesn't matter how much money you have or where you live," the Orland Fire Protection chief said, noting the drug has no geographic or economic barriers.
Schofield, who has long been involved in local awareness and prevention efforts related to heroin use, said the drug has a "huge market" in the south and southwest suburbs because it is cheap, accessible and more palatable to people adverse to needles.
"You can snort, smoke or inject it," he said.
Orland Park Police Chief Tim McCarthy said that Chicago remains the go-to location for suburbanites to purchase heroin although, "What often happens is people will buy a certain amount (in Chicago) and sell some (in the suburbs) to make money themselves."
Rising number of deaths
According to the CDC, there had been 4,000 deaths nationwide in 1999 due to overdoses of prescription painkillers, and in 2010 that figure had risen to 16,000. Over that same span, overdose deaths from heroin remained fairly constant. However, that quickly changed, with overdose deaths from heroin jumping by more than 25 percent between 2013 and 2014, when there were more than 10,500, according to the CDC. In 2014, the most recent year for which statistics are available, deaths from opioid pain reliever overdoses totaled more than 18,000, according to the National Institute on Drug Abuse.
The Centers for Disease Control and Prevention reports that almost 7,000 people are treated in emergency departments each day in the U.S. for using opioids in a manner other than as directed. While a sharp rise in prescriptions written by doctors for opioid painkillers has been blamed for contributing to the problem, statistics show that Illinois ranks among the lowest states in the country when it comes to physicians handing out such prescriptions.
In 2013, Illinois had 1,579 drug overdose deaths, and in 2014, the most recent figure available, that number had increased more than 8 percent, to 1,705 deaths, mainly due to heroin and other opioids.
According to the American Society of Addiction Medicine, of the 21.5 million Americans 12 or older who were diagnosed with a substance abuse disorder in 2014, 1.9 million of those cases involved prescription pain medication and 586,000 were heroin. Due to its lower cost and greater availability, heroin becomes a natural next step for those who've gained a dependency on prescription pain medication, according to the organization.
Kevin Lavin, executive director of Guildhaus, a substance abuse treatment center in Blue Island, said, "It used to be that marijuana was called the gateway drug, and now it's Vicodin that is the new gateway."
According to the American Society of Addiction Medicine, four out of five new heroin users said they began misusing prescription opioids; and in a 2014 survey of people treated for opioid dependency, 94 percent said they moved to using heroin because prescription meds were far more expensive and harder to come by.
When it was founded in 1967, the South Suburban Council on Alcoholism was helping those find and hold onto sobriety, and it would be 20 years before the words "and Substance Abuse" were added to the agency's name. In recent years, the East Hazel Crest agency has seen a growing number of people seeking treatment for addiction to heroin or other opiates, with that now accounting for between 30 and 40 percent of the roughly 2,300 people the council sees annually, according to Allen Sandusky, president and chief executive officer.
In many cases, drug addiction is going hand in hand with a mental health problem, often undiagnosed, and the drug use began as a way of keeping symptoms of the illness in check, treatment providers say.
Fentanyl raising alarms
Through May in Will County, there have been 32 deaths attributed to heroin and fentanyl, according to O'Neil, who expects the number will increase as toxicology reports on current cases come in.
O'Neil and other Will County officials attracted state and national attention to this problem, and obtained grants to combat it. Will County has held public forums, sponsored educational programs in local schools, focused on treatment instead of incarceration and trained police officers to use naloxone.
"This is a life-and-death situation. For anyone who is an addict, it's a crap shoot. Are you going to wake up?" O'Neil said. "We are trying to get the word out about the dangers of heroin and fentanyl. We report on it extensively."
Cook County Assistant Medical Examiner Dr. Eimad Zakariya has seen a "substantial increase" in overdoses related to heroin, fentanyl or similar drugs, affecting all ages, all walks of life.
In the first five months of this year, there have been 125 deaths due to heroin and 87 due to fentanyl -- compared to 424 and 102, respectively, for all of 2015. The office recorded another 84 deaths last year due to overdoses of other types of opioids. But the ME's office only began routinely testing for fentanyl in June 2015, it was noted. Toxicology reports are still pending on other fatalities.
His biggest concern is that "fentanyl analogues" -- illicit versions of the pharmaceutical grade -- are being mixed with heroin, with either users mixing it on their own to enhance their high, or dealers are mixing it to stretch their supply.
"People don't realize they are getting something so much more potent. It is a very strong drug -- 100 times more potent than morphine," the active component of heroin, Zakariya said.
Fentanyl is used for pain or anesthesia and acts like morphine. It causes respiratory depression and could cause a user to stop breathing. Typically people who use it gradually go from a state of lethargy into a coma, he said.
But it has only been in the last two or three years that medical examiners and coroners are specifically testing for fentanyl, which looks like heroin and has the symptoms of a heroin overdose. With more scientific tools, they can specifically test for these drugs.
Zakariya said he is now alerting medical professionals to look for and test for fentanyl. For fentanyl, because of its potency, several doses of naloxone might be needed to revive someone who has overdosed, O'Neil and Zakariya said.
Last year, CDC Director Dr. Tom Frieden reported that with heroin impacting communities and families across the country, an "urgent, all-of-society response" is needed to solve this crisis.
It is a solution that has to provide more recovery and treatment options, more naloxone, fewer opiate prescriptions, and a reduction in heroin's supply.
"The only way to beat this is when we all work together," Will County State's Attorney James Glasgow said at a recent summit on the issue.
Copyright 2016 - The Daily Southtown, Tinley Park, Ill.
