The epidemic of opioid overdose deaths has been geographically lopsided. West Virginia has the highest rate, followed by New Hampshire, Ohio and Kentucky. Illinois’ rate is one-third of West Virginia’s, but that’s only modest comfort. Last year, 1,889 people died from opioid overdoses in Illinois.
But people keep using heroin and prescription opioids despite the dangers. “I crashed three vehicles in one week,” one fentanyl user told the Tribune’s John Keilman. “I went to jail. But I liked it. I loved it – the rush, the euphoria, everything that came along with it.” Because fentanyl is much more potent than heroin, it carries a higher risk of accidental death.
This is a national problem that has to be addressed one user at a time, at every level of government. Fortunately, it’s not being overlooked in Illinois. In recent days, a report put together by a group of state agencies mapped out a comprehensive strategy to eliminate one-third of opioid overdose deaths by 2020. And Gov. Bruce Rauner appointed a task force to look for ways to implement the strategy.
The action plan sets out ideas that it separates into three categories: prevention, treatment and recovery, and response. To prevent deaths, it recommends getting more doctors and pharmacies to use the Illinois Prescription Monitoring Program, which can let them know when patients are trying to get multiple prescriptions. More education and training of providers about the hazards of overuse would save lives.
A big need is greater access to “medication-assisted treatment” (MAT), which offers methadone and buprenorphine, drugs proven useful helping those with “opioid use disorder” (addiction, in common parlance) beat the habit.
Medicaid covers the cost for those who qualify. But more than half the counties in Illinois have no MAT providers. Most of the doctors and clinics furnishing such therapy are in Cook County – which has a much lower fatality rate than many downstate counties. The report says that each year, 248,000 Illinois residents who need treatment go without.
Expanded treatment is needed in correctional facilities as well, because less than one-third of prisoners addicted to opioids get this kind of help. Most correctional facilities don’t refer departing inmates for MAT. But former inmates who fail to get needed treatment are at high risk of recidivism, relapse and overdose death.
Someone who has overdosed can be saved through the prompt administration of naloxone, and the state has made progress on this front. Thanks to legislation passed in recent years, the action plan report says, more than 90,000 people have been trained to administer the antidote, and all emergency vehicles are required to carry a supply.
But while many police officers have access to naloxone, the report notes, not all carry it or know how to use it. Making it easier to get this lifesaving remedy into the hands of ordinary people and community organizations would provide another line of defense.
There is no silver bullet here. Prescription opioids are an essential, legitimate tool in physician treatment of severe pain, which means some will always remain available for illegal trafficking. Synthetic forms can be produced in illegal labs. Some people will always be prone to drug abuse.
But expanding education, treatment and overdose remedies would prevent many Illinoisans from becoming addicted – and keep others from dying from using opioids. More ambitious efforts will take time, attention and money. But then, the human damage and death caused by the opioid epidemic are exacting an even higher price.