Short Wave - Opioids, COVID-19 And Racism: A Deadly Trifecta

Episode Date: February 3, 2021

Drug overdose deaths are on the rise all around the country, including in Chicago, Illinois. ProPublica Illinois reporter Duaa Eldeib explains how the coronavirus pandemic has exacerbated the opioid epidemic, and the challenges that public health officials are facing as they work to reduce opioid-related deaths. See pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences.NPR Privacy Policy

You're listening to Shortwave from NPR. In 2017, the governor of Illinois implemented a plan to halt the explosive growth of opioid deaths in the state. The plan was to cut those deaths by at least a third by the end of 2020. 2020 was going to be this turning point for Illinois. Dua al-Dib is a reporter with ProPublica. They started to see a decrease in opioid overdose deaths. And so they were really kind of making progress across the state, and they were really hopeful. But early last year, Dua got a tip that the number of opioid-related deaths might actually be on the rise in the region.

So she and her colleague Melissa Sanchez started investigating. They analyzed death records from the Cook County Medical Examiner's office, and what they found was alarming. We found that opioid overdoses surged in Cook County and specifically in Chicago, and that those overdoses were disproportionately killing black residents. I think by the summer we had seen about 1,100 residents who had died of suspected or confirmed opioid overdoses, which is about double the number from the year before. Drug overdose deaths are on the rise. all around the country.

This was a nationwide problem that we were seeing kind of start to rise before the pandemic and then just continue as the pandemic ravaged our communities. Yeah, absolutely. So I guess, this is the obvious question for me here,

is whether we have a sense of how much of this increase can be tied to the coronavirus pandemic. So COVID didn't cause the spike, but like, everything else that made it worse, the financial stress, the isolation, the desperation, all of that seems to be really exacerbating things. And then, you know, when we talk about isolation with opioid use, one of the things that

they say is, you know, if you're going to use, use with someone else so that then they can administer the loxone, the opioid overdose reversal drug. But, you know, people were not using with, you know, others. So today on the show, we take a closer look at Chicago, how the coronavirus pandemic has exacerbated the opioid epidemic there and what kind of challenges public health officials are up against. I'm Maddie Safaya and you're listening to Shortwave, the Daily Science Podcast from NPR. Okay, Dua, let's start in Cook County, the county where Chicago is located and where your reporting is focused. Walk me through what you found there last year while you were reporting. reporting on the opioid deaths? We found a devastating surge in the number of opioid overdoses in Cook County

and Chicago, and even more specifically on the West Side, and it was disproportionately killing black residents there. The West Side has been a community that has grappled with opioid overdoses for a very long time. But what we saw last year was the number of deaths was almost doubling. And half of the total deaths in Cook County were black people, even though black residents only make up less than 25% of the county's population. Wow. Wow. And I mean, I think that's a really important point because we are really talking about three simultaneous intertwined public health crises, right? opioids, the coronavirus, and racism and systemic oppression, all disproportionately impacting black people. And that's what's so heartbreaking and devastating about this.

You know, when we talk to, you know, some of the people, some of the families, what we were hearing was some of them lost loved ones to opioids. They lost loved ones to COVID. They lost loved ones to just, you know, structural racism. And the reason that the West Side in particular has been struggling with opioid overdoses for so long is just because if you look at that community, just decades of disinvestment. So unemployment is really high. The median household income is really low. So poverty, you know, concentrated poverty.

So it's like it's been hit so many times. And it's exactly like you said, this was kind of this trifecta of, um, opioids, COVID, and racism. Yeah, and that brings me to something I want to talk about, which is naloxone, this drug that can reverse opioid overdoses. How big of a role does it play in combating this crisis? Like, how effective is it in saving lives? So everybody that we've talked to talks about just what a lifesaver naloxone is. I mean, this is a game changer. But the problem is there's simply.

not enough of it and especially not in the communities that need it most. So, you know, one of the people that we were talking to, who was a lawmaker on the West Side, who is saying that there are people who are using opioids who don't even know that it exists. So there's a real push now to increase awareness and increase supply. And you're seeing that at the state level, you're seeing it with hospitals, clinics, and providers, they're all being increased awareness. They're all being encourage to give out as much naloxone as possible because it's so critical and it can save people's lives. Got it, got it. Okay, so let's talk about how treatment looks in the time of COVID. I have to imagine that's changed quite a bit. So in terms of treatment, I think one of the things that

we saw early on is that people were scared to go to hospitals and hospitals were not seeing as many overdoses coming in, and there's still some of that. But the message from the hospitals has been, you know, come, we're safe. And if you come to us, you're really increasing your likelihood of living. And so there's been a real push to kind of increase 911 calls, increase visits to hospitals so that then they can get the naloxone that they need. Yeah, yeah. And is there a role for telemedicine now? And I know, everybody has access to, you know, like a smartphone that they could do telemedicine. But is that, is that is that playing a role as well now? It is. And what we're hearing is that doctors and providers

for a long time had been pushing for more telehealth, but they're running into barriers. I think a lot of it had to do with reimbursement. But now with COVID, those barriers have been relaxed a little bit and they're able to reach more people. But again, you're right. It comes down to who has access and who has the resources to call on telehealth. Right, right. You know, I've read quite a bit about opioid use disorder treatment strategies. And it does feel like some of the treatments directly contradicts strategies meant to prevent the spread of COVID-19, right?

So that's a huge difficulty. It's a huge difficulty. And, you know, we heard more than once, Zoom treatment isn't the same as being in person and feeling that support and being with others. So I think that's something that people are really struggling right now with before they would do intensive outpatient where a person would go in, like they were going into work from like, you know, 830 to 5. And now they've moved that to all online.

And it's better than nothing. But I think it comes with its own challenges. Yeah. And the other thing I was thinking about is needle exchange programs. Has there been an impact on that and whether or not that's possible? At the beginning, especially of the pandemic, people were really struggling with just financial resources and keeping the lights on. And so some of those programs had to scale back.

I know in Chicago, they've been able to get back on the street with their needle exchange programs and their mobile van units. But funding overall is still a challenge. Yeah, yeah. Okay, so, you know, obviously this is a tremendous burden on an already overburdened community, especially right now. I mean, does the city of Chicago or state public health experts have a plan on how to move forward here? They have a plan, and I think it's continually being updated because, you know, the numbers just keep getting worse. overall, they're working on the laxone distribution, they're working on getting more funding,

they're working on treatment. But I think when you have so many competing epidemics, one is going to overshadow the other. And early on, we heard concerns that one of the reasons it was getting so bad is so much of the focus had shifted to the pandemic to COVID. So there's been, you know, kind of a struggle to kind of get that attention. back to opioids. It's just so hard when you have so many devastating fatal epidemics happening at once. Yeah, yeah. So you've done a lot of reporting on this, you know, are there solutions out there? I mean, are they feasible at this time? Maybe not even at the state level in Illinois, but nationally. Like, do you see programs or anything that give you hope as your

reporting on this? So there are people much smarter than me who have, you know, tried to take this on. And what I'm hearing from them, and I hate to keep going back to naloxone, but what I'm hearing from them is naloxone and increasing the supply and getting that out as much as possible because this is, you know, kind of the first step. It is a life-saving drug. But then you move into kind of, you know, step two and step three, which is treatment and how do you prevent it from getting to that point where it is life or death? And so there's different harm reduction strategies, methadone and buphernorphine and Medicaid-assisted treatment that seem to be showing promise. I think the other piece of this is really stigma. You know, unfortunately, when you look in places like Chicago,

where there's such a racial component that's only exacerbated, And so I think reducing that stigma and making it more easy to access care and access treatment the same way that someone would access care and treatment for diabetes or heart disease, I think that will also help in the long run. Yeah, yeah. And I have to imagine you're also kind of left with this feeling of a lot of that feeling like treating the symptoms, right, when in reality that what we're looking at here might be, you know, really deep systemic changes.

and deeply entrenched health inequities. Do you know what I mean? That's kind of the feeling that I've gotten from it. Absolutely. And, you know, the West Side is such a great case and point. I mean, if that community had had more investment, if there's more jobs, if there are more, you know, opportunities, if there, you know, health care access to primary care positions,

I mean, all of that, you know, if you can fix those deeply ingrained issues in that community, I think we would say a huge difference in opioid use. Okay, Duav, I really appreciate your reporting and I appreciate your time. Thank you for coming on the show. Thank you so much for having me. This show was produced by Britt Hansen, edited by Jazele Grayson, and fact-checked by Rasha Auredi. I'm Maddie Safaya.

Thanks for listening to Shortwave from NPR.