By Dan Rabbitt and Anthony Strong, Heartland Alliance
Originally Published in Crain’s Chicago Business on August 26, 2020
Chicago faces no shortage of demands on our collective attention. COVID-19 has dominated our focus since it swept Chicago, leaving over 69,000 infected and 2,800 fatalities in its wake. Our nation’s struggle for racial justice once again came to the fore after the murders of George Floyd. We have our hands full. Unfortunately, circumstance cares little about our burdens – and there are more emergencies to confront.
The opioid epidemic, the most serious public health emergency in the years prior to the coronavirus outbreak, has continued unabated throughout 2020. Recent reports show that Chicago may be experiencing double the rate of fatal overdoses seen last year, coming after four years of all-time high rates of fatalities. Though media coverage of the opioid crisis told a story of prescription opioid abuse by suburban or rural whites, Chicago has consistently faced higher rates of fatal overdoses – with Black residents more than twice as likely to die. This inequity has grown every year as white overdose rates stabilized and Black rates continued to rise.
Racism and discrimination overlap with the overdose crisis to compound the dire public health emergency facing our Black neighbors. The neighborhoods with the highest rates of overdose are on the city’s west side, known for its illicit heroin trade. Decades of war on drugs policies have overpoliced these areas and offered jail cells rather than treatment support. Racially inequitable police practices have traumatized these neighborhoods. Few are willing to take the risk of reaching out for help, and culturally appropriate services are too hard to find. Disparities in treatment also show potential bias. One study found whites were 35 times more likely than Blacks to be offered buprenorphine, the gold standard for opioid addiction treatment.
It is no shock that the COVID-19 pandemic and its related convulsions have intensified the opioid overdose epidemic. The isolation and despair that has come with social distancing and mass unemployment cause deteriorations in good mental health and substance use behavior. Opioid use by those who are socially isolated means no friends to assist in the event of an overdose, and fewer resources to connect individuals with long-term care. Heartland Alliance has seen this upfront, and what we see is disheartening.
We must do more to address this epidemic within the epidemic. We are in a period of upheaval where we have been forced to consider new ways of doing things, and we must do the same for this crisis.
Heartland Alliance has seen what can work. Our outreach workers and clinicians recognize that people use opiates as a response to pain – physical, mental, emotional, even societal pain. To treat the epidemic, we must treat the pain – and that requires compassionate care based on trust. We have built community health outreach services, led by peers instead of law enforcement, that can reach Black neighborhoods left behind during the war on drugs. We connect individuals with wraparound services to treat the underlying causes of substance use – including drop-in centers, mental health services, and access to basic human needs like transportation and housing. We’ve seen long-term harm reduction approaches save lives and help guide individuals to recovery.
Evidence-based treatment instead of harsh criminalization can help heal those who struggle. Our leaders must commit to taking this emergency and the pain it inflicts on our communities as seriously as it takes our other emergencies. As we commemorate International Overdose Awareness Day, let us all commit to doing what we need to do to save lives from overdose. We can flatten this curve too, if we act now.
This op-ed was originally published in Crain’s Chicago Business on August 26, 2020. A paid subscription may be needed in order to access the original article.
