The overdose epidemic that has ravaged Chicago has not spared the nearby suburbs, some of which have death rates comparable to anything seen in the city, according to a report released this week by the Cook County Department of Public Health.
ZIP codes in the towns of Worth, Broadview, Maywood and Forest Park, areas that “have substantially lower median household incomes and higher poverty rates,” have been especially hard-hit, the report said.
“If you happen to have an addiction or a predisposition to addiction and you live in poverty, I think it follows that that could potentially tip one over,” said Dr. Kiran Joshi, the department’s senior medical officer.
The report found that heroin and fentanyl, a synthetic opioid far more powerful than heroin that increasingly has been added as an adulterant to street drugs, accounted for the vast majority of the nearly 1,600 deaths that have happened in suburban Cook County since 2016.
It also found that middle-aged Black men have been particularly susceptible to overdose deaths, reflecting a national trend, and that suburban hospitals have spent more than $500 million to treat overdoses.
Report co-author Lee Friedman of the University of Illinois/at Chicago School of Public Health said the overdose problem in the county as a whole is comparable to the rest of the state. Some hot spots, though, particularly those adjacent to “high-risk” communities in Chicago, have elevated overdose death rates, he said.
The highest ones are in suburbs south and west of the city. A ZIP code that encompasses Worth and sections of Palos Heights, Palos Hills, Alsip and Chicago Ridge tops the list, with 42 opioid deaths per 100,000 residents over the last four years.
“(Some Cook County suburbs) have very elevated rates that are comparable to the highest rates that we are seeing within specific Chicago communities,” Friedman said.
Opioid deaths across the country have been rising because of the increasing presence of fentanyl, and Lydia Karch, a project coordinator for the department, said that has been true in Cook County as well.
“It’s becoming a more dominant share of the market,” she said.
The danger is made worse by the ingestion of other drugs. The Cook County medical examiner’s office found that most overdoses included more than one substance, including things such as alcohol, barbiturates or benzodiazepines — drugs that in combination with opioids increase the risk a person will stop breathing.
Suburban overdoses started to edge up in the middle of 2019, peaking in the spring of 2020 after the COVID-19 lockdowns had begun, though Friedman said cases that have yet to be closed by the medical examiner could affect that trend line.
Karch said a COVID-19-related spike makes sense.
“If you are in isolation and experience an overdose, there won’t be anyone to reverse the overdose,” she said. “It is not unreasonable to believe that might contribute to a higher number.”
She said the county is trying to fight the trend by stressing the distribution of naloxone, an overdose-reversing medication. Joshi said an even broader response, including an increase in the minimum wage and paid sick leave for workers, is needed to address the root causes of addiction.
“A little compassion can go a long way,” he said. “We know not only are things like poverty highly stigmatized, but of course addictions are stigmatizing. Following the science, addictions are a chronic disease, just like diabetes, just like emphysema, and we should treat individuals with addictions with the same dignity, the same respect we would treat anyone with a chronic disease.”