The good news is the number of opioid-related overdose deaths is down dramatically since the drug NARCAN was made available to Peorians a few years ago.
That's according to panelists at the recent “O+ Educate and Activate: Trends in Opioid Use, Treatment and Harm Reduction” roundtable held in Peoria's North Valley neighborhood on Aug. 24.
The bad news, however, is that a number of new “designer” opioids and drug cocktails are available on the streets, each with its own unique, toxic chemistry that can defy identification efforts and, ultimately, treatment. Add to the mix a dearth of affordable treatment options available to minorities in the city’s poorer neighborhoods, and the state of addiction in Peoria appears quite grim, said Seth Major, co-pastor of Reachway Church, a small ministry that meets at North Valley Commons at 1203 NE Perry Ave..
To examine recent trends in local opioid addiction and treatment, the panel of area health and addiction recovery experts was organized by Major, who also has served on several non-profit boards working in the space of homelessness, poverty, neighborhood ecosystems and community development in Peoria.
“Most recently, my employment with OSF HealthCare has exposed me to the realities of just how saddening and prevalent the local opioid climate is,” said Major, who hopes to open the doors of North Valley Commons’ chapel to more neighborhood “town halls” in the near future. “Before we can get to solutions, we need to be a part of the conversation. We want to be sure that before we get lost in headlines or bullet points for some politician’s meeting, that we realize that we are talking about human beings.”
Peoria’s opioid addiction crisis: a timeline
Kathyrn Endress, director of epidemiology and clinical services at the Peoria City-County Health Department, described the opioid crisis as a public health threat that descended on the nation — and central Illinois — in four waves. “The initial wave began with commercial opioids back in the 1990s, when physicians received information that these substances were not addictive and they should treat people’s pain accordingly with the medications. This is when we first started to see overdose deaths caused by prescription medications,” she said.
A huge market for black market opioids opened up in order to serve addicted patients whose doctor’s prescriptions for legal drugs had expired, or had not been renewed by their physicians, Endress continued, causing many patients to turn to street heroin to satisfy their addictions.
“This led to many, many overdoses from heroin, beginning in the late 1990s and 2000s. Beyond that, we began to see the infiltration of fentanyl in our illicit drug supply, which is 50 times more potent than heroin. Fentanyl was put into people’s heroin without their knowledge, leading to even more overdose deaths,” she explained.
“What we are now seeing in the fourth wave is what they are calling designer drugs. You’re seeing xylazine (an animal tranquilizer) contaminated in the heroin and you’re seeing benzos (benzodiazepines, a depressant drug) contaminated in the heroin, leading to this fourth wave of overdose deaths.”
Peoria County opioid overdose deaths topped out in 2017, when 52 central Illinoisans perished, according to county coroner records. In 2018, 42 people died, followed by 40 more in 2019 and 37 in 2020.
“What I attribute the decrease to is the administration of NARCAN in our community," said Endress. "There were approximately 600 NARCAN administrations in 2018, and we went up to 700 in 2019 and the 900s the last couple of years. We were able to calculate that without the availability of NARCAN in our community, we would see eight additional overdose deaths each month in Peoria County.”
New drugs hard to diagnose, treat
To date there have been 19 overdose deaths in Peoria in 2022, according to Endress. “A lot of (the deaths) we are seeing are due to those designer opioids that have tranquilizers or benzos mixed in that are not responsive to NARCAN,” she said. “NARCAN can reverse an opioid, but it cannot reverse a horse tranquilizer.”
Difficulty in diagnosing the physical properties of some of today’s designer drugs and opioid cocktails presents a major challenge in treating or reversing an overdose, noted panelist Dr. Mary Stapel, lead physician of OSF Medical Center’s Street Health Team.
“Treating an overdose of something other than an opioid is really hard when you don’t know what those substances are,” she said. “And there are other health complications we are seeing associated with these drugs. A big one can be wounds; there are certain additives that are present that seem to create tissue infiltration and can cause ulcerated wounds. Respiratory effects are another complication. These are things that again are hard to address when you don’t know what is in these substances.”
Under the tenets of the Overdose Harm Reduction Act of 2019, non-profit organization Jolt Harm Reduction, located at 2203 N. Sheridan Road in Peoria, began collecting samples of illicit street drugs and drug cocktails in order to analyze and categorize the substances. That service has “really ramped up” in the last six months since Jolt aligned with the Chicago Recovery Alliance and their access to mass spectrometers, GCMS testing and other technology used to identify the contents of drug samples.
“We’re seeing a mixture of multiple substances in samples; we’re hard pressed to find just heroin in the city anymore. These drugs aren’t arbitrarily put into the supply,” said Chris Schaffner, program director for Jolt Harm Reduction.
“Just this past weekend, we received confirmation of a substance that is known very prominently in Colombia in the club scene as ‘pink cocaine,’ which has absolutely no cocaine in it. It is a combination of drugs with MDMA, ketamine and often LSD, and sometimes has fentanyl in it. It’s a designer drug for a specific purpose within the club scene in Colombia that works a lot like MDMA, but with much more stimulative and hallucinogenic properties. We see changes (in drug composition) like this occurring every couple of weeks.”
Disparities remain in addiction treatment options, attitudes
Socioeconomic disparities remain in the perception and treatment of substance addiction within Peoria’s minority communities, further hamstringing efforts to bring drug overdoses, poverty and homelessness under control.
This is according to Chris Wade, a consultant in the field of addiction and HIV prevention for Jolt Harm Reduction and owner of CWade Consulting, LLC, who credited a general perception of distrust of doctors and others in authority by the Black community with hindering their progress toward healthier communities.
“Structural issues. Institutional issues. Not to mention the stigmas associated with health care and people of color. We have a distrust of the medical system,” said Wade, adding the $70,000 required for an average 28-day in-house addiction treatment program is beyond the means of many people of color who live without health insurance.
“We don’t like to provide a lot of information to our medical advisors. There’s a history of hospitals calling the cops. A lot of drug users don’t want to see a doctor because they might call the cops, they might have warrants,” he said.
The end result is a socioeconomic dichotomy between the races in regard to harm reduction and addiction treatment.
“Their folks are coming back from overdoses, and ours are dying,” said Wade, comparing white-to-minority overdose death rates, and noting “15 percent of Illinois is made up of Blacks, but we make up almost a quarter of all overdose deaths. (Treatment) can be life saving; you don’t have to die. Because of our decisions and lifestyle, a lot of people are dying. We need to do more about that.”
The power of addiction can become such a challenge to overcome that those caught in its throes may feel deprived of oxygen until their physiological need to “use” is sated, said Schaffner.
“The best way I can describe it would be to ask each of you to hold your breath for the next 10 minutes. After about two minutes you will start to panic and you will do anything you possibly can to take a breath,” said Schaffner, adding that he has dealt with his own addiction issues in the past.
“People describe it as a starvation that becomes a physiological need. It’s like being dropped into the deep end of a pool and not knowing how to swim — you will do whatever it takes to get to the surface and you will pull people down without real intent to harm them because you are so desperate to catch your breath."
