Cook County opioid deaths expected to set a record; researchers warn hundreds more deaths go uncounted


The number of opioid deaths in Cook County last year is likely to set a new record, according to the Cook County medical examiner’s office.

Sun-Times file

The number of opioid deaths in Cook County last year is likely to set a new record, possibly reaching over 2,000 once all autopsy tests have been completed, the Cook County medical examiner’s office said Tuesday.

The office already has confirmed 1,599 opioid overdose deaths for 2022, and it expects 400 to 500 of its pending cases will also be listed as death by opioid toxicity. In 2021, the county reported a record 1,936 opioid overdoses.

As troubling as those numbers are, University of Illinois Chicago researchers say the county may be seriously undercounting opioid deaths.

A study by the UIC School of Public Health found at least 633 hospital deaths from 2016 to 2019 that met the criteria for opioid overdose yet were not listed as such by the U.S. Centers for Disease Control and Prevention.

The researchers discovered that fewer than 20% of hospital patients who showed symptoms of opioid overdose were autopsied by the medical examiner’s office.

“We’re missing somewhere between 6-8% on the low end to as high as 15% of all opioid deaths within Cook County because people are dying within a hospital setting and they don’t meet the profile of your typical opioid use disorder individual,” said Lee Friedman, an associate professor at UIC who led the study.

“Therefore they’re not being sent over to the [medical examiner], who will do the accurate job of cataloguing the death appropriately and filling out the death certificate. And that gets reported to the CDC,” he explained.

Friedman said opioid deaths at hospitals typically involve pharmaceuticals and people who are older or suffer from chronic health conditions. 

Still, he acknowledged that fentanyl, 50 times stronger than heroin, is now at the center of the protracted opioid crisis.

In Cook County, the number of deaths involving fentanyl has increased steadily, rising from 96 in 2015 to 1,690 in 2021. The drug now contributes to the vast majority of the county’s opioid deaths.

Fentanyl contributed to the death of the youngest opioid overdose victim in the county last year, 12-year-old Joel Watts.

Watts died Aug. 19 at his home in the Roseland neighborhood. Autopsy results determined Watts had both ethanol and fentanyl in his system and ruled his death an accident. 

The Illinois Department of Children and Family Services was called to investigate Watts’ family nine times between 2016 and 2022 for reports of abuse and neglect, including charges of molestation.

According to a timeline provided by DCFS, Watts’ mother struggled with substance abuse and was referred to services on multiple occasions. After the boy’s death, several siblings were taken into protective custody.

One of his sisters began a GoFundMe page after the boy’s death, describing him as someone “full of life” who loved to cook, bake and dance.

In 2020 and 2021, as overdoses began to surge amid pandemic shutdowns, nearly 85% of the reported deaths were linked to fentanyl, according to the medical examiner’s office. That number, based on the preliminary data, rose to nearly 91% last year.

Friedman said the drug war-style approach of focusing on supply and locking people up “hasn’t proven effective.” He argued there’s a need for more treatment options and a broader embrace of existing solutions, like more pharmacists doling out clean needles and more medical professionals distributing drugs that reverse the effects of an overdose.

Those looking to address the opioid problem remain “hampered legally from implementing a lot of proven, effective harm-reduction strategies,” Friedman argued.

Unlike in Canada and Europe, medical professionals here can’t help users quit by administering high-powered, regulated forms of street drugs in a controlled setting. Illinois also doesn’t allow so-called safe injection sites where people can use illicit drugs freely and seek help.

State Rep. La Shawn Ford, a West Side Democrat, introduced a bill last year to allow safe sites for drug use, but the measure has been languishing for months in the House Rules Committee. 

Ford said he hopes the bill will move during the current lame-duck session in Springfield.

Ford is among a growing number of elected officials calling for the opioid crisis to be treated as a health issue, rather than a criminal justice issue.

Under the proposal, the Illinois Department of Human Services would create a “Harm Reduction Services license” that would be issued for injection sites. 

Applicants would be required to show they have a “hygienic space,” adequate staffing and safe injection supplies. The sites would need to provide first aid and monitor for possible overdoses.

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