People are showing up at Gateway Foundation sicker than ever from drug and alcohol addiction because of various factors at play in the third year of the COVID-19 pandemic.
Many people with substance-use disorder who walk through the doors of Gateway’s Springfield Treatment Center begin to shut down physically and lose consciousness. That’s according to Kerry Henry, who has overseen Gateway’s Springfield site for more than 20 years and is senior executive director of the nonprofit’s Central and Southern Illinois Community Division.
To be revived, some have needed multiple doses of Narcan, which can counteract an overdose of opioids. Some needed to be brought by ambulance to a local hospital and stabilized before they could be considered for residential drug treatment at Gateway, 2200 Lake Victoria Drive.
“Medically and psychiatrically, they’re very sick – the worst I’ve ever seen, and I’ve been here 28 years,” she said.
Because some clients have delayed seeking care out of fears of contracting COVID-19, those now traveling to Gateway sites in Springfield, Jacksonville, elsewhere downstate and in the Chicago area are displaying more advanced symptoms of substance-use disorder, including higher blood-alcohol levels. Some are almost unresponsive minutes after they arrive.
Gateway officials said phone calls from clients inquiring about treatment dropped about 25% for most of the past two years. But over the past two months, requests for services have been near pre-COVID levels.
The pandemic has created unusual and varied challenges for substance users and organizations trying to help them.
Springfield and the rest of the country are experiencing a lull in new COVID-19 cases. But those who treat substance-use disorder and deal with its results say the pandemic’s social isolation and other effects have led to more drug and alcohol abuse, and eventually, more demand for treatment services.
Fentanyl fuels more overdoses
The pandemic also has fueled the flow of fentanyl into the illicit drug supply locally, law enforcement officials and treatment professionals say. Fentanyl is a synthetic opioid that’s cheaper and up to 50 times stronger than heroin.
The drug is cited as the main reason for an upswing in fatal overdoses in Illinois and Sangamon County even as Narcan is increasingly available to both addicts and emergency responders.
“The common denominator is fentanyl,” Sangamon County Coroner Jim Allmon said. “Fentanyl is in everything.”
Some observers have said shipments of fentanyl from other countries have been easier to smuggle into the United States during the pandemic than heroin. Suppliers have used fentanyl to supplant other drugs they sell, while users sometimes prefer fentanyl, despite the risks.
There were 60 accidental, fatal drug overdoses in Sangamon County in 2021 – seven more than the 53 in 2020 and 57% more than the 38 overdoses in 2019, before the pandemic began, Allmon said.
Eighty percent of overdoses in the past two years involved fentanyl, often mixed in with heroin, methamphetamine or cocaine, he said.
The people who died appeared to be unaware of the fentanyl, and “they did not intend to die,” Allmon said. “No one knows what is in these illicit substances.”
The number of ongoing death investigations by the coroner’s office indicates that the trend of increased overdose hasn’t abated in 2022, he said.
RoseAmber Hutchens became one of those statistics.
Her mother, Springfield resident Barbara Hutchens, 56, said her 34-year-old daughter, a single mother of two, died Feb. 4 of an overdose in a Springfield apartment that was a “known party spot.”
RoseAmber, who previously worked at a currency exchange, was unemployed and using drugs full time when she died, her mother said, adding that her daughter stole to feed her habit. RoseAmber’s two children weren’t living with her at the time.
She had been injecting heroin and using methamphetamines since she was a teenager, Hutchens said.
During her teen years, RoseAmber also spent time in treatment facilities in Champaign and the state of Ohio, graduated from Lincoln’s Challenge Academy in Rantoul and was a member of Narcotics Anonymous, her mother said. RoseAmber later attended Alcoholics Anonymous meetings in Springfield.
Toxicology results after RoseAmber’s death revealed meth and fentanyl in her system, and there was evidence the drugs had been injected, Hutchens said.
Other people in the apartment had been using drugs, but there was no Narcan available, she said. “I don’t know if addicts realize they can get that for free,” she said.
Hutchens doubted that her daughter intended to use fentanyl.
“She probably thought she was getting heroin and meth,” Hutchens said. “They are lacing everything with fentanyl now.”
She said she wants the public to “pay attention” to substance use in Springfield’s neighborhoods and inform police when they observe suspected “dope houses.”
“People in the community need to know what’s going on under their noses,” Hutchens said. “Our loved ones are dying.”
Overdose deaths a ‘public health crisis’ statewide
The Illinois Department of Human Services told Illinois Times in an email that opioid use, overdoses and related deaths “continue to be a public health crisis in Illinois.”
There were 2,944 fatal overdoses in Illinois in 2020, or almost one-third more than the 2,219 in 2019, almost mirroring a nationwide trend, according to DHS official David T. Jones. Jones recently was named chief behavioral health officer for the state by Gov. JB Pritzker and previously was director of the division of substance abuse prevention and recovery at DHS.
There were 2,774 fatal overdoses statewide in 2021, based on provisional data. That total was 6% less than the 2,944 in 2020 but 25% more than the 2,219 in 2019. Even more people would have died without previous efforts to expand the use of Narcan, Jones said.
Data for the first three months of 2022 aren’t available yet, but he said some of the factors contributing to the rise in 2020, including fentanyl, are “still very much at play.”
The emotional trauma caused by the pandemic has led to an increase in a need for drug treatment and for overall mental-health services across Illinois, and that trend “is going to be around for a while, probably five to 10 years,” Jones said.
The Pritzker administration recently updated what used to be called the state’s Opioid Action Plan, renaming it the Overdose Action Plan to reflect the increasing use of multiple substances.
“Polysubstance use increases overdose risks, and the combined use of opioids and stimulants is particularly deadly,” the plan document says.
Medication-assisted treatment recommended
The plan says the pandemic and its “associated stresses” – which include social isolation, job loss, the disruption of in-person treatment and recovery support services – “also play a role in increased overdose deaths.”
“To save lives, we need to reach out to and engage individuals who are at risk for both fatal and non-fatal overdose due to multiple drugs: synthetic opioids, heroin, cocaine, methamphetamine and other substances,” the plan says.
It stresses increased coordination of services, expansion of medication-assisted treatment and “harm-reduction” strategies such as making free Narcan widely available to the general public. Sites in Springfield where free Narcan is available include the Sangamon County Department of Public Health, 2833 South Grand Ave. E.; Phoenix Center, 109 E. Lawrence Ave.; and Mini O’Beirne Crisis Nursery, 1011 N. Seventh St.
The plan also targets racial and social disparities in the overdose crisis, noting that Illinois opioid overdose deaths in 2018 decreased 6.5% among non-Hispanic white residents but increased 9.1% among non-Hispanic Black residents. In 2020, non-Hispanic Black residents were more than twice as likely to die from drug overdoses than non-Hispanic whites, according to the plan.
The disparities are related to less access to treatment and support services, as well as other stresses related to disproportionately higher levels of poverty among Black people, Jones said.
Pritzker said at a March 21 news conference in Chicago that the plan “is about deploying behavioral health assistance to support any Illinoisan who is fighting opioid addiction.”
“Here’s the truth: Everybody knows somebody who is struggling – everybody – and our systems need to reflect that, because pain left in the shadows hurts us all,” the Democratic governor said. “So if you’re struggling, know that your fight is my fight, and the government of the state of Illinois is here to assist you.”
Springfield groups try new approaches to save lives
In Springfield, Gateway Foundation, which operates a 108-bed residential facility for adults and also offers outpatient services, has worked to improve access for patients by referring them to other Gateway sites when the Springfield location is full, according to Karen Harrold, a Gateway program director.
The Springfield site opened a 16-bed medically monitored detoxification unit in 2020 to “better assist those clients needing medication management to address withdrawal symptoms before beginning traditional residential treatment,” senior executive director Henry said.
In addition to the trauma that many Gateway patients have experienced in the form of childhood abuse and post-traumatic stress disorder during their lives, those seeking services often have been separated from their families and other support systems during the pandemic, Harrold said.
Henry added: “It’s been a traumatic episode with no end with the pandemic. They’re unsure of when it’s going to stop. It’s precipitated them feeling very isolated and lonely.”
Having Narcan available in nasal and injectable form has saved lives in the community, she said, but she wasn’t surprised at the increase in overdoses.
Because fentanyl is so strong, she said, “you have to use multiple doses of Narcan to revive somebody. Two cartridges won’t be enough – usually four to six, and sometimes more.”
When serving more patients with advanced substance-use disorder, adequate reimbursement has been a problem, Henry said. Medicaid, which covers about 60% of patients, and private insurance, which covers the remaining 40%, typically will pay for inpatient stays of 28 to 30 days.
“That’s the hard part, because some of these people really need longer,” Henry said, noting that patients who don’t receive adequate treatment are at higher risk of relapse.
Another drug treatment center, Family Guidance Centers, has used telehealth services – by phone and video – as one way to provide services quicker during the pandemic in Springfield and at other locations, Chief Operating Officer Ron Vlasaty Jr. said.
Family Guidance Centers is a nonprofit organization based in the Chicago suburb of Glenview that operates a 60-bed treatment facility at 120 N. 11th St. in Springfield.
As part of a “cultural shift” to improve access to services, the organization worked with Memorial Health during the pandemic to station counselors in the emergency departments of Memorial’s hospitals in Springfield, Decatur, Jacksonville, Taylorville and Lincoln to assist patients with substance-use disorder, he said.
The staff in Springfield has noticed clients’ alcohol use increase during the pandemic because of social isolation, Vlasaty said.
Despite the innovations begun during the pandemic, FGC, like many behavioral health providers, has experienced challenges in hiring enough staff members, especially people with “lived experience” with substance use, to meet the demand, he said.
Memorial Behavioral Health, an affiliate of Memorial Health, has experienced an increase in clients struggling with substance use, said Amber Olson, regional director of clinical operations. Some clients have substance-use disorder in addition to other mental-health issues, she said. During the pandemic, Memorial Behavioral Health, 710 N. Eighth St., launched the Living Room, an emergency room alternative for adults experiencing psychiatric emergencies. The free, walk-in service uses peer counselors for crisis intervention and help connecting with community resources.
As part of its harm-reduction program, Phoenix Center, 109 E. Lawrence Ave., began offering free fentanyl test strips in spring 2020 and continues to offer them with financial support from the Sangamon County Department of Public Health, center Assistant Director Sara Bowen-Lasisi said.
The test strips, along with free Narcan, clean needles, syringes and other materials, have been popular with users, she said, noting the number of people served by the harm-reduction program doubled during the pandemic and now stands at more than 700 per year.
The materials, which people can receive without identifying themselves, can be obtained by walking into Phoenix Center during business hours or ordering them for delivery by mail or in-person. The nonprofit group serves a 15-county central Illinois region.
“It’s entirely a public health program” that can prevent overdoses and the transmission of hepatitis and HIV (human immunodeficiency virus),” Bowen-Lasisi said.
COVID-19 pandemic affects Gateway patients’ journeys
Tommy McNichols said his alcohol abuse got worse during the pandemic. The 31-year-old office worker for a state agency said he had been an “isolated alcoholic” for eight years, drinking one to 1½ pints of “cheap vodka” most days after work, often to the point of blackout.
McNichols, 31, of Springfield, said he believes he drank more during the pandemic because he thought his coworkers wouldn’t notice his hangover breath and his appearance through the mask he wore at work.
“They figured it out anyway,” he said.
The lack of options for social activities outside his apartment also contributed to isolation that made McNichols, who is single, more comfortable with drinking to excess, he said.
Passing out at his desk and embarrassing himself in front of a coworker were among incidents that led him to check himself into Gateway’s detox unit, he said. He has spent more than a month in the residential program.
The drug of choice for Christopher Hayes, another Gateway resident, was methamphetamine. The 32-year-old Atwood resident, a former fertilizer company worker, said he got addicted to meth several years ago and was clean for two years but relapsed during the pandemic.
More people staying at home in the early months of the pandemic, and the additional money available to people through economic stimulus checks from the government, resulted in more meth readily available in Atwood, a village about 69 miles east of Springfield, he said.
Hayes said he didn’t enjoy smoking and injecting meth most of the time. He would use meth to ease symptoms of withdrawal that included intense irritability, he said.
He believes the meth he used sometimes was laced with fentanyl, but he never overdosed.
Hayes said he has been at Gateway about three weeks and credited Gateway for giving him hope for beating his addiction so he can get back to his wife, 18-month-old son and 12-year-old step-daughter.
“It’s been a whole different world since I’ve been here,” he said. “It’s crazy amazing. I did not know who I really was.”
A recovering heroin addict who asked to be identified as Tyler said his inability to find a job at the beginning of the pandemic in spring 2020, and the related stress of being homeless and living on the streets of Springfield, distracted him from addressing his addiction.
Tyler, 32, who said he grew up in a small town south of Champaign, is going through his third stay at Gateway since the pandemic began after previously completing a 30-day rehab program in another state.
He said his use of heroin began after he received opioid prescription drugs to deal with the pain of cracked bones when he fell off a skateboard in his early 20s. A few years later, he was cut off from legal prescriptions and turned to heroin for a cheaper but similar high.
That high soon led to addiction. At that point, he said, he used heroin not to get high but to avoid the severe flu-like symptoms associated with withdrawal.
“I was using to function,” he said. “It was completely terrifying. It controlled my life.”
Tyler said he has been at Gateway about two weeks and is benefiting from the prescription medicine Suboxone, which reduces withdrawal symptoms and helps him cope with cravings.
He said he is in treatment while on leave from his job at a local department store and plans to return to the job.
Before this latest stay, “I was pretty much dopesick for a year,” he said. “I was sick and tired of being sick and tired.”
Tyler said he is more confident than ever his recovery will continue.
“This stay is the best experience of my life so far,” he said. “This is it for me. They’re not going to see me back here.
“Addicts are not bad people. We are broken people.”
Dean Olsen is a senior staff writer for Illinois Times. He can be reached at dolsen@illinoistimes.com or 217-679-7810.
Information about services and resources for substance users is available 24 hours a day through the Illinois Department of Human Services’s confidential Helpline at 833-234-6343.
This article appears in A rocky recovery.
