"In all my years I have never seen anything like fentanyl," said Marnell Brown. He is the founder of a harm reduction organization focused on drug use and violence prevention in Chicago. Brown has been in recovery for nearly two decades, and said he has been working in prevention for about the same amount of time. Fentanyl is a synthetic opioid that's 50 to 100 times more potent than morphine. Brown testified during an Illinois Senate hearing March 30.
The number of opioid-related deaths in Illinois jumped 30% last year compared to 2019 and about 83% of opioid deaths were attributed to fentanyl, according to preliminary numbers from the Illinois Department of Public Health (IDPH).
Fentanyl, a synthetic opioid that treats pain, is legally prescribed in small doses, in the form of a shot, lozenge or skin patch. Other forms of the drug – pills, powder, eye drops and nasal sprays – are illegally produced in labs. Even small doses of fentanyl can be deadly and illegal forms of the drug can be easily mixed in with other drugs as a filler. Brown said some dealers are unaware that drugs they sell are cut with fentanyl. Fentanyl overdoses cause hypoxia, a condition that stops oxygen from reaching the brain. Narcan is the brand name for a device that delivers naloxone, a drug that instantly reverses overdose effects and saves lives. Brown and other harm reduction specialists advocate that Narcan be made more widely available.
Brown also said the number of people affected by addiction and fentanyl has been hidden by COVID-19. Brown's organization, called To Walk in My Shoes, has an outreach team that monitors police scanners and helps assist in overdoses and drug-related deaths in Chicago. Brown also allows community members to set up funeral donation boxes at the clothing store he owns for those who have died from overdoses. Since COVID-19, the outreach team has heard less over scanners, said Brown. But the number of opioid-related deaths and funeral donation boxes are increasing. Brown said he believes the overdoses have gone increasingly unnoticed, because people have been more isolated during the pandemic. He also believes coroners sometimes fail to rule fentanyl as the cause of deaths, accidents and overdoses.
Brown has found that some substance users have no idea they are ingesting fentanyl, and experience accidental overdoses and deaths as a result. His team worked with a man this year who thought he'd purchased and ingested PCP, a hallucinogenic anesthetic, but it was laced with fentanyl and he overdosed. The team was able to intervene and administer Narcan. "So he came through," said Brown at the hearing. State Sen. Patricia Van Pelt, D-Chicago, said during the health committee hearing that a former business partner of hers was not as fortunate. He had purchased unregulated cannabis in Ohio. It was laced with fentanyl and the man died.
IDPH data analyst Leslie Wise said at the hearing that the number of opioid-related deaths rose 27% for African Americans and 48% for Latinx populations across the state in 2020. Brown said occasionally To Walk in My Shoes has access to fentanyl-testing strips. The organization gives the strips to drug users and dealers to prevent overdoses and deaths. Brown said he has found African American people are receptive to using the tests, but others coming to Chicago from other counties or suburban areas of the city are dismissive of the strips and some are actually actively seeking fentanyl. Brown said in his neighborhood, he finds more predominantly white and younger individuals are knowingly seeking and using fentanyl. "It has become a problem of humanity," said Brown, "not just an African American problem."
Advocates like Brown say more funding and increased public awareness are needed to prevent deaths. With a well-informed community and rapid-response teams in place, lives can be saved and treatment can be provided, he said.
During the hearing, others advocated harsher penalties for drug dealers and manufacturers of illicit drugs cut with fentanyl. In DuPage County accidental drug-induced deaths are referred by the county coroner to the state's attorney for further investigation. Since 2015, 17 cases have been pursued and 13 led to drug-induced homicide convictions. One case was dismissed and three are pending. That's according to Bob Berlin, DuPage County state's attorney. Some advocates seeking justice for drug-related deaths were in support of the state adopting the same model for investigations.
Those at the hearing recognized the importance of extended-recovery services and addiction treatment. When people are admitted to hospitals due to an overdose, some are released and leave the hospitals under a 48-hour observational period. A bill extending in-patient and safety-net coverage was approved by the Illinois Senate health committee March 31. The bill would require hospitals to offer in-person treatment for up to two days after a person is admitted because of an overdose.
Contact Madison Angell at firstname.lastname@example.org.