The growing heroin and opioids epidemic in the western suburbs
Audrey Albright’s son, Michael, was a sweet, happy boy with many interests. He played soccer. He was a dedicated Boy Scout. He sketched faces and strummed the guitar with nearly an innate virtuosity. But as a teenager at York Community High School in Elmhurst something sinister and powerful took hold of him. He wrote about it: “Sober? What is that? Nothing for me as I empty my foil into a burnt-up spoon, anticipating my next move. I tell myself that things are going to be OK and in seconds my mind is clear. I wish I could just disappear, leave this place and just exist. Heroin does that to me.”
The opioid epidemic has become a national story in recent years. The latest numbers are mind-boggling. A consequence of opioid addiction, drug overdose deaths in the United States topped 59,000 in 2016, making drug overdoses the leading cause of death for Americans under 50. Fifth highest among states, Illinois had 2,278 drug overdose deaths in 2016. More than 80 percent — 1,826 — were opioid related.
National news stories on opioid abuse often focus on states with the highest fatality rates, such as West Virginia and Ohio. In these places mills and factories have closed. Hopes dim for a bright future, and drug use is explained as an outgrowth of social malaise, a futile but predictable response to economic conditions.
DuPage and Will County are affluent areas with robust economies. Teenagers tend to be surrounded by successful adults, and it’s reasonable for youths to assume a similarly prosperous future. Yet the counties have suffered large increases in opioid-related deaths over the past several years. DuPage had 78 heroin-related deaths in 2016, compared to 51 in 2015, and Will had 76, compared to 53 in 2015. In much-larger Cook County there were 1,091 heroin-related deaths in 2016. So, over the course of five years at the 2016 mortality rates, Cook County would have 10 deaths per 10,000 people followed by Will at six deaths per 10,000 and DuPage at four deaths per 10,000. In Kane County, heroin-related deaths have been fewer, but even so, rates have been sharply rising. In one month alone last year there were nine heroin-related deaths in the relatively small county.
Some adults, mindful of their own past, view teen drug use as regrettable but part of growing up. But today it has taken a deadly turn. “Everyone knows someone who is affected. This (drug abuse) is not anything like a rite of passage. Young people are starting with drugs in their teens and overdosing in their 20s,” says Kathleen Burke, a public health official for Will County. “Heroin is readily available. You don’t have to go to the city. Any kid knows what kid has drugs. Access is very easy.”
Each individual story of addiction is a tragedy with a long, terrible reach. The deleterious effects are felt at schools, in the office and other workplaces, emergency rooms and outpatient clinics, and at police stations and among first responders. Mostly, addiction takes a toll in the home. “Addiction is not an individual crisis. It’s a crisis that affects the entire family. You see financial distress, divorce. Teenagers are kicked out of homes. So there’s homelessness. Even prostitution,” says Jackie Tamer, who counsels those with addiction at the Midwest Counseling and Diagnostic Center in Chicago and chairs the Elmhurst Commission on Youth.
West Suburban Living talked to a variety of addiction experts and public health officials about the opioid epidemic. The glass is both half empty and half full. Doctors, parents and school officials are more aware of the crisis and are taking steps to curtail addiction. Public officials have greater resources on hand to curb abuse. More first responders carry Naloxone, an overdose reversal drug, that has saved hundreds of lives locally.
Yet options remain limited. Insurance does not adequately cover treatment. A relatively new threat to mortality is fentanyl, a potent synthetic drug that has been mixed in with heroin. Fifty times more powerful than heroin, it has led to a new round of premature, sudden deaths. Beyond these concerns, the stigma attached to drug use prevents young people from seeking help and society from more fully addressing the epidemic, say health officials.
Albright says Michael’s drug use began with marijuana. She and his father separated when he was 12. “He went from having a 24-7 dad to a one-hour-a-week dad,” she says. He was depressed and dealing with ADD. “He tried self-medicating with pot,” Albright says. Prescription pills such as Vicodin and codeine came next. Then, eventually, heroin.
Like any loving parent, Albright tried to get him help. He was in rehab four times — once for 23 days and then for shorter stints. “That’s what insurance paid for,” she says. “Tough love” also was tried. “He was out on the streets in December,” she says. “One day he overdosed and nearly died. “It was just horrible,” says Albright.
This year Burke, who headed the addiction-fighting and recovery group Strategic Prevention, was hired by Will County to coordinate anti-opioid efforts. Personal experience has taught her that addiction typically comes unexpectedly and it’s not easily overcome. A daughter of a friend overdosed. “She lived. She’s doing well. They got her into a program. I knew the system. People don’t know how to navigate the system,” she says.
Before that episode, Burke grappled with her own son’s addiction. “I was dumbfounded,” she recalls. “If someone like me who is part of the system didn’t know where to go, what can you expect of a parent?”
She advocates a three-pronged approach to the epidemic: education and prevention, access to Naxolone, and treatment. The education component is not just about alerting parents and warning youth but also educating physicians. “They need to take a look at their prescription habits — a new prescription protocol,” she says.
The drug crisis is rooted in the over-prescription of opioids that began in the late 1990s. The Federal Drug Administration approved OxyContin in 1995, and pharmaceutical companies began aggressively marketing opioids as pain relief for chronic conditions such as back pain or arthritis. Prescription drugs became almost ubiquitous. In 2016, 236 million prescriptions were made. The United States, with less than five percent of the world’s population, consumed 80 percent of the world’s opioids. Unaware of the addictive power of opioids, doctors filled medicine cabinets at home with drugs that fell into the hands of young people.
“The kids see it in the medicine cabinet. It’s a prescription. It’s prescribed by a doctor. It can’t be bad, right?” says Dr. Aaron Weiner, director of Addiction Services at Linden Oaks Behavioral Health in Naperville.
Prescription drugs are dangerous in themselves but also lead to heroin. “You can’t always get a pill, but you can get heroin. You can get it off the street,” says Burke.
The first step to addiction often is seemingly benign. “Lots of times it’s a sports injury. They end up in the ER and take a prescription home,” says Tamer. Or the family home is the springboard. “It can start when a kid gets high off what’s in the family medicine cabinet,” says Tamer. “A pill can be $50, Heroin is a lot cheaper. Kids do have money to spend. But not a ton of it. So they go from pills to heroin. It’s readily available. Years ago you had to drive down I-290 and exit at Independence Boulevard. We have dealers out here now.”
Addiction to prescription pills can be startlingly quick — a month or less. A common presumption about prescriptions sometimes has terrible consequences. “There’s the belief you’re supposed to take all the pills in the bottle. But they should be used as needed for pain,” says Burke. It does not take long before a youth begins to feel a nudge to take another pill. “After two weeks of using it you may not feel so great without it. You don’t feel up to par.”
Youths with a family member who has an addiction are 50 percent more likely to become addicted, says Burke. Other risk factors are underlying mental health issues such as depression or anxiety. Death, divorce, sexual abuse or other trauma also can lead to addiction.
By senior year of high school, eight percent of students in DuPage County used a prescription drug to get high, according to an Illinois Department of Human Services study, which surveyed nearly 20,000 students. That compares to 33 percent who tried marijuana.
In 2016, three percent of 10th-graders used a prescription drug not prescribed to them in the last 30 days; that figure is four percent for high school seniors (but down from five percent in 2014).
Where do the drugs not used for medical purposes come from? Fifty-four percent of users age 12 and older got them free from a friend or relative, and 15 percent bought or took them from a friend or relative, according to a 2012 national survey by the U.S. Department of Health and Human Services. Nineteen percent got them from a doctor, and 4 percent got them from a drug dealer or stranger.
Weiner cites the role of marijuana in opioid addiction. “It’s a gateway drug,” he says. “Ninety-one percent of heroin users have used marijuana. The growing social acceptance of marijuana is worrisome.”
Ultimately, it’s not surprising, given opioids’ widespread availability, that young people with promising futures derail their lives. The teen years often are fraught with raging insecurities, suffocating peer pressure and volatile relations with parents. Youths use drugs because it makes them feel good, to fit in, to cope with problems or simply to experiment, says Weiner.
Michael and his mother battled his addiction. The pull of drugs was powerful. “Fear trembles through me as I’m getting closer to the point,” he wrote. “I hold my head up high today, ‘cause tomorrow is not a choice. When temptations get the best of me, I’m sad to say I’ve got a recipe.”
His DuPage County court drug program proved to be punitive, not rehabilitative. “It just added so much stress. He’d call me and say, ‘I’ve got to get tested now,’” recalls Albright. He needed therapy but could not get it. “I had excellent health insurance — Blue Cross Blue Shield. The counselors were begging them for more time (in rehab).”
Albright wanted him in a halfway house with structure and oversight. But he ended up at an institutional “sober home” in Bellwood. A roommate thought he had left his light on. But he had been dead of a drug overdose for six to eight hours when found. It was October 27, 2012. Michael was 21.
“I could blame the judicial system. I could blame the insurance company. I could blame the counselors at rehab. I could blame his dad for not being involved in his life. I could blame his girlfriend, and I do,” says Albright. But as a boy Michael was innocent and honest. Even in the depths of his addiction he wrote forthrightly about his failures and struggles. “At the end of the day, I have to blame Michael. He said it was OK to use.”
Alarmed by the growing use of opioids, the Robert Crown Center for Health Education in Hinsdale began educational outreach to schools in 2012. Since then it has alerted an estimated 30,000 students in junior high and high schools to the dangers of opioids. Its approach is “train the trainers” — instruct teachers in health classes to use innovative videos and software on how the brain works and why young people are susceptible to drugs. “We try to make sure kids are told the whole story. They’re told ‘drugs will kill you,’” says Mark Robinson, program manager. “They see kids at parties getting high and having a good time. They’re not dying the next day. But you could die someday. Addiction is a terrible thing.”
Early on, some schools were reluctant to implement the program. “There was push back. Heroin? Not my kid, not my school,” says Robinson.
Overcoming addiction is not a heroic exercise of will involving multiple occasions of resisting temptation to finally be free of a demon. “Insurance treats it like an acute disease. But you need six months of therapy, not 21 days of treatment,” says Burke. “A two-week abstinence does not work. Recovery is a lifelong process. ‘I can stay off it for a while, and I’ll be fine.’ It doesn’t work that way.”
On average, those with an addiction must go through three treatment periods before arriving at a safe place. “It’s difficult to get over the hump,” says Tamer. “First, you need to get to three months. A relapse can happen. You need to get to six months, nine, a year. You need to keep seeing the psychologist, keep taking the steps you are on. People fool themselves. They say, ‘I can do this.’ They don’t think they need their medication. They go to places they should not go. They see people they should not see. They think they’ll be OK.”
Linden Oaks in Naperville has several drug treatment facilities at its disposal. It has its own 12-bed detox unit as well as outpatient centers in Naperville, Plainfield, St. Charles and Hinsdale. Some patients enroll in “partial hospitalization” — as much as six hours of treatment a day. Others choose “intensive outpatient” — typically three hours a day four to five days a week. Another option is the 12-bed residential unit at Northwest Community Hospital in Arlington Heights, where stays can last as long as a month.
For those 18 and older, the most effective treatment, says Weiner, involves medication-assisted therapy. Methadone or Suboxone are often used. “Addiction has biological, social and psychological components. The methadone takes care of the biological component. There will be few or no cravings,” he says.
Socially, people using drugs need to stay away from other users. They also need people they can lean on. “Forty to 60 percent of people relapse within one year of professional treatment,” says Weiner. “Relapse often happens because of an emotional event. You need a friend to talk to. You may need just to cry.”
Cognitive behavioral therapy addresses psychological issues. The goal is to “equip them with coping skills,” says Weiner. “When you have a craving you feel you need to respond. Like urinating or being thirsty or hungry, you believe it will get worse. But in 15 or 20 minutes the craving fades. You have to be able to tell yourself, ‘I can handle this. I can get through this.’”
First responders provide a different kind of treatment — a lifesaving one. The nasal spray Naloxone (also known as Narcan) reverses the effects of heroin and other opioids. The DuPage Narcan Program began in 2013 and as of March more than 3,150 people have been trained to administer it. There were 145 “saves” with Naloxone in 2016.
Will County has stepped up efforts to train first responders and others to use Naloxone, and Burke wants to train social workers, parents of those with addictions and others. This year 17 lives in the county have reportedly been saved by Naloxone.
Beyond the training and altering prescription practices, a seismic shift in how people think about addiction is needed, say addiction experts. “It’s not a moral failure,” says Weiner. “I can’t emphasize this enough. Maybe in the beginning choice was involved. But it’s a disease.
“We need to remove the stigma,” adds Weiner. “Parents have no idea their child has a problem. If only we could talk about it: ‘Mom, I have a heroin problem.’ We label people with the disease — ‘addict.’ Parents who know their child has a problem could have Naloxone and know how to use it.”
Nationally, less than 10 percent of Americans with an opioid problem get treatment — a testament to inadequate or no insurance, a lack of treatment facilities and a tendency to view the problem as a criminal-justice matter. Doctors and healthcare advocates worry that changes to the national healthcare law could further jeopardize access to treatment.
A more enlightened, less judgmental approach is urgently needed, argues Burke. “Addiction is a disease,” she says. “It should be treated as a medical disease like it’s diabetes or hypertension.”
Albright mourned her son, found a support group of people who lost loved ones to opioids, and then one day returned to York Community High School. She spoke to five health classes. “It was one of the hardest things I’ve ever done. I shared Michael’s story five times. I don’t know if I could do it again.”
But she trusts the students took her talk to heart. Drugs destroy, not enable. “My message was your mind is beautiful as it is,” says Albright. “You don’t need to do anything to it at all.”Edit Module