Chicago Department of Public Health
City of Chicago Chicago Department of Public Health
Lori E. Lightfoot, Mayor www.chicagohan.org Allison Arwady MD MPH, Commissioner
August 13, 2021
2021 Chicago Mid-Year Opioid Report
Key Messages and Action Steps
• There were 5,517 opioid-related EMS responses1 and at least 467 opioid-related deaths2 in Chicago in January – June 2021.
• This is a 24% decrease in opioid-related EMS responses and a 18% decrease in deaths compared to 2020.
• For the total number of opioid related deaths from January – June 2021, 90% involved fentanyl.
• For the opioid-related overdose deaths that involved polysubstance use dring this same perond, 40% involved cocaine.
• Consider immediate initiation of buprenorphine in persons whose opioid overdose was reversed with Naloxone. Share these Harm
Reduction Interventions for people who use drugs.
Hospitals and Community orgaizations can register to become a Drug Overdose Prevention Program to order and distribute
Naloxone at no cost to their organization.
Recognizing Opioid Overdose: Signs and symptoms include slow, shallow breathing or no breathing; no response when the person’s name
is called; blue or gray lips and fingernails; pale, cold and clammy skin; slow pulse or no pulse; small and constricted pupils.
Laboratory: Diagnosis of opioid overdose is often made clinically, when the signs and symptoms listed above are observed. Urine drug
screens can be helpful in confirming the presence of opioids in the system. Providers should test specifically for fentanyl because synthetic
opioids such as fentanyl are not detected with routine toxicology testing.
Treatment: Opioid use disorder is a chronic condition and can be effectively managed with evidence-based treatment and life-long support.
The three FDA-approved drugs for treatment of opioid use disorder are methadone, buprenorphine, and naltrexone. Settings where these
medications can be initiated include the ED, inpatient settings, outpatient primary care and behavioral health clinics, telehealth/virtual care
visits, and mobile clinic settings. Providers can initiate buprenorphine immediately after reversal of an opioid overdose with naloxone using
this updated protocol. When making referrals for treatment, a warm handoff is preferred.
Naloxone is a medication that acts as an opioid antagonist and is designed to reverse an opioid overdose rapidly. If the first dose does not
reverse the overdose symptoms in 3 minutes, administer a second dose. It is important to increase access to this medication by providing
naloxone to all people who use opioids and those who know people who use opioids. Given the possibility of adulteration with synthetic
opioids, people who use other drugs such as cocaine, should also carry naloxone. Earlier this year, the FDA approved a higher dose naloxone
hydrochloride nasal spray product, named KLOXXADO, to treat opioid overdose. The Illinois Department of Human Services, Division of
Substance Use Prevention and Recovery (IDHS/SUPR) has invested $13 million to expand access to naloxone. IDHS/SUPR expanded its
hospital-based and community-based Overdose Education and Naloxone Distribution (OEND) through its Drug Overdose Prevention
Program (DOPP). By registering to become a DOPP, organizations can access free of charge and distribute the life-saving medication
naloxone (Narcan nasal spray).
Earlier this year, the U.S. Department of Health and Human Services (HHS) released its ‘Practice Guidelines for the Administration of
Buprenorphine for Treating Opioid Use Disorder’. All clinicians who can prescribe medications and have a valid state license and DEA can
register for an X wavier without mandatory training using this simple process. For more information, please watch this short video.
Chicago Connects is a treatment and resource finder for substance use, mental health, and violence prevention services.
Rethink Recovery is a statewide public awareness campaign provides education and resources directly to those needing Medication-Assisted
Recovery (MAR) the services.
Patient Counseling: The Brief Negotiated Interview can be used with people who experienced an overdose to raise the subject of opioid use,
provide feedback on their use, assess readiness to change, negotiate their goals, and initiate treatment or provide a referral to treatment.
Regardless of readiness for treatment, harm reduction interventions such as providing naloxone and fentanyl testing strips should be
implemented. Patients should be counseled to carry the opioid reversal medication Naloxone at all times and to inform those in their social
circle that they possess naloxone for overdose reversal. The use of fentayl test strips on drug samples prior to consumption may help
minimize the risk of overdose.
Reporting: When a drug overdose treatment is provided in a hospital’s Emergency Department (ED), the case shall be reported to the
Illinois Department of Public Health (IDPH) within 48 hours after providing treatment for the drug overdose.
Visit https://overcomeopioids.org/ * Bureau of Behavioral Health * https://www.chicagohan.org
1.Chicago Fire Department Emergency Medical Services. Data provided reflect all EMS responses where naloxone was administered and where there was indication of opioid involvement.These cases have not been confirmed by a clinician.
2.This count comes from the Cook County Medical Examiner’s opioid dashboard as of 7/27/21. This data is provisional and subject to change.
CHICAGO OPIOID UPDATE: Mid Year 2021
Opioid-Related overdose deaths are provisional, and subject to change. For internal use only
There were 5,517 opioid-related EMS responses and 467 opioid-related deaths in Chicago in January-June 2021.
This is a decrease of 1,784 opioid-related EMS responses and a decrease of 106 deaths compared to the same
time period in 2020.
Figure 1: Chicago opioid-related EMS responses by month, January – June 2020 and 2021
1600
Number of opioid-related EMS runs
1414
1400 1316
1189 1213 1180
1156
1200
1013 985 1010
1000 946
763
800
633
600
400
200
0
January February March April May June
2020 EMS Responses 2021 EMS Responses
Key Findings:
Table 1. Opioid-Related Overdose, Chicago
January- January- 2020 - 2021 • 467 opioid-related overdose deaths
June June % Change in occurred in Chicago from January-June
2020 2021 count 2021, an 18.7% decrease in rate from the
January-June same time period in 2020.
EMS Runs1 7,301 5,517 -24.4%
Naloxone doses administered 2 8,878 6,670 -24.9% • EMS has responded to opioid-related
Opioid- Related Overdose Deaths 3 573 467 -18.5% overdoses in all 77 community areas.
Current CDPH actions to combat the opioid epidemic: • Consistent with January- June 2020,
• Coordinate harm reduction services in the most impacted during the first half of 2021, opioid-
communities. These services include naloxone distribution, related overdose deaths were the
fentanyl testing, syringe exchange, initiation of medicated highest among men; Blacks, Non-Latinx;
assisted recovery (MAR) by mobile clinic teams, and community and adults aged 55-64.
health educator outreach.
• Monitor and detect overdoses in the community in real-time and • Deaths that involved fentanyl as the only
communicate those increases to healthcare partners, first opioid and deaths that involved opioid
responders, and community outreach organizations through the pain relievers were the only drug types
Chicago Health Alert Network (HAN) system (chicagohan.org) that increased from the first half of 2020
• Expansion of the Narcotics Arrest Diversion Program (NADP), to 2021.
which diverts individuals with substance use disorder away from
the criminal justice system and towards treatment and recovery • In the first half of 2021, about 90% of
services. opioid-related overdose deaths involved
• Co-locate syringe disposal units in several encampments fentanyl. This is a slight increase from
throughout the city. 2020 (82%).
• The rate of opioid – related overdose
1Chicago Fire Department Emergency Medical Services. Data provided reflect all EMS responses where deaths involving methamphetamine or
naloxone was administered and where there was indication of opioid involvement. These cases have not been
confirmed by a clinician. benzodiazepines increased from the first
half of 2020 to 2021.
2This count only reflects naloxone administered by the Chicago Fire Department Emergency Medical Services.
3This count comes from the Cook County Medical Examiner’s office as of 2020 data are as of 7/22/2020 and
2021 data are as of 7/27/21. Numbers are provisional and subject to change.
Table 2. Opioid-related overdose death characteristics, Chicago January - June 2021
January - June 2020 January - June 2021
2020 to
n % Rateii n % Rateii 2021 %
Change in
Rate
Chicago 573 100.0% 20.9 467 100.0% 17.0 -18.7%
i
Drug Type
Heroin-involved 264 46.1% 9.7 164 35.1% 6.0 -38.1%
Fentanyl-involved 471 82.2% 17.2 420 89.9% 15.3 -11.0%
Fentanyl - Only 213 37.2% 7.7 226 48.4% 8.2 6.5%
iii
Opioid pain reliever-involved 36 6.3% 1.2 39 8.4% 1.4 16.7%
Methadone-involved 62 10.8% 2.3 29 6.2% 1.1 -52.2%
Gender
Male 438 76.4% 33.3 366 78.4% 28.0 -15.9%
Female 135 23.6% 9.5 101 21.6% 7.3 -23.2%
Race-Ethnicityiv
NL Black or African American 340 59.3% 35.6 293 62.7% 30.9 -13.2%
NL White 151 26.4% 15.8 110 23.6% 11.4 -27.8%
Latinx 73 12.7% 10.6 61 13.1% 8.7 -17.9%
NL Asian or Pacific Islander 5 0.9% 2.9^ 1 0.2% 0.8^ -72.4%
Age (years)v
0-14 1 0.2% 0.1^ 0 0.0% 0.0 -100.0%
15-24 29 5.1% 7.1 19 4.1% 4.7^ -33.8%
25-34 86 15.0% 16.7 67 14.3% 13.0 -22.2%
35-44 96 16.8% 25.4 70 15.0% 18.5 -27.2%
45-54 157 27.4% 46.3 130 27.8% 38.4 -17.1%
55-64 149 26.0% 56.7 145 31.0% 55.2 -2.6%
65-74 50 8.7% 33.1 34 7.3% 22.5 -32.0%
75+ 3 0.5% 3.3^ 2 0.4% 2.2^ -33.3%
Table 3. Polysubstance use among opioid-related overdose deaths, Chicago June –January 2021
January - June 2020 January - June 2021
2020 to
n % Rateii n % Rateii 2021 %
Change in
Rate
Chicago 573 100.0% 20.9 467 100.0% 17.0 -18.7%
Drug Typei
Opioid-Only 347 60.6% 12.8 232 49.7% 8.5 -33.6%
Cocaine -involved 193 33.7% 6.9 187 40.0% 6.8 -1.4%
Methamphetamine - involved 15 2.6% 0.6 22 4.7% 0.8 33.3%
Benzodiazepine-involved 32 5.6% 1.2 46 9.9% 1.6 33.3%
Data Source: Cook County Medical Examiner’s office as of 7/27/21. Numbers are provisional and subject to change US Census Bureau. Note: NL = Non-Latinx. Numbers include all opioid-related overdose deaths
that occurred in Chicago, regardless of decedent’s address of residence.
i Categories are not mutually exclusive as some deaths involved more than one type of opioid. Deaths may involve additional substance (e.g. alcohol or cannabis), which are not reported here.
ii Rates are expressed as number of overdoses per 100,000 people in the population. Denominators are based on the 2010 census. Rates are age-adjusted to the 2000 US standard population.
iii Opioid pain reliever: buprenorphine, codeine, hydrocodone, hydromorphone, meperidine, morphine, oxycodone, oxymorphone, or tramadol. Opioid pain reliever- involved deaths may also have involved other
substances including heroin, fentanyl, or cocaine.
iv In 2020 3 deaths and in 2021 2 deaths were missing race-ethnicity
v In 2020 one death were missing data for age.
^ For counts less than 20, rates may be unstable and should be interpreted with caution .
Most Impacted community areas for EMS
responses January-June 2021:
• Austin (n=608)
• West Garfield Park (n=458)
• Humboldt Park (n= 367)
Community Areas with fewest EMS responses
January-June 2021:
• Burnside (fewer than 5)
• Forest Glen (n= 5)
• Hegewisch (n=6)
• Edison Park (n= 6)
• Pullman (n=6)
Data Source: Chicago Fire Department.
.
Map 2. Percent change in opioid-related overdose EMS
responses, Chicago January - June 2020 to 2021
Geographic Key Findings
January-June 2020 to 2021:
• 52 community areas had a decrease in opioid-
related overdose EMS responses and 26
community areas had increase in number of
responses.
• In Humboldt Park and East Garfield Park, opioid-
related overdose EMS responses decreased by
over 50%. Humboldt Park had 470 fewer EMS
responses, and East Garfield Park had 321
fewer responses.
• West Englewood had the largest increase in the
number of opioid-related EMS responses, an
increase of 63 (33.3% increase).
• In Rogers Park opioid-related overdose EMS
responses increased by 66.7%, an increase of 32
responses.
Data Source: Chicago Fire Department.
.
Most Impacted community areas January-
June 2021:
• Austin (n= 39)
• West Garfield Park (n=28)
• Humboldt Park (n=24)
Data Source: Cook County Medical Examiner’s office as of 7/27/21. Numbers are provisional and subject to change
Note: Numbers include opioid-related overdose deaths that occurred in Chicago. More than one death can occur at the same location.
