Addressing the Opioid Crisis

Deaths due to opioid overdose have risen substantially in recent years, both nationally and in the six states of U.S. Department of Health and Human Services’ (HHS) Region 5, which includes Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin. Combating the opioid crisis is one of the top priorities of HHS Secretary Tom Price, MD. In May 2017, to facilitate communication and action planning across the Region, the Office of the Assistant Secretary for Health (OASH)-Region 5 hosted A Public Health Approach to Addressing Substance Misuse and Addiction, Region 5. The meeting, held in partnership with the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Region 5 HHS Health Resources and Services Administration (HRSA), brought together state health officials, state substance abuse authorities, and other key stakeholders from Region 5 states to share information and plan possible actions to address substance misuse.

Leadership from the Illinois Department of Public Health (IDPH) and the Illinois Department of Human Services (IDHS) participated; representatives from both state agencies shared their upcoming opioid-related projects and discussed collaborative opportunities with participants. This article describes opioid overdose prevalence in Illinois and highlights some of IDPH and IDHS’ current opioid-related work.

Opioid Overdose Prevalence in Illinois and the Chicago-area

According to recent IDPH data, in 2016 there were 1,888 deaths due to heroin and opioid analgesics in Illinois, representing a 37 percent increase from 1,382 deaths in 2015. Additionally, from 2009 to 2014, Illinois reported 269.1 opioid-related inpatient hospital stays per 100,000 population.

The City of Chicago has been impacted significantly by these overdoses; in 2015, there were 111 deaths due to opioid analgesics overdose. In 2016, this number increased by 263 percent to 403. Suburban Cook and Collar Counties also experienced increases in opioid overdoses through 2016. Rural areas have also seen increased death rates, but the Chicago area accounted for the greatest total number of overdose deaths.

Real-Time Surveillance in Hospitals and Training New Providers

In response to this crisis, IDPH has established an automated, real-time syndromic surveillance system for all acute care hospitals with emergency departments (ED) in Illinois. This system includes free text of the diagnosis, chief complaint, and details of the reason for visit from patient self-report and provider notes. Dashboards are available to hospital and health department staff to view real-time data, including detection alerts when cases exceed local baseline levels.

Additionally, in May 2017, IDPH launched a video training module that aims to reach more than 5,000 medical residents and dental trainees. This training focuses on the Centers for Disease Control and Prevention’s CDC Guideline for Prescribing Opioids for Chronic Pain, screening for substance misuse, and use of the state’s prescription drug monitoring program.

Increasing Access to Treatment and Support

IDHS is responsible for overseeing $16.3 million in SAMHSA-administered state targeted response of the opioid crisis grant (Opioid STR) funds, awarded in spring 2017. Some of the projects that IDHS plans to implement using these funds include:

• Implementing hospital ED-based screening, recovery coaching, and linkage services.
• Supporting Cook County Hospital and Health Care Systems in developing and maintaining a community triage center in Chicago’s West Side.
• Supporting Rush University Medical Center in implementing a comprehensive substance use consultation service and aligning it with a set of new training programs including an addiction medicine fellowship.
• Expanding recovery home services for individuals with an opioid use disorder who are participating in Medication-Assisted Treatment.
• Developing and maintaining an Illinois opioid crisis line.

HHS OASH Region 5 continues to work with IDPH, IDHS, and other Illinois partners and will host regional meetings for further information-sharing and collaboration. Internally, OASH Region 5 has established a Prevention Collaborative focused on coordinating federal efforts.

Anna Gonzales, MPH, is a Captain in the U.S. Public Health Service and Acting Regional Health Administrator at the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Health—Region 5 (IL, IN, MI, MN, OH, WI). Contact us at Lesley.Craig@hhs.gov. Heidi Clark, MPH, is the Division Chief of Health Data and Policy within the Office of Policy, Planning, and Statistics at the Illinois Department of Public Health. Contact her at Heidi.Clark@illinois.gov.