Fighting Opioid Abuse in Chicago

Senator Durbin’s letter to stake holders in the war on opioid abuse is only part of the story

AS PART OF the ongoing war against opioid abuse, U.S. Senators Dick Durbin (D-IL), Sherrod Brown (D-OH), Angus King (I-ME), Amy Klobuchar (D-MN), and Tammy Duckworth (D-IL) sent letters in mid-May urging the U.S. Drug Enforcement Administration (DEA), the Centers for Medicare and Medicaid Services (CMS), and commercial insurers to use public data to improve oversight of opioid prescribing practices and hold doctors accountable for overprescribing dangerous and addictive painkillers. The Medicare Part D Opioid Prescribing Mapping Tool, developed by CMS, provides localized data on Medicare Part D opioid prescription claims across the United States. The senators believe it could be used to identify hotspots and prevent overprescribing and diversion.

Senators Durbin and Duckworth also sent letters to Health Care Services Corporation (the parent company of Blue Cross and Blue Shield of Illinois), the Illinois State Medical Society, the Illinois Medical Licensing Board, and the Illinois Board of Dentistry asking how they have used the mapping tool to protect Illinoisans from the growing opioid epidemic. The number of people dying from opioid overdoses is on the rise, with one of the biggest increases being seen in Illinois. The Centers for Disease Control and Prevention (CDC) reported that the opioid-related death rate in Illinois rose 120% from 2014 from 2015. Specifically in Cook County, the biggest increase has been in fentanyl-related deaths. According to the Cook County Medical Examiner, there were 20 fentanyl-related deaths in 2014. In 2016, there were approximately 400.

According to the National Institute on Drug Abuse, the number of opioid prescriptions in the United States has risen dramatically from approximately 76 million in 1991 to more than 245 million in 2014. And, the United States is by far the largest consumer of these drugs—accounting for almost 100% of the world total consumption of hydrocodone and 81% of oxycodone). The increased frequency with which prescription opioids have been prescribed in recent years has played a major factor in our nation’s escalating heroin epidemic, including an alarming increase in opioid-related emergency room visits, opioid-related treatment admissions for abuse, and opioid-related overdose deaths. Between 2002 and 2013, the rate of heroin related overdose deaths nearly quadrupled, with more than 8,200 people dying from heroin in 2013. According to the federal government’s National Survey on Drug Use and Health, four out of five current heroin users report that their opioid use began with prescription opioids.

New and Innovative Programs
The letters were part of a multi-pronged approach by numerous groups to combat the growing threat. “Any successful anti-drug strategy involves three equal parts—prevention and education, treatment and enforcement,” says Special Agent-in-Charge Dennis Wichern of the Chicago Field Division of the Drug Enforcement Administration. “Senator Durbin and his peers wrote the letter as part of our strategy to improve provider awareness and their knowledge of safeguards such as how to write the correct prescription.”

While the education and prevention component includes a wide variety of programs, one is a newly designed DEA class for providers entitled “Prescription Drug Updates and Medical Provider Safeguards.” The one-hour class provides information on drug trends, safeguards for physicians and updates on opioid abuse and offers CME and GME credits. Contact Dan Gillen at Dan.j.Gillen@usdoj. gov to find out about upcoming classes. Wichern also cites the Robert Crown Center for Health Education in Hinsdale as having an excellent heroin prevention program to help keep children from even trying their first dose. When it comes to enforcement, clearly the DEA is targeting drug gangs and cartels. The Agency has also made sure that “take back drug” boxes are available 24 hours a day, 7 days a week in law enforcement departments in the Chicago area so that patients can safely and securely dispose of drugs they no longer need.

Treatment, too, is an area that concerned citizens are targeting. Numerous groups including physicians, law enforcement and politicians are joining forces to increase the availability of Naloxone. Illinois passed Lali’s Law in 2015, allowing the drug to be sold without a prescription in pharmacies. By late 2016, more than 500 Walgreens locations had begun selling the drug with sales at CVS and Jewel-Osco locations quickly following. Wichern also notes that innovative new programs are constantly being introduced. A program called “A Way Out” that was started in Lake County but is also now offered in Cook County is available 24/7 for anyone who seeks treatment. “The program provides a window of opportunity for anyone who has hit rock bottom and doesn’t know where to go,” says Wichern. “Patients go into a participating law enforcement agency, which will connect them with the appropriate treatment program—without fear of facing charges.” The program is often called the “angel” program because of the many devoted volunteers who sit with program participants while treatment arrangements are being made. And that’s certainly a heavenly deal for patients.