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Illinois Opioid Crisis: A Carceral System

By Paulina Carrillo and Nicole Sroka

Posted: Tuesday, Dec. 17, 2019 

In 2017, Illinois, ranked first in the U.S. in opioid-involved overdose deaths with 1,187.

Chicago had 63,594 narcotic-related arrests from January 2015 through January 2019. Of these arrests, 16,841 were related to opioids, ranging from heroin possession to the altering and forging of prescriptions.

Those arrests, which often lead to convictions, leaves prisons full of people they cannot help, experts say.

Considered the “new asylums,” prisons have a high population of mentally ill inmates. Individuals struggling with opioid addictions are increasingly being incarcerated where they do not receive adequate treatment, experts say.

StoryMap: Opioid crisis centers in downtown Chicago

Dr. Liat Ben-Moshe, an assistant professor in the department of Criminology, Law and Justice at the University of Illinois at Chicago, rebuked the idea that prisons provide rehabilitation.

“Prisons are not there to rehabilitate people, and prisons are not there to treat anybody” Ben-Moshe said. “Honestly this comes from wardens even, wardens will tell you that.”

 An online report by The National Institute on Drug Abuse addresses a main challenge with addressing substance use disorders in American prisons. A small population of those struggling with opioid addictions receive treatment and often the aid is insufficient.

Punitive measures are becoming instilled in civil and administrative sectors of society, predominantly within the criminalization of those with substance use disorders and mental illnesses. The criminalization of those with drug addiction has roots in the Eugenics movement.

“It literally came from Eugenic policy and so it's not just that there is remnants of it, I think there's a little bit of a resurrection of these ideologies in actual policies, federal and state” Ben-Moshe said.

The U.S. Department of Health and Human Services defines opioids as a class of drugs including synthetic drugs like fentanyl, illegal drugs like heroin, and pain relievers such as oxycodone.

The Illinois Consortium on Drug Policy addresses the benefits of treating individuals with substance use disorders instead of incarceration. Benefits include higher chances of employment, a reduction in recidivism levels, and an improvement in overall health.

Dr. Alana Gunn, an assistant professor in the Criminology, Law and Justice department at the University of Illinois at Chicago, has researched working with individuals who have been incarcerated as well as those who are under community-based supervision.

“We’re talking about substance use that is trauma infused … the ultimate goal to decriminalizing drug use and instead say that we need to allow individuals to be treated in the community while they’re reestablishing their lives,” Gunn said.


Community-based methods, like opioid crisis centers, would prove beneficial to those with substance abuse disorders where they would receive necessary treatment to allow them to combat their addiction which can lead to criminality, experts say

Downtown Chicago harbors several opioid crisis centers-- seven within the Loop community area, including the Gateway Foundation to the Positive Sobriety Institute. But an issue lies in the disproportionate distribution of crisis areas throughout the city. People residing in neighborhoods on the West and South Sides do not have immediate access to treatment.

Charlie Andrews, a 21-year-old from Brookfield, said at age 15, he began to misuse hydrocodone – an opioid used to treat prolonged pain – by occasionally taking the medication from his mother’s medicine cabinet.

Andrews was later introduced to codeine, another narcotic for the treatment of pain or coughing. By his senior year in high school, Andrews began to regularly use heroin, a highly addictive and highly misused drug that produces euphoria.

“I noticed initially when I first started taking it that I used it almost as a social lubricant, and it made everything easier to do,” Andrews said.

By 19, he began noticing differences within himself, particularly with his mental health.

“I realized my mental capacity kind of shrunk," he said. "I lost a lot of social skills. I became a lot more introverted. Having been an extrovert, I just noticed that I wasn't talking as much, so things like that. I just didn't feel like myself anymore."

Areas in the state with large percentages of opioid users lack treatment resources or are only readily available for those that can afford them.

When asked if he believes there are adequate resources available in his area for treatment, Andrews said that there are not a lot of reasonable treatment options.

“I didn’t know of anything that was readily available”, he said. “I know of treatment places around me where people have been, but the demographic of people that have been there seems to be more middle-class white people, you know?”

Anna Mitroszewska is a third-year nursing student at Illinois Wesleyan University, where the nursing program is among the top 30% of the country. She said some hospitals are providing resources to those struggling with substance abuse disorders.

“Hospitals now, if they're lucky enough, have substance abuse and recovery units in which people can come for day programs or sometimes stay overnight depending on hospital policies,” she said.

 The Chicago Tribune reported that opioid-related deaths in Chicago have “spiked by nearly 500%,” based on data from the Cook County’s medical examiner’s records. An article by WTTW highlights the growing need to address drug and opioid abuse.

Dr. Kiran Joshi, senior medical director of the Cook County Department of Public Health, emphasized a need to expose the severity of opioid related deaths in the city.

“The opioid overdose epidemic is a serious public health crisis,” he said.

One of the primary goals of bringing awareness to opioid abuse revolves around recognizing when someone is experiencing an overdose. The Harm Reduction Coalition designed a website that lists the signs of an opioid-related overdose.

Symptoms include a loss of consciousness, slow and shallow breathing patterns, drastic change in skin tone, and the inability to speak. When responding to a victim who is having an overdose someone can call for emergency services, perform CPR, or administer naloxone

Naloxone, known as Narcan®, is used to counter the effects of opioid-related overdoses, according to the Harm Reduction Coalition. Ways in which Naloxone can be administered: injected into a vein, under the skin or muscle or sprayed into the nose.

Medical or emergency personnel are not the only individuals that are qualified to administer Naloxone if a person is experiencing an overdose. People with minimal training can administer the drug: individuals who are prescribed opioids are often taught how to inject Naloxone.

The Centers for Disease Control and Prevention released data revolving around the race and ethnicity of people who died due to drug and opioid-involved overdose deaths in the United States in 2017.

In 2017, there were 70,237 drug-related deaths and 47, 314 of those deaths were due to opioid overdoses. The majority of those who died were White, non-Hispanic people: 37,113 White individuals died due to drug and opioid-involved overdoses.

Although the mortality rate is high  for those who abuse opioids –– in terms of overdose related deaths –– the numbers do not represent the number of people that are seeking rehabilitation.

Many users are not prone to seek treatment because they are unaware of the free resources that are offered within their city. One main factor that deters individuals from seeking assistance are the high costs of the services.

At one year of sobriety, Andrews recalled the lack of treatment centers being available to the public, stating that he believes privileged individuals are able to receive adequate treatment.

“But I don't think it goes for everybody, I think that there isn't like a reasonable amount of treatment options that anybody could go through," he said. "I think it's something that you sort of need to have the privilege to do.”

Editor's note: A surname was used for the source described as Charlie Andrews in this story.

Read more: Chicago, Cook County on front lines of opioid crisis |  Return to The Red Line Project

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