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Illinois and Chicago need more evidence-based solutions to prevent overdose deaths

Chicago Tribune

Monday, September 11, 2023  |  Column  |  Sean McCormick

Aug. 31 was International Overdose Awareness Day. On a day dedicated to recognizing the tragedy of every overdose death, five Chicagoans will die from unintentional overdoses. In total, close to 2,000 Chicagoans died from overdoses last year, with the vast majority of these deaths linked to opioids.

The frequency of these deaths cannot make us numb. Rather, it must motivate us to explore all evidence-based options that will prevent these losses, in particular those options grounded in harm reduction.

The scientific community has accepted the effectiveness of harm reduction for decades. At its core, harm reduction promotes and protects health by recognizing and centering the dignity of all people. It acknowledges that behavior change regularly is incremental and inconsistent. More than simply individual, compartmentalized choices, health behaviors are influenced by social, political and economic systems in which people find themselves. When it comes to reducing the harms of substance use, evidence-based approaches focus on empowering and validating safer and achievable choices, while refraining from chastising less healthy ones. Nonjudgmental, approachable harm reduction services provide an opportunity for people to receive needed care without the restrictive caveats of abstinence and other barriers.

Chicago has long been at the forefront of many of these harm reduction approaches. Amid the initial years of the HIV/AIDS epidemic, Chicago Recovery Alliance and others pushed for “any positive change” and opened some of the first domestic syringe service sites. Today, Chicago continues to invest in evidence-based approaches, such as the recent initiatives to expand access to naloxone, a reversal agent for opioid overdoses, and medication for opioid use disorder and campaigns to increase testing of substances for potentially unexpected drugs. While these efforts have mitigated the damage caused by the overdose epidemic, the severity of the crisis warrants exploration of all options.

For more than 30 years, overdose prevention centers (OPC), also called supervised consumption sites, have saved thousands of lives by providing people a space to use illicit substances while under the care of trained staff. Due to the high stigmatization of drug use, many overdoses occur when people use drugs alone, outside of the presence of someone with naloxone, so OPCs offer a safe setting for using drugs that come from an often unstable, unpredictable supply. In addition to using in the presence of qualified staff, participants can access services such as HIV and hepatitis C virus testing, wound and injury care, mental health support and social services. Across the hundreds of OPCs that have operated throughout the world, thousands of overdoses have been reversed, and no fatal overdoses have occurred. In addition to reducing behaviors associated with HIV and hepatitis C virus infection, OPCs also decrease public drug use and the litter associated with use.

While most sites are international, OnPoint NYC opened two locations in New York City near the end of 2021, becoming the first sanctioned OPC in the United States. Since its start, the program has reversed more than 1,000 potentially fatal overdoses and linked thousands with critical services in a nonjudgmental and compassionate manner. The success of these enduring international examples, along with OnPoint’s model, have prompted many to call for Chicago to follow that lead.

A bill pending before the Illinois General Assembly, House Bill 2, would create the first state-sanctioned OPC in Illinois. The bill outlines a pilot OPC program that would provide first aid services, encourage and enable drug checking, provide referrals to social and other services, and allow participants to use drugs under the supervision of trained staff. The OPC would also conduct outreach to local communities to determine the best location for the site.

This bill represents a promising step toward embracing the full scope of evidence-based approaches for addressing the overdose crisis. Even if the General Assembly fails to approve the legislation, Chicago must continue as a leader in harm reduction and move forward with establishing an OPC. Every day that we fail to fully capitalize on evidence-based approaches, we needlessly allow Chicagoans to die from fatal overdoses.