The U.S. is facing an opioid epidemic, and Cook County is not immune. 

In the last decade, opioid use and abuse has skyrocketed, becoming a public health crisis that shows no signs of slowing down.

Not only is the number of opioid-related medical emergencies multiplying, the cases tend to be more severe than they have been in the past, largely because of the emergence of highly-potent synthetic opioids like fentanyl. 

This opioid crisis is complex and crosses every socioeconomic and demographic strata. Such a dire issue requires a coordinated and multi-pronged approach and collaboration between health care providers, elected officials, first responders, pharmaceutical companies and community leaders.

Cook County Health, including the Cook County Department of Public Health (CCDPH), the Cook County Medical Examiner, and the Chicago Department of Public Health have joined in a task force to coordinate their response to this growing epidemic and are releasing annual reports about the local opioid crisis.

For more information on Cook County Health’s key initiatives to combat opioid use, visit our Making an Impact page.  

What are opioids?

Opioids are a broad class of drugs that contain opiates. Opiates are naturally occurring compounds such as morphine, but opioids are synthetic or man-made compounds.  Some opioids include hydrocodone, oxycodone, and fentanyl.  Opioids and opiates cause the brain to release large amounts of dopamine. Dopamine triggers the body’s pleasure receptors in throughout the nervous system, limiting pain messages from getting to the brain. This makes opioids effective painkillers. It also makes opioids a highly addictive class of drugs, as the body doesn’t naturally release such large amounts of dopamine.

There are prescription opioids like hydrocodone, oxycodone and morphine, as well as illicit street opioids, such as heroin. Recently, health and law enforcement officials have seen more overdose cases related to synthetic opioids: fentanyl (a powerful prescription opioid used during surgeries), carfentanil (a large animal tranquilizer), and acrylfentanyl (an illicit “designer” drug). Often these synthetic opioids are added to heroin to make it more powerful. However, this practice is extremely dangerous as users are often unaware of the substance’s potency, greatly increasing their risk of overdose. Carfentanil, for example, is 8,000-10,000 times more potent than morphine and can quickly cause fatal overdoses.

What is the problem with opioids?

Toxic doses of opioids impact the body’s ability to regulate breathing, leading to fatal respiratory arrest and brain damage.

When prescription drugs are used outside their prescribed parameters, they carry heightened risks, especially for addiction. The pathway from legal use of prescription opioids to illegal use of illicit opioids, including heroin, has been well documented.

Prescription opioids are effective in treating patients with pain, when prescribed correctly and taken a directed. Doctors should discuss the risks and side effects of a prescription opioid with their patients.

What are the signs of opioid use and overdose?

Individuals under the influence of opioids may present with small pupils, slurred speech, drowsiness and slowed breathing. Overdose symptoms can present quickly and include: inability to respond to stimuli, loss of consciousness, respiratory and cardiac arrest and death.

What is naloxone?

Naloxone is an opioid antidote that can reverse the effects of both illicit and prescription opioids. Naloxone can save the life of a person who has overdosed and can be safely administered by emergency first responders, family or friends. The strength of synthetic opioids often necessitates much larger doses of naloxone.  Individuals who overdose on heroin often require just 0.4 milligrams of naloxone to be revived, but some who have ingested synthetic opioids, such as fentanyl, may require up to 10 milligrams. Naloxone must be administered promptly after an overdose as it does not reverse the effects of prolonged respiratory arrest.