While substance use remains a public health concern in Chicago, opioid and drug-related deaths and overdose EMS calls appear to be declining, according to a recent Chicago Department of Public Health (CDPH) report.
The same report cites harm reduction, a public health approach aimed at minimizing the negative impacts of drug use, as an important element of Chicago’s plan to address drug-related fatalities.
“[Harm reduction is] a set of principles and practices that is aimed at meeting an individual where they are, and so giving them what they need in that moment, in the way that truly reduces harm,” said Chicago Department of Public Health (CDPH) employee Dora Khoury, a research grant specialist in CDPH’s Bureau of Behavioral Health.
Harm reduction strategies include supplying the public with access to information, medical resources to prevent drug overdose, and drug-testing strips.
Harm reduction is distinct from abstinence, an approach that prioritizes the end goal of cessation from substance use.
A nationwide epidemic
According to the CDC, 105,451 overdose deaths were reported from Jan. 2023 through Jan. 2024 in the United States.
During this period, 8.9 million Americans reported using opioids recreationally, 9.7 million Americans reported misuse of Central Nervous System stimulants like methamphetamine and cocaine, and more than 800,000 Americans reported misusing Fentanyl, according to the 2023 National Survey of Drug Use and Health.
In 2023, the Illinois Department of Public Health reported 1,598 deaths involving opioid overdose in Cook County, and CPDH data reported more than 7,100 reports of overdose to EMS services.
The number of overdose calls totaled 5,735 in 2024, suggesting that harm reduction strategies could be making a significant impact.
What is harm reduction?
Harm reduction is a tool used by professionals in the field of substance use to center and personalize assistance to individuals impacted by substance use.
Harm reduction emphasizes person-first treatment and is aimed at reducing the harms related to stigma around drug use and the criminalization of drugs.
Narcan and other drugs that can be administered to stop or reverse an overdose may come to mind when thinking of harm reduction, but the principles of harm reduction also include education, community outreach, and providing contraceptives.
Harm reduction resources include overdose reversal drugs, drug testing for dangerous additives like fentanyl, kits that provide safe equipment for snorting or injecting drugs, access to shelter or medical attention, and resources for counseling and treatment.
What resources are available?
Chicago has widespread harm reduction resources in every part of the city.
Having started in 2022, Narcan is now available for free in all 81 branches of Chicago Public Libraries (CPL).
Additionally, the CDPH has five free public health vending machines in the Uptown Library, Garfield Community Service Center, Harold Washington Library, the 95th/Dan Ryan Red Line CTA Station, and Roseland Community Triage Center.
Chicagoans can go online to the CDPH website or at a public library front desk to register for a code to access Narcan, drug testing kits for fentanyl and xylazine, menstrual supplies, and general health resources.
CPL librarian Anya Owens said she has personally seen library resources save a life when a man suffered an overdose outside of the Whitney Young CPL branch in 2023.
“Just to have these things on hand in the neighborhoods that some of these branches are in, it’s a great thing, because it can be a life or death situation at that moment,” Owens said.
CDPH works with community partners such as Chicago Recovery Alliance (CRA) to distribute resources in neighborhoods with higher levels of overdose reports.
CRA, a diverse outreach group that focuses on building relationships in highly affected communities, offers pop-up services daily in Woodlawn, Humboldt Park, and Englewood.
They provide on-site drug testing, safe snorting or injecting kits, Naloxone (a type of overdose prevention drug like Narcan), and resources for counseling and treatment as well as education on overdose and harm reduction strategies.
Daily locations are posted on their website.
Education is also a big part of harm reduction, said Khoury.
“Substance use is present.
It’s a problem that we would like to address in a mindful way, but we want to think of it as a health issue,” she said.
“We want to approach that person in a non-judgmental way, recognize that there are a lot of reasons why they might be in this space, in this moment, and then also be mindful that substance use does impact the broader community.”
Where did harm reduction originate and how is it evolving?
Harm reduction began during the HIV crisis in the 1980s, said harm reduction research professor Mary Ellen Mackesy-Amiti of the University of Illinois – Chicago.
European countries were the first to implement the principles in the early 1980s, and cities like New York and San Francisco picked up the practice in the years following.
While harm reduction started as education and resources for HIV prevention, the concept carries through to present-day substance use.
“It’s not just about getting people into recovery.
That’s not really the primary goal,” Mackesy-Amiti explained.
“They deserve to be able to protect their health and not die just because they’re using drugs,” Mackesy-Amiti explained.
Mackesy-Amiti’s current project works with harm reduction in rural communities in southern Illinois.
She said her research team is piloting resource drop boxes for those who don’t have access to brick-and-mortar harm reduction services.
Narcan, drug testing, and safe injecting and snorting kits through CDPH and other partner organizations are focused on immediate health care and survival.
The CDPH offers follow-up support for those seeking treatment or counseling through their Medication Assisted Recovery NOW (MAR NOW) program.
MAR NOW provides free, low-barrier access to recovery resources to anyone in Chicago regardless of insurance or ability to pay.
The program offers tele-health and at-home treatment options as well as transport to clinics and full care management.
Tanya Sorrell, Director of Rush University’s Substance Use Disorder Center of Excellence, said that harm reduction approaches fight the stigma surrounding drug use through a focus on personhood.
“When people may use drugs for whatever reason and in whatever way, they quickly may lose their personhood to the problem-hood that our society has deemed drug use, and they become numbers,” Sorrell explained.
“When we provide harm reduction, it reminds the person who’s using that they’re a person and that they have meaning.
image source from：https://www.chicagoreporter.com/chicagos-new-approach-to-preventing-overdoses/
