The Bobby Buonauro Clinic gives out free Narcan, a lifesaving naloxone spray that treats opioid overdoses. (Photo by Duncan Agnew)

Nationwide, the opioid crisis has accelerated during the COVID-19 pandemic, killing more Americans than ever before. 

According to data collected by the Centers for Disease Control and Prevention, more than 100,000 drug overdose deaths occurred in the United States from April 2020 to April 2021, an increase of 28.5% from the number of fatal overdoses in the previous 12-month period.

The exponential rise in deaths during the pandemic means drug overdoses – especially from opiates like heroin and fentanyl – now kill more people in the U.S. annually than guns and motor vehicle crashes combined, according to statistics tracked by the CDC and The New York Times.

Evanston is far from immune to this disturbing upward trend. In 2019, the city reported 12 overdoses and one death, Evanston Police Commander Ryan Glew said. In 2021, Evanston had 43 overdoses and 14 deaths, according to Glew. Since 2017, opioids have caused at least 70% of drug overdoses in Evanston, based on data from toxicology reports.

For many doctors and drug abuse experts, this increase is troubling but not surprising, given the social disengagement and isolation caused by COVID-19. 

“People were at home isolating and excessively using substances due to the co-morbid depression and isolation from the pandemic,” said Dr. Laura Parise, an addiction psychiatry specialist for NorthShore University HealthSystem who runs its Chapman Psychiatric Center. “The disease of addiction is a disease of isolation. Not only are we isolating from the pandemic and the fear and anxiety surrounding the pandemic, but now you have people who have a tendency to use substances and isolate with those substances.” 

The local impact of the opioid crisis

Clinic founder Elizabeth Buonauro with her husband Bobby, the clinic’s namesake, before his death in 1999. (Photo via Facebook)

Elizabeth Buonauro has worked in drug abuse rehabilitation services in Chicago and Evanston for 28 years. Since August 2002, she has run the Bobby Buonauro Clinic, named after her late husband who also helped others struggling with addiction, out of the same location on Howard Street in Evanston, just around the corner from Amita Health Saint Francis Hospital.

Buonauro said the last year or so of COVID-19 “has been pretty extreme” for opioid overdoses and deaths in the greater Chicago area. Because in-person counseling has been limited during the pandemic, people with substance use disorders have had less access to effective treatment. 

“Especially when people are new to treatment, that first six months to a year is a hard time, and if something happens, they’re not quite stable, and they can easily fall through the cracks and become another statistic,” Buonauro said. “It really was a perfect storm for them.”

Described as “colorful” by Elizabeth Buonauro, the Bobby Buonauro Clinic is already decorated for St. Patrick’s Day. (Photo by Duncan Agnew)

Pandemic supply chain disruptions have also impacted the illegal drug trade, causing the market of opiates and other illicit substances in the Chicago region to become increasingly tainted with fentanyl – a synthetic opioid 100 times more potent than morphine and 50 times more potent than heroin. In August, The New York Times reported that six people died over a span of three days in Suffolk County, New York, after a batch of cocaine laced with fentanyl circulated through the area. 

According to Buonauro, people can access fentanyl and heroin easily and cheaply across the Chicagoland area, with drug dealers sometimes even hand-delivering orders to apartments and houses within minutes. That kind of ready supply of deadly opioids means early intervention and public awareness are key to minimizing the risk of overdoses and deaths, Buonauro and Parise said. 

And because fentanyl is such a powerful drug, people who overdose are requiring more and more Narcan – the emergency opioid-overdose naloxone drug that can be injected or sprayed into the nostrils – to survive. The Bobby Buonauro Clinic hands out free Narcan to anyone who needs it or wants to carry it with them just in case, and the Evanston Fire Department is “well trained in the deployment of Narcan,” Glew said. 

But despite increased awareness of the opioid epidemic and decreased stigma around addiction treatment in recent years, Buonauro said she still commonly sees problems like doctors running sham clinics to hand out opioid prescriptions for a profit.

“There are still so many doctors that are out there that are writing prescriptions for opiate drugs just to make money,” Buonauro said. “I know of several just in the Evanston area, where you can legitimately walk in the door and hand them $100, and they will write you a prescription for opiate drugs to this day. I find that shocking and appalling, but we see it all the time.”

According to Buonauro, treatment clinics and law enforcement agencies are able to report those doctors to the U.S. Drug Enforcement Agency, but the DEA is so overwhelmed with complaints that it can take months for them to get to each new report. 

Lifesaving treatments

Addiction often goes hand-in-hand with mental health disorders like anxiety and depression. The kind of isolation caused by the COVID-19 pandemic worsened the risk of severe depression, anxiety and addiction all at once, Parise said. 

As a result, both before and especially during the pandemic, developing sustained human connections and relationships is vital to a successful recovery, she said. 

“It’s so critical for people in recovery and trying to get treatment for their addiction to be connected with other people,” Parise said. “At the Chapman Center, we have managed, both through telehealth and a hybrid version of treatment, to strike that balance of connection with safety, but part of a recovery plan is ongoing connection with other people, whether it’s in a 12-step group or other myriad ways to attempt to maintain sobriety.”

Parise and Buonauro also both emphasized that they strongly believe in the effectiveness of medication-assisted treatment, which involves alleviating the effects of withdrawal for patients by administering a course of a different kind of opiate like methadone or Suboxone. According to Parise, those two medications work by binding to the same receptors in the brain as other opioids, but instead of activating an intense high, they can blunt people’s craving for stronger drugs like heroin and fentanyl. 

Research has shown that Suboxone can reduce the risk of a fatal overdose by up to 50%, Parise said.

“I’ve seen people who everyone had given up on, and I’ve seen them finally get clean [with medication-assisted treatment] and back to work and back to being a productive member of society,” Buonauro said. 

Ultimately, the Evanston Police and Fire departments, local addiction experts and treatment centers agree that improving access to medication-assisted treatment, making Narcan more widely available and intervening with early signs of addiction are key to reversing the upward trend in overdoses.

“There is help. If there’s anything we’ve learned in this pandemic, it’s that if we want help, we’re going to need to reach out for it,” Parise said. “Now more than ever, people are increasingly willing to attempt to destigmatize addiction and get support and get help.”

If you or a loved one is struggling with addiction, you can call the Substance Abuse and Mental Health Services Administration 24-hour helpline at 800-662-4357.

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Duncan Agnew

Duncan Agnew covers Evanston public schools, affordable housing, City Hall and more for the RoundTable. He also writes long-form investigations, features and the morning email newsletter three times a...