The Cook County Medical Examiner’s Office said Tuesday that the number of opioid deaths in Cook County last year is likely to set a new record, possibly reaching more than 2,000.

The office has already confirmed 1,599 opioid overdose deaths for 2022, and it expects 400 to 500 of its pending cases to be listed as opioid poisoning deaths as well. In 2021, the county will report a record 1,936 opioid overdoses.

As troubling as those numbers are, University of Illinois at Chicago researchers say the county may be seriously underreporting opioid deaths.

one discovery by UIC School of Public Health At least 633 hospital deaths were found from 2016 to 2019 that met criteria for opioid overdose, yet were not listed by the US Centers for Disease Control and Prevention.

Researchers found that fewer than 20% of hospital patients who showed signs of opioid overdose had autopsies performed by the medical examiner’s office.

“We’re missing anywhere between 6-8% on the low end within Cook County to as high as 15% because people are dying in hospital settings and they don’t meet the profile of your typical opioid use disorder person,” said Lee Friedman, an associate professor at UIC who led the study.

“That’s why they’re not being sent up [medical examiner], who will do the correct job of properly listing the death and filling out the death certificate. And that gets reported to the CDC,” he explained.

Friedman said opioid deaths in hospitals most commonly involve pharmaceuticals and people who are older or suffer from chronic health conditions.

Still, he acknowledged that fentanyl, 50 times more potent than heroin, is now at the heart of a protracted opioid crisis.

In Cook County, the number of fentanyl deaths has steadily increased, from 96 in 2015 to 1,690 in 2021. The drug now contributes to the vast majority of the county’s opioid deaths.

Fentanyl contributed to the death of 12-year-old Joel Watts, the youngest opioid overdose victim in the county last year.

Watts died on August 19 at his home in the Roseland neighborhood. Autopsy results determined that Watts had both ethanol and fentanyl in his system and ruled his death an accident.

The Illinois Department of Children and Family Services was called to investigate Watts’ family nine times between 2016 and 2022 following reports of abuse and neglect, including allegations of molestation.

According to a timeline provided by DCFS, Watts’ mother struggled with substance abuse and was referred to services on several occasions. After the boy’s death, several siblings were taken into protective custody.

One of his sisters started a GoFundMe page after the boy’s death, describing him as “full of life” who loved to cook, bake and dance.

In 2020 and 2021, when overdoses began to rise amid pandemic shutdowns, about 85% of reported deaths were linked to fentanyl, according to the medical examiner’s office. This number rose to about 91% last year, based on preliminary data.

Friedman said the drug war-style approach of focusing on supply and locking people up “has not proven to be effective.” They argued that there is a need for more treatment options and a wider embrace of existing solutions, such as more pharmacists doling out clean needles and more medical professionals dispensing drugs that reverse the effects of an overdose.

Friedman argued that those who want to address the opioid problem are “legally hindered from implementing many proven, effective harm-reduction strategies”.

Unlike in Canada and Europe, medical professionals here cannot help users quit by administering high-potency, regulated forms of street drugs in a controlled setting. Illinois also does not allow so-called safe injection sites where people can freely use illegal drugs and seek help.

State Representative LaShawn Ford, a West Side Democrat, introduced a bill last year to allow safe sites for drug use, but the measure has languished for months in the House Rules Committee.

Ford said he expected the bill to move forward during the current Lame-Duck session in Springfield.

Ford is one of a growing number of elected officials who want the opioid crisis treated as a health issue rather than a criminal justice issue.

Under the proposal, the Illinois Department of Human Services would create a “Harm Reduction Services License” that would be issued to injection sites.

Applicants must demonstrate that they have a “clean space”, adequate staff and safe injection supplies. Sites will need to provide first aid and monitoring for possible overdose.

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