In the central region of Illinois, the Champaign-Urbana Health District (CUHD) is giving out free naloxone to local restaurants, gas stations, hotels and other businesses. Hundreds of local businesses have already accepted kits containing the overdose-reversal medication this year.
The project, which began in 2019, currently gives out about 500 kits per month, according to organizers. Joe Trotter, a prevention specialist for CUHD, explained that they’re trying to take both a “broad” and “targeted” approach to distributing naloxone (brand name: Narcan)—making sure it gets into the hands of people who use drugs and their families, but also everywhere else. It’s informed by the reality that overdoses can happen anytime, anywhere.
“We brought on some additional staff and most of their time is spent going out into these locations and walking in and saying, ‘Hey, we have Narcan, do you guys want it?’” Trotter told Filter. “They’re not selling it, they’re not leaving it there if it’s unwanted—the idea is we need to raise awareness in the general public about overdoses.” Department staff also offer businesses training in how to administer the naloxone, spending up to 45 minutes teaching employees.
“Ninety percent of all places will take a kit.”
Asked which types of businesses have responded well to this effort, Trotter said, “Just about all of them. It’s rare we have someone who doesn’t want to take a kit of Narcan. Ninety percent of all places will take a kit.” Although CUHD does collect data on when it hears that its naloxone has been administered, it won’t always be reported, and Trotter described the current data as “unreliable.”
CUHD additionally runs a syringe service program in Champaign, which is where it first started distributing naloxone to local residents. As reported by the local News-Gazette, the health district receives state grant money to buy naloxone in bulk. It estimates that for the whole of 2022, it will spend about $400,000 on Narcan.
Getting harm reduction tools—like naloxone or fentanyl test strips—into the hands of local businesses from bars to libraries is a key strand of overdose prevention efforts. Drug use, however secretive, is happening in these locations. Health departments or independent harm reduction workers are giving naloxone to local businesses in jurisdictions throughout the country—including Kentucky, Iowa, New York City, San Francisco, Oregon and Delaware.
“Several” other Illinois health departments are also using the same model as CUHD, Trotter said. He explained that two changes at the state level made this work possible. The first was Illinois issuing a “Naloxone Standing Order” in 2017, which makes the drug accessible to anyone who wants it with no prescription needed. And then in 2019, the state provided grant money to counties to address opioid-involved overdoses.
“We want to make sure those areas that are more distant from an EMS can respond to an emergency a little faster.”
Although CUHD is Champaign County’s health department, it is also distributing naloxone in nine other surrounding counties. Many of these settings are more rural, with emergency response times slower than in the city. “If it’s a smaller town, maybe they have a gas station and a restaurant or a bar,” Trotter said. “We want to make sure those areas that are more distant from an EMS can respond to an emergency a little faster.”
Like much of the US, Illinois has been hit hard by the overdose crisis. State health data show that in 2020, nearly 3,000 residents died of an opioid-involved overdose—about eight people per day, and an increase of nearly 33 percent on 2019. There were over 3,500 total drug-related deaths in 2020. More recent data from the US Centers for Disease Control and Prevention (CDC) estimate over 3,800 overdose deaths in the state in 2021, a 7.4 percent increase on 2020. Synthetic opioids like fentanyl have been the primary factor in the increase since 2013.
Illinois law gives civil and criminal immunity to people who administer naloxone in a suspected overdose. According to a law passed in 2012, this immunity from criminal prosecution also applies to people who possess small amounts of drugs and seek emergency assistance for someone else. This includes up to 3 grams of heroin, cocaine or morphine. The law doesn’t specifically mention possession of fentanyl, however.
And while this “Good Samaritan” law can encourage people to call for help, Illinois’ “drug-induced homicide” statute has the opposite effect. This law creates a felony charge for “unlawfully delivering a controlled substance to another, and any person’s death is caused [by] that controlled substance.” In October 2021, a McHenry County judge rejected a Good Samaritan defense from a woman charged with drug-induced homicide.
Trotter acknowledged the state’s policies should be improved, but said that business owners should not be discouraged from having naloxone on hand. “We’re telling these agencies and people who take a kit, when you make a reasonable attempt to save someone’s life, you cannot be held liable for doing that. I would argue you’re more liable if you don’t do anything about it.”