CHICAGO — Overdose deaths kill more people in Chicago than gun violence and car crashes combined, officials have said. But a simple nasal spray, Narcan, can save lives by stopping overdoses.
How can someone get the potentially lifesaving aid? Walking into a city library, grabbing it and walking out with no questions asked is now an option.
The Chicago Department of Public Health stocks Narcan in 51 libraries across the city. The program will expand citywide by the end of the year, CDPH Commissioner Dr. Allison Arwady said.
The new effort makes the crucial medication accessible for all Chicagoans, including those who misuse potentially dangerous opioids.
“It’s a miracle, really,” said Legler Regional Library Director Shilo Jefferson as she pulled out a Narcan device, which looks and works like a basic allergy spray.
Jefferson’s library stocks the medication in a small, open box next to first aid supplies. Kits containing two Narcan devices fill the box. People can take them without having to share information.
Narcan distribution is just another way the library supports the West Garfield Park neighborhood, Jefferson said.
“We do way more things than books,” she said. “We are here to help people if they need help and we’re here to help them with no judgment.”
About 60 kits have been taken since the library became one of the first in Chicago to offer Narcan, a brand name for the generic medication naloxone, in January. The public health department refills the supply every week, Jefferson said.
Legler Library staff also gets training on how to use Narcan and keep some handy just in case. That preparation kicked in when a woman became nonresponsive recently before a nearby produce market. She had been sitting in a walker and was slumped over, not breathing.
“Then somebody ran inside to get the Narcan,” Jefferson said.
Jefferson said she administered two doses before paramedics arrived, and the medication resuscitated the woman before they got to the scene.
“It’s a very much needed program, especially in the neighborhood,” said Jefferson, who now keeps Narcan in her purse. “Addiction is a real illness. I think this program is helping people.”
Overdose deaths have risen across the country and in Chicago as fentanyl, a powerful opioid prescribed to treat severe pain, is increasingly sold illegally and laced in other illicit drugs.
Eight hundred fifty-five people overdosed on opioids and died in 2019, and there were 1,303 fatalities in 2020, according to the city’s Department of Public Health.
“I believe that is because people don’t have access to Narcan,” said Daphne Smith, a department administrator overseeing the effort to get the medication into libraries.
Smith lost her daughter to a fentanyl overdose three years ago. She wants to stop other parents from having to go through such tragedy.
“If I knew about Narcan, she may still be here,” Smith said. “I want people to have this. I don’t want you to always have to use it, but if you need it, I want you to have access.”
The program she helps lead has trained around 300library staffers in overdose prevention and distributed nearly 800 Narcan kits across the city by the end of August.
The miraculous “opioid antagonist” medication overpowers opioids by binding to receptors in the body where opioids had previously been attached, said Dr. Wilnise Jasmin, the CDPH’s behavioral health medical director.
“Anyone can walk in and grab Narcan. It could be because of your personal use … but it also could be in case you encounter someone else whether you know them or if they’re a stranger,” Jasmin said.
A statewide standing order allows pharmacies to give naloxone to anyone requesting the medication, without a direct prescription, and bill their insurers.
State law allows anyone to administer it to someone experiencing an overdose without liability, and also allows people to seek emergency medical help for an overdose without risking criminal liability for illegal drug possession.
The CDPH works with local groups to target outreach, Narcan distribution and offers of addiction treatment in areas hardest hit by overdoses. That includes the “heroin corridor,” Smith said, a 10-block area near Garfield Park where Ledger Library is located.
A few key signs can signal an overdose. An overdosing person may appear drowsy, be breathing slowly or be making a gurgling sound, Jasmin said. People with darker complexions may take on an ashen or blue color, while people with lighter skin often turn red, Smith said.
If someone is unresponsive, you can grind your knuckles on their breast bones to try to wake them up, experts said, and if that doesn’t work, it’s time to call 911.
The next part — administering Narcan — is easy, they said. The nasal spray works like Flonase or other over-the-counter drugs: insert the tip into the person’s nose and push down the plunger, which causes the medication to spray. Each Narcan device holds two doses, and the second dose should be administered two to three minutes after the first if the person isn’t responding.
“It’s a very simple tool. Very hard to use in the wrong way, no side effects to using it. But it does everything to save someone’s life if they’re overdosing on opioids,” Jasmin said.
While opioid overdoses kill Black and Latino men in poor areas at the highest rate, they have affected every community area in Chicago. Jasmin wants to see Narcan become as common as CPR kits or fire extinguishers.
Smith hopes that the accessible Narcan in libraries helps reduce the potential for overdosing.
“The fact of the matter is that drug usage is not going anywhere,” she said.
Some librarians worry about someone coming in and taking all of the Narcan. Smith tells them to put the medication out and let them.
“If they take 10, I don’t care. I’ll get you 25. I’ll get you as much as you need,” she said. “Just take it.”
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