Sheila Haennicke was woken up around 2 AM on November 16, 2021, by an Oak Park policeman who informed her and her husband that their 29-year-old son was found unresponsive and his body was at Ascension Resurrection Hospital.
In the hours before, Sheila Haennicke’s son, David Haennicke, died of an accidental overdose on the CTA Blue Line at the Rosemont stop.
“For several months, I was pretty on edge,” Sheila Haennicke, who is a social worker, said to me on a Friday afternoon in late March. “I’d have to stop myself from wanting to run out the door at odd hours and get on the Blue Line and just start grabbing people and saying, ‘Don’t use, don’t use.’”
David Haennicke was found unconscious with a pulse by a CTA worker, but was pronounced dead by EMTs who arrived on the scene five minutes later, according to a Freedom of Information Act request Sheila Haennicke filed.
Sheila Haennicke, who stayed in contact with her son and met up with him “if he was ever in need of even cigarettes or food,” found that David Haennicke had Narcan in his pockets. Narcan is a brand name for the nasal spray version of the drug naloxone, which reverses opioid overdoses by binding to opioid receptors and aiding the recipient’s breathing.
In the months that passed, she “got more energy and decided to get more focused. I just thought, ‘Well, why not have Narcan on the train?’ If that worker who found David had been equipped with it, it’s possible he would have been revived. It’s not certain, but at least it would give a chance.”
In early 2023, Sheila Haennicke joined the West Side Heroin/Opioid Task Force and its CTA work group, which has specific goals like training and equipping CTA workers with naloxone and increasing the availability of naloxone on CTA platforms.
As the number of fatal opioid-involved overdoses in Illinois climbs higher each year, nonprofit social service groups across Chicago work tirelessly to slow the rising toll through harm reduction, a myriad of tactics proven to be effective in saving the lives of those using drugs.
Since 2017, annual numbers of accidental overdose deaths in Illinois have routinely exceeded the total number of homicides and traffic accident deaths, according to the Illinois Department of Transportation and the Centers for Disease Control and Prevention.
Still, when adjusting for inflation, state contributions to the Illinois Department of Human Services are hardly up from Illinois’s budget in 2000, according to the Center for Tax and Budget Accountability’s (CTBA) analysis of the proposed 2024 fiscal year budget.
David Haennicke’s death was just one of over 3,500 accidental opioid-involved overdose deaths that occurred in Illinois in 2021, according to the CDC. His death, along with those thousands of others, was preventable.
University of Illinois Chicago School of Public Health researchers Chibuzor Abasilim and Lee Friedman attest that the state’s official yearly number of opioid-involved accidental overdoses—a staggering 3,000-plus deaths in 2021—is still a hefty undercount.
They contributed to a first-of-its-kind paper, published last September, linking medical examiner data and hospital data to investigate nearly 5,000 opioid-involved deaths in Cook County that occurred from 2016 to 2019.
They found that older patients with more comorbidities were less likely to be sent in for an autopsy.
This hole in critical data has lasting repercussions, according to the UIC team, as autopsies are required to acquire a full toxicology report.
When accounting for prior undercount assumptions and the error range found in their Cook County study (as much as 15 percent), Friedman said, “[the amount of opioid-related deaths] is 50 percent higher than what our current estimate is, for a variety of reasons. It’s a big death toll right now.”
“We found older patients, patients with cancer comorbidities, who a lot of physicians are not thinking about,” Abasilim, the lead author, said. “We found that these patients are not being sent to the medical examiner. It isn’t clear why.”
“Not considering this patient means that when you’re making public health decisions, you’re not accounting for the fact that older patients may be more affected,” he said. “If you’re making a budget, you’re not thinking about the fact that you have to provide resources for these patients.”
Death toll is not the only consideration when it comes to budgeting for social services aimed at harm reduction.
Federally, the Substance Abuse and Mental Health Services Administration, partially responsible for funding the Illinois Department of Human Services, utilizes the National Survey on Drug Use and Health (NSDUH) to assess rates of use and see how “federal resources can be used efficiently for prevention and treatment programs,” according to the survey’s website.
“One of the limitations of national surveys—like NSDUH—is in capturing the totality of the care needs of patients who use substances like opioids,” said Danya Qato, director of graduate pharmaceutical health services research at the University of Maryland, Baltimore.
Dr. Ju Park, an assistant professor at Brown University and founder of the Harm Reduction Innovation Lab (HRIL), said that the NSDUH is often painting an incomplete picture of drug use in the U.S. for a complicated mess of reasons.
“Those estimates are very, I would say, wildly inaccurate and probably huge underestimations because drug use is so stigmatized,” Park said. “The way these surveys are conducted, they actually exclude huge numbers of people who probably have the highest rates of substance use.”
The NSDUH does not survey unhoused individuals, or folks who are in jail or incarcerated. Park also pointed out a lack of language options for the survey to be conducted, “so there are just many limitations to these surveys.”
Surveys also fail to present solutions. Park recently founded HRIL at Rhode Island Hospital with the goal of promoting the collective well-being of people who use drugs through research in key areas such as reception and strategy of harm reduction centers, technology for overdose detection, and development of pilot drug-checking programs in Rhode Island.
“We definitely need much more investment, not just in harm reduction and substance use treatment, but in public health and prevention broadly,” Park said.
That investment, many harm reduction advocates say, needs to extend to correctional facilities and jails. In Illinois, there is no access to medications for opioid use disorder (MOUD) within Illinois Department of Corrections facilities unless you are a pregnant woman entering the facility on MOUD.
It’s still a crime to possess hypodermic needles in Illinois (though it’s not policed as heavily as it was in prior years). According to the Chicago Police Department arrests database, the last time anyone was charged with such a crime was in August 2022. Simple possession of as little as 15 grams (or about half an ounce) of heroin can result in a minimum sentence of four years in jail.
Since the start of 2020, Chicago police have made over 200 arrests that charged possession of 15 grams of heroin, according to the CPD arrests database.
The rising number of deaths would be even higher if it were not for the work of the Chicago Recovery Alliance, Thresholds, various departments of health, and numerous other social service organizations determined to save lives.
A majority of those harm reduction services in Illinois are funded through the Substance Use Prevention and Recovery (SUPR) division of the Illinois Department of Human Services. SUPR receives the smallest share of the IDHS budget each year, and most of that money is from federal dollars.
The Reader reached out to SUPR for comment but the division was unable to respond before this article’s initial publication.
Source: Illinois Department of Human Services budget site Credit: Dilpreet Raju 
Source: Illinois Department of Human Services budget site Credit: Dilpreet Raju 
Source: Illinois Department of Human Services budget site Credit: Dilpreet Raju
“[State] spending priorities and their tax systems are the result of all the budgets that have come before it. All the decisions that have been made are built into that,” said Richard Auxier, senior policy associate at the Urban Institute. “There’s a starting point that prioritizes what to spend, how to spend it, how to allocate resources.”
Ralph Martire, executive director of the CTBA, said government spending increases each year “if you’re only looking at nominal dollars and you’re not adjusting for inflation.” He added, “But if you don’t adjust for inflation, you’re not comparing apples to apples.”
When adjusting for inflation for the coming 2024 fiscal year, Illinois has invested 4.5 percent more into the IDHS than the 2000 Illinois General Assembly did, the first bump in two decades.
“I mean, that’s not much of an increase if you think about it over time,” Martire said. “It’s less than 1 percent a year. It’s about 0.19 percent per year.”
Funding from each source does not hold equal weight in the eyes of program coordinators, who are some of the major officials working to implement more services toward those in need.
Metrics tied to federal grants are often “very frustrating,” according to one former program coordinator from the Cook County Department of Public Health who spoke under the condition of anonymity.
“If you’re not engaging people who smoke, you’re not going to be able to get them and stop them from overdosing and dying,” the former program coordinator said.
The Illinois Department of Public Health is managing a multiyear grant from the Substance Abuse and Mental Health Association, according to the Illinois Catalog of State Financial Assistance.
The SAMHSA grant prohibits anyone utilizing the grant from distributing naloxone to anyone besides police officers and first responders, which limits the scope of who is receiving doses of naloxone and who is receiving training.
As it currently stands with federal funds, you cannot buy safe smoking supplies or needles. However with Illinois dollars, harm reduction providers are afforded more discretion on how they can spend their money.
“You can never buy needles with federal funding,” said the former program coordinator. “Illinois is a pretty progressive state legislatively, so if you fall within the state guidelines, you’re allowed to purchase a fair amount of that stuff where other states wouldn’t allow you to.”
“If you’re not engaging people who smoke, you’re not going to be able to get them and stop them from overdosing and dying,” the former program coordinator said.
They said having a diversity of service options “means having different services available, not just needle exchanges. So if you don’t get money for that, you’re always going to have this huge gap in services . . . There’s been a lot of fuss made about how the Biden administration is more progressive, but they’re just talking and they’re not actually freeing up the money, which is what matters.”
Chicago Recovery Alliance—by way of its late founding executive director Dan Bigg—brought syringe exchanges and naloxone to the forefront of the harm reduction conversation. Today, they have nine full-time outreach workers.
John Werning, executive director of Chicago Recovery Alliance, said that while some rules are in place (like geographic restrictions) so that programming can be spread out evenly, the overall barriers that providers face when attempting to access funds can be enough to turn away folks interested in helping.
“Speaking very broadly on harm reduction, there needs to be lower barriers across the board, especially for midsized and smaller agencies. The application process can also be a huge barrier for a lot [of people], including myself,” Werning said.
Most grants are paid out on a reimbursement schedule, which further complicates how harm reduction organizations can budget their staffing, services, and supplies.
Dr. Thomas Huggett, a family doctor at Lawndale Christian Health Center, said that caring for patients experiencing substance use disorder has become more accessible as a result of the Affordable Care Act and the removal of the DEA waiver that was required for providers to prescribe MOUD drugs like buprenorphine, a popular drug used to help people ease feelings of cravings.
When I met with Huggett and Mr. Rankin (a peer recovery support volunteer) in June, Huggett said that before the removal of the waiver, “our options for people were limited so [we told them] ‘Well, go to detox. Go to meetings. Clean up.’ That type of thing. That’s what we used to say, I’m embarrassed to [admit].”
“As a family doc, I really wasn’t trained in that, how to work with folks with substance use disorder, and I was even saying wrong words like ‘substance abusers,’” Huggett added.
“There are a lot of people like Mr. Rankin who would love to do this type of thing but also need to have some way of paying the rent,” Huggett said. “Since we know from literature that peer support is really important, we should be paying more for that.”
In the past 60 days, as of June 23, Lawndale Christian had seen over 400 patients for MOUD services, and Huggett says there are officially 46 providers who can now prescribe buprenorphine. They are one of many health centers, along with Cook County Health, Heartland Alliance, and others, integrating MOUD services more regularly.
Huggett first met Rankin in 2017, when he was experiencing homelessness for about nine months and living in and out of shelters. Rankin works as a mechanic, is five years free of using, and volunteers with Lawndale Christian Health Center’s peer recovery team as part of his 12th step to recovery.
“I’m doing good, I got my own place. I stay up north. I’m three blocks away from North Avenue Beach,” Rankin said.
“You’ve got some people who are concerned, some people that aren’t concerned” with those struggling with substance use disorder, Rankin said.
Peer support and harm reduction social work, in general, have been proven to be effective in saving lives. So far, zero people have died at an overdose prevention site across the globe—the U.S. has two overdose prevention centers operating in New York City. Providence, Rhode Island is set to open one of their own next year. Meanwhile, Canada has nearly 40 safe consumption sites, as they’re also called.
Opening an overdose prevention site in Chicago is a primary goal of state representative La Shawn K. Ford, who said growing up around overdose allowed him to see that substance use disorder is a disease just like any other, not a moral failing.
“The number one harm reduction tool that’s available in the world are overdose prevention sites,” Ford said. “A space that’s a medical setting where people could actually get help. And actually stop using drugs and move to medicate them.”
Dr. Park’s HRIL in Providence, Rhode Island, is looking at how safe consumption sites are being established across the U.S. and how stigma plays a role in people’s aversion to having one in their city.
“It is a medical intervention and staffed by people who are trained,” Park said. “The idea is that this is a safe and welcoming space where people who use usually just don’t have anywhere else to go.”
“A popular misconception, or complaint, is that these spaces bring drug use or bring discarded syringes and trash on the street. But when you look at the evidence, it’s the opposite,” Park said. “These spaces are usually set up in places with high drug activity and the idea is that you bring all of the substances, the paraphernalia, indoors and so they have safe disposal.”
“We’ve been pushing for this for two legislative sessions,” Ford said, of getting an overdose prevention site off the ground. “The progress is educating the members of the general assembly.”
Ford said many members are worried about voting appeal to their respective constituencies.
“It’s not easy to quit, and so we need to have law enforcement and the community to see people with compassion,” he said.
“There are a lot of people like Mr. Rankin who would love to do this type of thing but also need to have some way of paying the rent,” Huggett said. “Since we know from literature that peer support is really important, we should be paying more for that.”
An overdose prevention site would also open the door to legally requiring the IDHS to have a dedicated number of staff on site, a requirement that currently IDHS is less privy to, as compared to police departments and school districts.
Even though “there is real demand for more employees to provide the social services that would satisfy our demographically-driven needs,” Martire said, the problem lies in pay. “Especially if you look at the pay associated with a number of these human services jobs, these social worker jobs.”
“We lost a lot of those employees during the Rauner administration when human services spending was significantly cut, and it’s difficult in a tight labor market to get folks back in here because the wage level for many of these jobs is somewhat depressed,” Martire said.
Sheila Haennicke still boards the CTA “almost daily” and can “hear this rushing sound as the trains come in and out” from the open windows of her Oak Park home in the summer.
Just over a year after David Haennicke’s death, she sent a letter to CTA leadership asking if the CTA is going to consider training and equipping employees with naloxone. Despite follow-up attempts in the months since, both personally and through her volunteer work at the West Side Heroin/Opioid Task Force, she has not heard back.
David Haennicke was a polysubstance consumer from age 15 until his death, something that rattled his mother, at first.
“What I realized was that if I couldn’t fix him, which was my driving motive—to try to save him—we would love him,” Sheila Haennicke said. “When it was freezing or he couldn’t get into shelters, we of course let him stay with us but we just were trying to help him stay alive and hopefully come to a point where he would accept help.”
This story was produced as part of the Reader Institute for Community Journalism’s Racial Justice Writers’ Room.
