Chicago Mayor Rahm Emanuel, Cook County President Toni Preckwinkle and DuPage County Chairman Dan Cronin today announced that they have sent a letter to leaders of the medical community urging bold action to stop the rampant over-prescribing and abuse of pharmaceutical opioids, a class of highly addictive narcotic painkillers. Specifically, the letter calls on medical groups to adopt a policy limiting opioid prescribing to no more than seven days for acute pain.

“Opioid abuse, addiction and overdose have ravaged families and communities in Chicago and across the nation,” said Mayor Emanuel. “From preventing deceptive marketing by pharmaceutical companies to eliminating the over-prescription of opioids to ensuring adequate addiction treatment resources, we all must play a role to effectively address this crisis.”

“Our Health and Hospitals System and Medical Examiner’s office see, on a daily basis, the destruction of lives caused by opiate overuse and abuse,” said President Preckwinkle. “That is why we are joining with Mayor Emanuel and Chairman Cronin in urging these important healthcare associations to support reasonable restrictions on the prescriptions of opioids.”

“Today’s heroin crisis knows no boundaries,” said Chairman Cronin. “Families from urban, suburban and rural areas have lost loved ones to this terrible scourge. As leaders, as parents, and as citizens we have to use every means possible, including common-sense prescribing policies, to break heroin’s deadly grip here in Illinois.”

The letter, sent to the American Medical Association, American Dental Association and American Pharmacists Association, asks that the medical groups do more to act on the recommendation to combat the over-prescribing of opioids contained in a recent Centers for Disease Control and Prevention (CDC) Guideline for Prescribing Opioids for Chronic Pain (Opioid Guideline). The guideline states that, “when opioids are used for acute pain, clinicians should prescribe the lowest effective dose of immediate-release opioids and should prescribe no greater quantity than needed for the expected duration of pain severe enough to require opioids. Three days or less will often be sufficient; more than seven days will rarely be needed.” In addition to adopting policies limiting opioid prescriptions for acute pain, the letter asks the medical groups to make the Opioid Guideline a top priority across all sections of the associations, from policy makers to academic physicians to medical students.

The over-prescribing of pharmaceutical opioids is a well-established fact. The sale of prescription opioids in the United States rose four-fold between 1999 and 2010 even though Americans were not reporting more pain. Also since 1999, prescription opioid deaths have quadrupled, and heroin deaths have risen even more. Further, a 2014 study in the journal JAMA Psychiatry found that nationally, 75 percent of people who recently began using heroin actually initiated with opioid painkillers.

Under Mayor Emanuel’s leadership, the City of Chicago has undertaken numerous efforts to fight opioid abuse and protect residents from deceptive marketing of prescription drugs. The Mayor’s 2018 budget proposal includes an additional $500,000 to invest in Medication Assisted Treatment (MAT) and recovery homes, evidence-based practices helping Chicago residents working to overcome addictions to opioids; the additional investment will allow an additional 500 people access treatment next year. In September, it was announced that more than 1,000 Pharmaceutical Representatives have obtained a Regulated Business License that has been required since July 1, 2017 as a result of a Mayoral initiative that has enacted the country’s toughest regulations on pharmaceutical representatives. The licensing fee has freed up $700,000 that will help provide opioid addiction treatment to an estimated 1,000 Chicago residents. Under one of the requirements of this new license, Chicago became the first City in the nation to require the disclosure of interactions between pharmaceutical representatives and health care professionals on opioids and other controlled substances.

Further, the City’s recent $250,000 investment in naloxone, a life-saving medication that stops an opioid overdose, contributed to 1,544 overdose reversals in the past year. In addition, Chicago Recovery Alliance has distributed more than 4,500 naloxone kits thanks to a City investment.

In 2016, the City announced a landmark agreement with Pfizer, Inc., that commits the company to strict standards for the marketing and promotion of prescription opioids. As part of the agreement, Pfizer committed to fairly and accurately disclose the risks of opioids in its promotional activities and external communications, including through its sales representatives who promote drugs directly to doctors. In 2014, the City of Chicago was the first city to file a lawsuit against leading opioid manufacturers alleging that these firms knowingly misrepresented the benefits of opioids and concealed the serious addiction risks associated with their usage, specifically targeting the elderly and veterans, and made false promises that opioids were unlikely to be addictive and would help improve patients’ function and quality of life. Since the lawsuit was filed, the City has defeated repeated attempts by the well-resourced defense teams representing the pharmaceutical companies to have the suit dismissed. Chicago’s case is the only one in the country that is in the discovery portion of the suit.

In addition, the Chicago Police Department is conducting a pilot program that diverts low-level drug offenders to treatment in lieu of an arrest and criminal record. The City is also developing a community education effort privately funded at $350,000 by Pfizer, CVS and Walgreens.

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