Not so long ago, the drug plaguing the Illinois Valley was heroin. Prosecutors cursed it for spawning crime. Physicians lamented the overdoses. Families pleaded for help.

Recently, heroin use began to wane and that decline has continued into 2025. That would be good news, except that fentanyl is taking its place.

The La Salle County Coroner’s Office reported an uptick in overdoses in 2025, with a projected 15 deaths ascribed to drug abuse. The projected total would be two more than last year.

Coroner Rich Ploch is neither celebrating nor panicking. In 2022, there were a whopping 42 fatal overdoses, mostly from heroin, which gave La Salle County one of the five worst per capita rates in Illinois. It was a distinction Ploch wanted no part of.

Soon after reaching that unhappy milestone, however, the volume of overdoses slid by half. Ploch said we have hit a plateau and that this year’s uptick is a statistical deviation.

“We are still, I think, trending in a positive way,” Ploch said. “As I’ve said before: one overdose is always one overdose too many. That’s always tragic for not only the person and their family, but everybody. That affects the whole community.”

Luke Tomsha, executive director for The Perfectly Flawed Foundation, welcomed the decline in fatal overdoses but cautioned against drawing any conclusion that non-fatal overdoses are declining.

“We get multiple reports of reversals weekly across the counties we serve through our naloxone distribution program,” Tomsha said. “Many overdoses still occur but do not get reported through traditional systems like hospital emergency departments and EMS.”

Behind the numbers

Toxicology results show most (though not all) Ploch’s cases were the result of deadly mixtures of drugs. His first case of the year was a 49-year-old male whose panel came back positive for cocaine, methadone and fentanyl. Increasingly, “fentanyl” is an umbrella term for a host of hazardous drugs.

“We’re still seeing some of the fentanyl derivatives,” he said, “such as acetyl fentanyl and norfentanyl and even some of the carfentanil, which is a horse and cattle tranquilizer. And we are still seeing some of the Xylazine, which is another veterinarian-type tranquilizer.”

More worrisome to Ploch is the fact that street drugs are laced with some or all of these products. There is evidence to suggest that overdose victims might have been unaware of all they were ingesting.

Declining Heroin

All those interviewed agreed that heroin use has diminished, but also yielded market share to other drugs of abuse.

“Heroin has been on the decline for years in place of shorter-acting but more potent opioids (fentanyl, carfentanil) that are easier to conceal and often cut with animal tranquilizers (xylanzine, medetomadine) to prolong the effects,” Tomsha said. “This escalation of potency is called the ‘Iron law of prohibition,’ much like we saw during alcohol prohibition. The harder we squeeze, the more potent and dangerous substances become.

“People didn’t stop drinking, but they switched from beer to spirits and competition and violence amongst organized crime increased because the market existed.”

Ploch credits the decline in heroin to a combination of better education, pinpoint law enforcement and the availability of naloxone, better known by the brand name Narcan.

Support groups have supported the purchase of naloxone at schools and workplaces, which in turn have kept some overdose victims out of Ploch’s office. Naloxone shows up in toxicology results, which shows that while it isn’t always effective, it is at least available in emergency situations.

That explains a modest decline in Bureau County’s numbers. Coroner Kurt Workman said he had three fatal overdoses (two confirmed, one suspected) through Dec. 26.

“I will attribute the slight decrease to the accessibility to Narcan in helping avoid opioid deaths,” Workman said.

Workman said his figures have been “fairly consistent” the past few years: there were four fatal ODs in 2024 and 2023, and five in 2022.

Tomsha confirmed that naloxone has reduced mortality.

“Widespread access to naloxone, specifically to those in active use has been a key strategy that has prevented a lot of fatalities.

A middle-aged issue

In 2025, the average age of an overdose victim was 43 in La Salle County. That’s been a stable figure in recent years.

Ploch speculated that the prevalence of fatal overdoses in the middle years may be attributable to financial pressures and unemployment, though he welcomes additional research to flesh out causes more fully.

“I wish I could dig into that a little bit deeper to help understand that,” Ploch said. “I’d like to talk to some of the support groups and see if they had some input on that.”

An unregulated player

While Ploch isn’t seeing it regularly, Kratom is an Asian product derived from a plant. It is not currently deemed a controlled substance but is instead termed a cautionary product because of a still-emerging understanding of its effects.

“We have had, unfortunately, an overdose each year for the last three years now from that product. Currently, in Illinois, you have to be over 18 to obtain it. Some municipalities and some that do have local things can actually ban it from sale altogether.”

Ploch said he’s had preliminary discussions with local law enforcement agencies about imposing municipal bans on the product. He’s also watching the Illinois General Assembly to see if lawmakers limit its availability, say by increasing the minimum age for purchase to 21.

While it mimics heroin’s effects, albeit with less potency, Ploch warns, “you can overdose from it.”

“Unfortunately, your body receptors will become numb to it and you need to take more to get the same effects.”