Emerging signs of hope in Long Island's war against fatal overdoses

Fatal overdoses declined dramatically in Suffolk and Nassau between 2022 and 2023, according to public health data, mirroring a drop in drug deaths nationwide.

Public health experts, treatment providers, law enforcement officials and anti-opioid advocates familiar with Long Island's battle against the opioid crisis said there are several factors behind the drop in drug deaths — after significant increases during the COVID-19 pandemic. Perhaps the prime reason, they said, is the widespread availability of Narcan, the lifesaving nasal spray that reverses opioid overdoses.

While lauding the decline in fatalities, those experts said the scourge of opioid addiction that has claimed thousands of lives on Long Island since the late 1990s is hardly over.

"Two hundred people die every day in the United States [from fatal overdoses]," said Frank Tarentino, the special agent in charge of the U.S. Drug Enforcement Administration’s New York office.

"As good as it is to see a decline, the numbers are ridiculously high. Too many people are dying," he said.

Remaining vigilant

Fewer fatal overdoses does not mean a drop in the use of opioids, cocaine and other drugs, said Kurt Hall, director of operations for Hope House, a Port Jefferson-based treatment program. He said there is a shortage of beds in recovery facilities and that it's often difficult for drug users to access comprehensive care for mental health issues, which fuel substance abuse.

"Until there are no fatalities, we are still experiencing this epidemic," Hall said. "I am cautiously optimistic, but I don’t want to be too optimistic."

Educational campaigns are also convincing people to be more cautious about street drugs, according to the experts.

"People are still using, but are they being more careful? I hope so. I hope people are a little frightened to use recreational drugs," said activist Carole Trottere of Old Field, a member of Families in Support of Treatment (FIST) and Gabriel's Giving Tree, which helps families who have lost loved ones to overdose with burial expenses. Trottere began organizing Narcan training and distribution events after her son died in 2018 from an overdose. 

There were 463 fatal overdoses in Suffolk County last year, an 11.47% drop from the 524 reported in 2022, according to data from the county medical examiner’s office. Those figures represent a change in how the county reports overdose deaths. The Suffolk Medical Examiner now includes a wider range of drugs, which officials said provides a more comprehensive view than in the past.

Positive trends

Suffolk has the potential for an even bigger decline by the end of 2024; 164 fatal overdoses were reported in the county as of Aug. 1. Barring any catastrophic surges, Suffolk is on pace for roughly 281 drug deaths this year.

In 2023, 209 people in Nassau lost their lives to overdoses, according to information provided by New York State’s Offices of Addiction Services and Supports, also known as OASAS. That represents a 16.4% drop from the 250 in 2022.

Nassau County Executive Bruce Blakeman’s office wouldn't provide Newsday with data about fatal overdoses.

"I assume you had that all from your sources already," Blakeman spokesman Chris Boyle said in an email.

The downward trend in Nassau drug deaths, 62 reported this year through Sept. 17, also appears to be holding, according to data from the police department provided to the county’s Heroin Prevention Task Force and shared with Newsday.

Those numbers only reflect fatal overdoses reported to police and may not reflect the overall number of deaths.

Surge in pandemic fatal ODs

Many people struggling with depression, anxiety, loneliness and fear during the COVID-19 pandemic turned to alcohol and drugs to self-medicate, sparking a surge in fatal overdoses on Long Island and nationwide, public health and law enforcement officials said. People who had been in recovery, but because of COVID-19 restrictions were unable to attend 12-step meetings or therapy sessions, fell back into substance abuse, officials said.

The pandemic also disrupted the supply of drugs such as heroin and cocaine, law enforcement officials said, prompting dealers to cut their products with fentanyl. 

Fentanyl in lethal doses is now found not only in opioids such as heroin or counterfeit oxycodone, but also in cocaine and counterfeit Xanax and Adderall, as well as other bogus prescription drugs. Experts and activists refer to deaths from those drugs as poisonings, not overdoses. The cheap and deadly synthetic opioid is responsible for most of the fatal overdoses on Long Island in recent years.

"So many kids are dealing with anxiety and depression, and they may take something loaded with something that they weren’t expecting," said Nassau Legis. Delia DeRiggi-Whitton (D-Glen Cove), the legislature’s minority leader. "You shouldn’t take anything unless you got it from a pharmacy."

DeRiggi-Whitton said she requested $10,000 from the Blakeman administration to distribute fentanyl strips, which detect the presence of the synthetic opioid in drugs, allowing users to take steps to reduce risks, but was rejected. Boyle, Blakeman's spokesman, did not respond to a request to respond to DeRiggi-Whitton's allegation.

"We need to get Narcan kits out there," DeRiggi-Whitton said. "We need to get fentanyl strips out there." 

The nationwide COVID-19 surge in fatal overdoses appears to be somewhat abating, according to the Centers for Disease Control and Prevention. The CDC said there were an estimated 107,543 drug overdose deaths in the United States last year, a 3% drop from the 111,029 deaths estimated in 2022.

Reason for hope

That decline represents the first nationwide decrease since 2018, according to the CDC, and the numbers look even more promising for 2024: Overdose deaths dropped more than 10% between April 2023 and April 2024.

Within those statistics, said Jeff Reynolds, executive director of the Family & Children’s Association in Garden City, are glimpses of hope where there was previously despair.

"Twenty years into this, hope is a precious commodity," said Reynolds, whose organization provides treatment and support programs. "Each one of these numbers, each one of these percentage points that go down, represent families who will celebrate the holidays together."

The DEA and other law enforcement agencies, Tarentino said, have disrupted the flow of the precursor drugs necessary for manufacturing fentanyl.

The DEA and its partners also have cracked down on the international cartels that distribute fentanyl in the United States, he said, citing the August arrest of Mexico’s most wanted drug lord — alleged Sinaloa cartel leader Ismael "El Mayo" Zambada — in El Paso, Texas.

"We have disrupted the fentanyl supply chain," Tarentino said.

Perhaps the biggest reason for the decline, experts said, is the availability of naloxone, better known by its brand name, Narcan. Narcan was not widely available to the public until March 2023, when the U.S. Food and Drug Administration approved it for over-the-counter use.

Since then, it has become ubiquitous at Long Island’ schools, places of worship, bars, restaurants or anywhere else people congregate. Narcan is available on the cashier’s counter at many convenience stores and pharmacies, right next to the ChapStick and the chewing gum.

"People are using with friends and a lot of people are reviving each other," Hope House’s Hall said.

The availability of Narcan in turn amplified awareness about the dangers of fentanyl, said Allison Van Cott-McEntee, who founded the Play It Forward Project, a nonprofit that trains people to use the lifesaving drug, after her brother, Steven Robert Van Cott, died from an overdose in 2017.

Showing results

"A year ago, I would ask people what they knew about fentanyl, and many did not know what it was," said Van Cott-McEntee, who hosts a WUSB/90.1 FM radio show — also called "Play it Forward" — that addresses opioids and addiction. "There is more awareness, and Narcan is a huge factor."

Suffolk police Emergency Medical Services Officer Jason Byron has been conducting public Narcan training since 2015. Byron teamed up with Trottere in 2022 to offer quick demonstrations at events such as Alive by the Bay in Bay Shore and Alive After Five in Patchogue. He said he has distributed 7,354 doses of Narcan so far this year.

"In the past, we were dealing with a lot of people who were in denial that we have a fentanyl issue," Byron said. "People are more aware of opiates now and they want a Narcan kit. We encourage people to treat it like a fire extinguisher. It’s there if you need it, and we hope you won’t need it."

Reynolds said the decline in deaths by overdose may be because some drug users may have built up a high tolerance for opioids. Doses that might be fatal to newbies are not lethal to longtime users, he said.

The Family & Children’s Association chief said the drop in drug deaths provides "a golden moment" for public health experts, law enforcement officials, treatment providers and activists to figure out what works and doesn’t work — and allocate resources accordingly.

"We need to do whatever it takes," Reynolds said, "to end this crisis once and for all."