The State of Opioid Abuse — How Bad Is It?

Deaths by overdose still going up in Rochester, year after year

By Deborah Jeanne Sergeant

Three years ago, area experts could only guess the effects of the pandemic on the area’s opioid abuse problem.

Early data recently released in a report by the Office of the Medical Examiner Monroe County show that the number of opioid-related deaths in Monroe County increased by 62% between 2019 (181) and 2021 (293).

The increase represents an upward trajectory from the previous several years, a trend that the report from the Office of the Medical Examiner Monroe County associated with fentanyl use.

“Fentanyl remains by far the most common opioid associated with overdose deaths,” the report said.

“Fentanyl and analogs were present in 97.6% of these opioid deaths in 2021. In contrast, the heroin and morphine prevalence continued a sharp decline from its peak in an earlier wave of the opioid crisis, from 42.3% in 2017 to 5.8% in 2021—having been superseded and largely replaced by the more potent fentanyl in recent years. Only four (1.4%) of the overdose deaths contained heroin and morphine in the absence of fentanyl, consistent with 2020.”

This is largely because those using drugs are now aware of the presence of fentanyl in any given dose. Its extreme potency contributes to accidental overdoses.

Ashley Tomassini, coalition coordinator for Substance Abuse Prevention Coalition of Ontario County and The Partnership for Ontario County, said that opioid use continues to be a big problem for the county, despite less airtime given to opioid use lately.

“The pandemic happened and it took a lot of people’s attention away from opioids,” Tomassini said. “Opioids are still an issue we’re looking to address. It’s a key part of our prevention strategies.”

These efforts include encouraging residents to monitor their supply of medication, secure them and dispose of them properly. Providing medication drop boxes and anonymous “take back” events in coordination with the Ontario County Sheriff’s Department has helped curtail the flow of legal medication into misuse.

“We are reducing the access,” Tomassini said.

She said that the Ontario County Sheriff’s Office has begun administering Sublocade (buprenorphine) to individuals who are incarcerated and have opioid or heroin use disorder. A monthly injection appears to help them remain abstinent from drugs.

“We continue to experience the worst overdose crisis in the history of the nation, which is devastating individuals, families and communities,” said Evan Frost, assistant director of communications and public information for the New York State Office of Addiction Services and Supports in Albany. “Fentanyl continues to be a major factor in overdoses and deaths in New York state. In 2021, the vast majority of overdoses involved synthetic opioids like fentanyl. The main danger from fentanyl is that it is often added to a substance without the user’s knowledge, which can substantially raise the risk of an overdose since the person using the substance has not built up a tolerance.”

Administering naloxone (such as Narcan) to counter the effects of an opioid overdose is saving lives. In 2020, emergency medical services in Monroe County administered naloxone 695 times, 623 in 2021 and through the third quarter of 2022 (the most recent data available), 409 times. Law enforcement personnel also administered naloxone 71 times through the same time period and the Registered Community Opioid Overdose Prevention program reported 393 events. Actual numbers may be higher, as not all events are reported.

Ontario County experienced a decrease in overdose deaths. In 2017, 30 died by overdose of an opioid, but by 2022, that number was halved. Just as with Monroe County, naloxone may indicate part of the reason why. Emergency medical services administered the life-saving medication 76 times in 2020, 69 times in 2021 and 21 times by the end of the third quarter in 2022, the most recent data available. Law enforcement personnel also administered naloxone 45 times through the same time period and the Registered Community Opioid Overdose Prevention program reported 27 events. Actual numbers may be higher, as not all events are reported.

Statewide, the introduction of telehealth and mobile treatment in recent years has helped reach people who may otherwise not have accessed services.

“These initiatives have allowed us to meet people where they are and deliver individualized, person-centered services to meet their needs,” Frost said. “We are also collaborating with the office of Mental Health on efforts to treat co-occurring substance use and mental health disorders, including through certified community behavioral health clinics, which provide an array of coordinated services to address substance use and/or mental health, and crisis stabilization centers, which provide support, assistance and urgent access to care for individuals experiencing a crisis situation related to substance use and/or a mental health condition. We plan to build on these efforts in the coming year.”

Frost said that OASAS will continue with street level outreach teams, outreach and engagement services, shelter in-reach programs and ensuring providers have access to naloxone and fentanyl test strips. The strips can help a person using opioids know if fentanyl is present.

“Other harm reduction programming is included in these efforts,” he added.

OASAS also plans to “improve treatment equity. Historically, addiction treatment has not been as available to minority communities,” Frost said.

On Feb. 8 this year, New York state announced it will make available to 18 providers statewide $8.6 million to develop integrated outpatient treatment initiatives targeting opioid use. The money comes from a more than $2 billion fund received from settlements with opioid manufacturers. Some of the fund will be distributed to municipalities and the rest to support opioid programs.

The New York State Department of Health recently reported that in 2021 statewide:

4,766 overdose deaths involving opioids, a 14% increase over 2020.

10,430 outpatient emergency department visits due to opioid overdoses, a 12.6% increase over 2020.

19,139 instances of naloxone being administered by emergency medical services, an 11.8% increase over 2020.

Anyone struggling with addiction or a family member can call the HOPEline 24/7 at 1-877-8-HOPENY (1-877-846-7369) or by texting HOPENY (Short Code 467369).

NYS OASAS treatment availability dashboard at FindAddictionTreatment.ny.gov or through the NYS OASAS website, www.oasasd.ny.gov, lists treatment options.

Anyone struggling to file a claim or who has been denied a claim can contact the CHAMP helpline at 888-614-5400 or ombuds@oasas.ny.gov.

Number of Opioid-Related Deaths in Monroe County

Year – Number of Deaths

2014 – 81

2015 – 69

2016 – 169

2017 – 220

2018 – 195

2019 – 181

2020 – 238

2021 – 293

Number of Opioid-Related Deaths in Ontario County

Year – Number of Deaths

2014 – 10

2015 – 7

2016 – 17

2017 – 30

2018 – 14

2019 – 16

2020 – 2

2021 – 15

In 2021, there were 6,037 overdose deaths in New York State. This is an increase of approximately 101% since 2015.