During last year’s third quarter (July–September), 498 people died from overdoses in New York City — the lowest in the past five years, according to new preliminary data from the New York City Department of Health and Mental Hygiene (DOHMH). Mayor Eric Adams’s administration points toward investments in harm reduction and recovery services as the reason why, and Adams announced $4 million in total contracts with nine opioid treatment providers.
“While overdose deaths in New York City show signs of continued decline, we must keep our foot on the gas pedal to continue to save more lives,” said DOHMH Acting Commissioner Dr. Michelle Morse in a statement. “The New York City Department of Health and Mental Hygiene remains committed to investing in equitable access to harm reduction, treatment, and services that will not only keep our neighbors alive but help them thrive. Using these dollars to support evidence-based interventions through trusted community partners will allow us to reach more New Yorkers and keep people engaged in these lifesaving services.”
Advocates echoed Morse’s comments about needing to build on the positive downward trend in overdose deaths. However, recent federal Medicaid cuts and increased enforcement by the NYPD’s new Quality of Life division pose new challenges for the city to maintain recent progress.
“The Medicaid cuts will be devastating to our ability to continue to downward turn the overdose crisis,” said Jasmine Budnella, VOCAL-NY director of drug policy. “Medicaid is the single largest payer of substance use disorder treatment. People will lose access to their methadone and buprenorphine, which inevitably will be harmful if people return to use — their tolerance is so low and the drug supply is so messed up right now and unstable that the risk of overdoses surging will … happen.”
President Donald Trump’s One Big Beautiful Bill is likely to cost around 1.5 million New Yorkers their medical insurance. Budnella said that while the Republican-led federal government is certainly to blame, the state’s democratic leadership is not helpless. “We need to raise revenue to not only make sure we don’t have [cuts to Medicaid but also] that we can actually address the issues that have long been neglected,” she said.
On the municipal level, the city has increased criminal enforcement against quality of life issues like drug use, which traditionally increases overdose deaths. Notably, a recent crackdown against a so-called “open air drug market” kicked off in the South Bronx’s bustling Hub. Budnella said everyone deserves to feel safe but believes that more services like a drop-in center rather than “police theater” is the solution.
“The increasing of policing on people is not going to decrease public drug use,” said Budnella. “It’s not going to decrease overdose deaths, and the impact will have the opposite effect, so the mayor, for us to continue to bring down overdose death, needs to look at the holistic aspects of the overdose crisis.”
Both the city and state sued pharmaceutical companies in the late 2010s, resulting in massive opioid settlements to fund addiction prevention and treatment. Through such payouts, the city pays for programs like syringe service providers and street outreach teams.
“While we saw the number of overdose deaths decline very slightly in 2023 and in the data we have for 2024, we continue to lose too many New Yorkers to overdose,” said a DOHMH spokesperson by email. “The recent draconian federal cuts will have a damaging ripple effect on the health care and social safety net systems in place that support many people with substance use disorders.
“The Health Department’s job is to keep New Yorkers alive and connected to the dignified, evidence-based care and resources they need, and we will continue to prioritize these lifesaving resources no matter what.”
DOHMH currently funds 14 syringe service providers like VOCAL-NY at 21 sites, which assist roughly 22,000 people a year. The organizations offer access to safer drug use, the life-saving medication naloxone, and hepatitis C and HIV testing. The health department also directly operates Relay, an emergency response unit tasked with connecting clients to service providers.
Questions remain about how helpful the most recent city data can be toward overdose prevention efforts, due to the time passed. Toni Smith, Drug Policy Alliance director of New York State, said better and faster data continues to dominate the conversation during opioid settlement advisory board meetings. The need also applies to the city level.
“It’s not groundbreaking because the state has already announced that there have been declines across the state,” said Smith, “but this is helpful to begin to contextualize what that means for New York City. Also, these are provisional numbers, and so those are obviously still subject to changes as more data becomes available and is backfilled.
“Also, the provisional data does not give us a granular look into how the reductions are distributed across the city … One of the ongoing concerns has been that underneath the big headlines in the reduction of overdose death, we know that overdose deaths are not coming down equitably across the state,” Smith added.
While the downward trend from 2024’s third quarter is certainly good news, Smith said much remains left to chance for where the right resources are being deployed, due to a lack of real-time data for where the “crisis is most acute.”
This past May, the state reported a 32% drop in reported overdose deaths in 2024 compared to 2023. The New York State Department of Health boasts more than 1,300 opioid registered programs spread throughout 5,000 sites statewide.
Black and Brown New Yorkers face some of the highest rates of overdose death, along with New Yorkers living in low-income neighborhoods and those between the ages 55 and 64, according to the DOHMH.
Centers for Disease Control and Prevention epidemiologic research shows a general overdose death decline in Bronx County since 2022, but sharp racial disparities persist. White, non-Hispanic residents faced higher overdose rates than Black residents in 2022, but that changed in 2023, despite a steady decline in Black overdoses as well. Still, such decreases are a promising sign.
“Perhaps deaths are beginning to come down among Black and Latino people in New York City,” said Smith. “If that’s the case, that is what we are looking for to see as a trend. However, as we brace for federal funding cuts and as the city is ramping up criminalization, we know that the first people who are going to be hurt and hurt the most are Black New Yorkers.”
Overdose deaths increased during the COVID-19 pandemic and peaked during 2022’s fourth quarter, when 859 people died. Hotspots throughout the Bronx and in parts of Upper Manhattan, Central Brooklyn, and Staten Island face the highest rates per resident.
To be clear, opioid overdose deaths are largely preventable and opioid overdoses can be reversed by naloxone, the generic brand name for Narcan. The DOHMH said more than naloxone kits and 56,000 fentanyl test strips were distributed last year.
“For too long, opioid overdoses have ripped families and communities apart, but there is light on the horizon with opioid overdose deaths citywide seeing their lowest numbers in five years,” said Adams. “We are committed to maintaining this downward trend by continuing to invest in the programs and treatments that support those who are struggling. With smart investments, including those awarded through opioid settlement funds, we are making our city safer, healthier, and the best place to raise a family.”