city confronts opioid epidemic

There were nearly 1,100 overdose deaths involving heroin, fentanyl or prescription pain medication in New York City last year — nearly double the number of traffic deaths and homicides combined. There were 223 overdose deaths in Manhattan in 2016, an increase of more than 50 percent over 2015. And there have been 162 opioid-related deaths citywide so far in 2017, up from 126 at the same point last year, according to the NYPD.

Prosecutors attribute the rise in overdoses to the increased prevalence of fentanyl, a synthetic opioid up to 50 times more powerful than heroin that is often mixed with heroin and counterfeit pills. Users are often unaware that they are buying fentanyl or fentanyl-laced drugs, which results in increased overdoses because the drug is so much more potent than heroin. Stephen Goldstein, chief assistant district attorney with the city’s Office of the Special Narcotics Prosecutor, said at a City Council hearing last week that the presence of fentanyl is likely to increase because it is cheap and easy to produce, boosting profits for distributors.

In March, Mayor Bill de Blasio announced a broad initiative to address the opioid problem with the goal of reducing overdose deaths by 35 percent over the next five years. The city will spend $38 million annually on the plan’s wide-ranging strategies, which include expanding access to addiction treatment, investing in laboratory testing and information sharing, and stepping up enforcement with an emphasis on targeting distribution networks.

Key to the city’s overdose death prevention strategy is the distribution of 100,000 kits of naloxone, a drug that can reverse the effects of an opioid overdose, to police officers, treatment centers, shelters and pharmacies. The NYPD plans to equip all 23,000 of its patrol officers with naloxone kits. The department currently has 13,000 naloxone kits and is working to outfit and train the rest of the patrol force.

Law enforcement officials said that the number of opioid-related fatalities would be even higher were it not for naloxone. In Staten Island, 35 overdose victims have been treated successfully with the drug so far in 2017, compared with 17 overdose deaths, according to Michael McMahon, the borough’s district attorney. “Without it, think of what our numbers would be,” McMahon said at last week’s Council hearing. “This year we would already be over 50, close to 60 deaths.”

“It’s really a game-changer,” he added. “It’s saving lives.”

Naloxone was administered by EMS 2100 times in Manhattan in 2016, according to the state Department of Health. It is less effective, however, in treating fentanyl overdoses.

The availability of prescription opioid pills is commonly cited as a source of rising addiction rates. According to the Office of the Special Narcotics Prosecutor, oxycodone prescriptions filled by New York City residents dropped by 4 percent in 2016 after steadily rising for many years, due in part to increased awareness on the part of medical professionals and regulatory changes at the state level. “This is really significant, because the majority of people who develop heroin addictions first become dependent on prescription pills,” Goldstein said. But despite the slight drop since 2015, the number of oxycodone prescriptions filled in the city last year was still more than double what it was 10 years ago.

The NYPD has responded to the crisis by forming new teams dedicated specifically to heroin, opioid and fentanyl enforcement. The department plans to add 64 new officers to work specifically on narcotics enforcement, 10 of whom will be stationed in Manhattan. “This will allow the NYPD to more effectively investigate, track and identify opioid usage patterns. The teams will work with the district attorney’s offices, special narcotics court and federal prosecutors to incarcerate dealers and their associates,” NYPD Chief of Detectives Robert Boyce said.

On March 29, prosecutors announced charges against 34 defendants, including individuals from all five boroughs, for their alleged involvement in a Brooklyn-based distribution ring that sold furanyl fentanyl, an analog of fentanyl that is often produced in China. Police said it was the first time they had encountered furanyl fentanyl in New York City. Furanyl fentanyl, due to its status as a relatively new arrival on the illegal drug market, is not a controlled substance under New York State law, but it was made illegal at the federal level in November 2016.