The State of Opioid Abuse — How Bad Is It?

Deaths by overdose still going up year after year

By Deborah Jeanne Sergeant

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

As it turns out, the isolation and disruption contributed to higher use. However, the trend may soon slow.

“Over the last few years, we have been affected by the pandemic,” said Mariah Senecal-Reilly, coordinator of the mental health and substance use initiatives program with Onondaga County Health Department. “We’ve seen some increases in overdose fatalities and occurrences related to a number of factors like disruption of treatment, financial downturn and feelings of despair. We do have some tentative good news: this year, if we continue on the same path that we have been, it looks like our fatalities will have decreased for the first time in years.”

The uptick in overdose deaths in recent years is largely because those using drugs are unaware of the presence of fentanyl in any given dose. Its extreme potency contributes to accidental overdoses.

“Most everything has fentanyl in it,” Senecal-Reilly said. “We’re seeing it laced in methamphetamines, cocaine and counterfeit pills. About a month ago, spike, synthetic marijuana, was laced in that as well. Fentanyl is 100 times stronger than heroin and 50 times stronger than morphine. When someone’s not expecting, it they’re at a significant increased risk for an overdose.”

The department’s emphasis on prevention includes education in several school districts, teaching self-regulation and developing resiliency, which are proven to reduce substance abuse. Reducing harm represents another strategy, including case management for people at risk for overdosing and reducing barriers to accessing naloxone, which counteracts the effects of opioids during an overdose episode and fentanyl test strips. Peer services support those pursuing recovery.

“We’re planning on doing a real-time as possible overdose response,” Senecal-Reilly said. “We’re thinking this will be helpful to the vulnerable population. We’re expanding our funding to evidence-based prevention in schools.”

She views telemedicine as another tool for aiding in substance use recovery, especially for people with limited ability to participate in traditional settings. Oftentimes, stigma, transportation and employment and child or elder care obligations hamper patients’ ability to pursue treatment.

Eric A. Bresee, licensed mental health counselor and executive director of Farnham Family Services in Oswego, said that a greater emphasis on a medical model and education—and a shift away from scare tactics—has proven more effective in his field.

“The educational approach is a lot more respectful of people and where they’re at,” he said. “We’re treating people with respect and dignity and support them for achieving their true goals.”

He said that in Oswego County, opioid use has continued its steady increase since 2011, less changed by the pandemic then elsewhere. However, “alcohol use disorder rose significantly,” he said.

Access, legality and social norms all likely contribute to the increase in alcohol use compared with other substances.

Among the pandemic-influenced changes at work, home and society, “there were a lot of stressors involved and some folks turned to alcohol, and that’s why we saw those rates rise,” Bresee said.

Like Senecal-Reilly, he views telehealth as another tool for providers, but not a replacement for face-to-face care.

“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 & 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.

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 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 can call the HOPEline 24/7 at 1-877-8-HOPENY (1-877-846-7369) or text HOPENY (Short Code 467369).

Family members may also use these services.

NYS OASAS Treatment Availability Dashboard at or through the NYS OASAS website,, 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

Number of Opioid-Related Deaths in Oswego County

Year – Number of Deaths

2016 – 23

2017 – 18

2018 – 14

2019 – 31

2020 – 27

2021 – 35

Number of Opioid-Related Deaths in Onondaga County

Year – Number of Deaths

2016 – 128

2017 – 79

2018 – 78

2019 – 98

2020 – 134

2021 – 160

Through June 2022

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