While Nassau and Suffolk Counties have a lot in common, such as traffic congestion and a high cost of living, there is one important difference. While Nassau County had one of the lowest rates of opioid and other drug overdose deaths in the state, Suffolk County’s rate was almost twice as high, according to Federal health data from 2021. Drug overdoses in Suffolk were higher per 100,000 residents compared to Nassau County, according to federal statistics.
In New York State, the counties with the most overdoses in 2021 were Sullivan, Dutchess, and Cayuga. Nassau County was among the sixth lowest, with Queens County being the lowest. Suffolk County ranked mid-way between Sullivan and Queens County, but nearly twice as high as Nassau, per the 2022 New York State Opioid Annual Report.
There is no question that federal and local officials were caught off guard the past decade as to the opioid epidemic, enabling a profit-driven quadrupling of opioid prescribing for a broad range of chronic pain conditions, typically reserved for cancer. It was not until 2017 that the U.S. Department of Health and Human Services (DHHS) officially declared that an opioid crisis was taking place in the U.S.
As a result of poor government oversight and substance abuse, hundreds of thousands of people have fatally overdosed on prescription opioids and millions more became addicted. Heroin markets became saturated with synthetics, including the more deadly and cheaper drug, fentanyl.
According to the Centers for Disease Control (CDC), pharmaceutical grade fentanyl is a synthetic opioid, approved for treating severe pain, typically with advanced cancer. It is 50 to 100 times more potent than morphine. Unfortunately, it can also be illegally diverted for misuse with catastrophic effect.
Illegally manufactured drugs containing fentanyl are sold through illegal drug markets, many operating out of Mexico or Central America. It is often mixed with heroin and/or cocaine, usually without the user’s knowledge, to increase its euphoric effects. The consequences can be deadly. In 2022, in Suffolk County, 78% of drug overdoses were fentanyl related.
Last May, to commemorate International Overdose Awareness Day, those mourning lives lost to drug addiction came together on Long Island to advocate for solutions. “Illicit fentanyl claims a life every eight and a half minutes,” said then-Suffolk County Legislator Kara Hahn (D-Setauket) at the gathering.
On Long Island, the fentanyl crisis has led to Narcan stations in bars, restaurants, and schools. While Narcan can prevent a fatal overdose, it does little to address the root of the problem: the wide availability of drugs and their lethality.
Nationally, there were six times more drug overdose deaths in 2021 than in 1999, according to CDC data. Since 1999, more than a million people in the U.S. have died of drug overdoses, per federal statistics.
Aggressive and misleading promotional campaigns by Purdue Pharma and other drug manufacturers spread misinformation that opioids were low risk, influencing medical education and ensuring less restrictive legislation through aggressive lobbying and campaign contributions. (see Painkillers, a docudrama on the causes and consequences of America’s opioid epidemic, available on Netflix).
In 2021, a batch of fentanyl-laced cocaine led to eight overdoses and six deaths on the North Fork and Shelter Island. “We’ve been telling folks who use drugs to assume there’s fentanyl in street drugs, because there is,” Dr. Jeffrey Reynolds, president and CEO of the Family and Children’s Association. “The biggest challenge right now is counterfeit pills designed to resemble Xanax and ADHD medications.”
After the North Fork bust, the Suffolk County District Attorney’s Office cited three crime rings that peddle Tranq, a non-opioid sedative that can be mixed with opioids like heroin, fentanyl, and cocaine to enhance their effects. However, most of those arrested were released almost immediately, a result of New York’s bail reform laws. “We stood by helplessly,” said Suffolk County DA Ray Tierney (R) at a press conference.
When contacted by email, Tierney released this statement: “I will continue to push for common sense changes in our laws to combat the opioid overdose crisis and save lives. Fentanyl is killing hundreds of our young people in Suffolk County ever year. We need a death by dealer law and the ability to ask for bail on those who deal deadly quantities of fentanyl.”
When reached by phone, Suffolk County Legislator Leslie Kennedy (R-Nesconset) reiterated DA Tierney’s concerns regarding Albany’s bail reform laws.
“We can’t be allowing dangerous people back into the community,” said Kennedy. “There is definitely more street level drug dealing taking place in Suffolk.”
There is some evidence elected officials have begun to take notice. Recent state-level policies have included stricter prescription drug monitoring and increased availability of naloxone (Narcan) to prevent overdoses. Medication-assisted therapy for treatment of substance abuse and overdose prevention has also increased.
The problem is not just one of criminal enforcement. The proliferation of anxiety and depression among young people post-COVID, a shortage of mental health programs, and supply chain issues with ADHD meds, have steered people to access low-level street dealers pushing counterfeit pills that are often contaminated with fentanyl. Mental health and drug abuse are strongly linked.
Additionally, beginning last January, Suffolk County began distributing $25 million in settlement funds from lawsuits against opioid manufacturers. The funds will be used to support drug treatment and prevention centers. Suffolk is expected to receive $200 million over the next 20 years.
Illegally manufactured drugs containing fentanyl are sold through illegal drug markets, with many operating out of Mexico or Central America. It is often mixed with heroin and/or cocaine as a combination product, usually without the user’s knowledge. The consequences can be, and often are, deadly.
Dr. Mark Solomon, Medical Director of the Acute Detox and Chemical
Dependency Unit at St. Charles Hospital, is also concerned about the illicit manufacture of synthetic marijuana, which can also be laced with fentanyl. Known on the street as K2, fentanyl-laced marijuana can be just as deadly as Heroin or cocaine.
The fentanyl crisis is not without political division. Many Republicans in Congress want stricter security to prevent the flow of drugs across the southern border. They are also demanding that on-line platforms do more to crack down on illegal fentanyl sales, including purchases on Snapchat, TikTok, and Instagram.
Many Democrats, however, believe that overdose deaths are part of a broader social problem, stemming from unemployment, economic decline, and mental health challenges. They further believe that focusing on drug interdiction does not address the root cause of these overdoses.
When asked about what addiction professionals really need, Dr. Solomon said he wants to see a comprehensive approach, beginning with targeted education of adolescents in schools.
“It’s fine to revive someone with Narcan, but we are still left with an individual with a very severe drug problem,” stated Dr. Solomon. And that person will need all the resources available to begin the long road back to sobriety. Dr. Solomon would also like to see a crackdown on internet sales, which find “loopholes” such as claiming a compound is “not fit for human consumption.”
“It feels like a race against time as the body count continues to rise and more families face the horror of losing a loved one to a preventable condition,” said Dr. Reynolds.
