CAPITAL REGION — A new state report shows that heroin and opioids killed scores of people in Capital Region counties in 2016.
The state Health Department's County Opioid Quarterly report, part of a new reporting system started last year, not only documented the deaths of nearly 2,000 people — outside New York City — from drug overdoses in 2016, but also showed that thousands of people were saved by the increased availability of the overdose reversal agent Narcan.
The report, which was released in January, provides a window on a widespread drug epidemic that has proven hard to get a handle on. The report includes, in some cases for the first time, county-level statistics that illustrate the growth of the opioid crisis in both fatal and non-fatal overdoses.
However, medical professionals and those who study addiction caution that the true narcotics death toll is almost certainly higher, with deaths sometimes attributed to other causes because of the stigma that clings to addiction and overdoses.
"There are many coroners and medical examiners who will say a person died, say, of heart disease when really the cause was an overdose," said state Sen. George A. Amedore, R-Rotterdam, co-chairman of the Joint State Senate Task Force on Heroin and Opioid Addiction.
The federal Centers for Disease Control estimates an average of 115 people per day died of overdoses nationwide between 2010 and 2016.
Schenectady County saw 29 overdose deaths in 2016, according to the Health Department report, up from a dozen deaths the year before. The county edged out Albany County for the most lives lost to either heroin or one of the synthetic opioids.
Previous stories in The Daily Gazette have recognized heroin's toll on Schenectady.
"These reports do not capture a true sense of the horror and ugliness of this epidemic," said Amedore, who has participated in hearings around the state, including one last week in Binghamton. "It is in every corner of every community in this state."
Albany County, which has a much larger population base than Schenectady County, saw 26 overdose deaths in 2016, a drop from 31 the year before.
Statewide outside New York City, there were 1,990 drug overdose deaths reported in 2016, up from 1,520 in 2015, according to the Health Department report. Across upstate, only Schuyler County saw no overdose deaths in 2016, and some counties — those that contain large cities like Buffalo, Rochester and Syracuse — saw more than 100 overdose deaths each.
The year-to-year jump in fatalities is in keeping with a trend among all New Yorkers — and particularly among residents classified as white — since 2010, according to the Health Department's annual opioid report, which was published in October.
"What we're seeing and hearing is that the opioid epidemic continues to ripple across the county — that unintended overdoses are coming in from every corner of the county," said Janine Stuchin, executive director of The Prevention Council, an education and recovery program in Saratoga Springs. "The availability of Narcan [naloxone] is vital."
Addiction is costly for communities, and addicts are behind many crimes, officials said. It is a problem federal and state officials wrestle with constantly.
The federal budget agreement includes $6 billion in new funds "to address mental health care and opioid substance abuse disorders through prevention, treatment and recovery programs," according to U.S. Sen. Charles E. Schumer, D-N.Y., the Senate minority leader.
The county-by-county breakdown of deaths, overdoses and naloxone uses is new information: Such reporting was one of the recommendations of Gov. Andrew M. Cuomo's Heroin and Opioid Task Force in 2016 and hadn't been done at the county level before.
Health Department officials said the statistics should be interpreted cautiously: Numbers for 2017 are incomplete because it often takes weeks for toxicology tests to determine whether an unknown cause of death was actually the result of an overdose, and other factors could contribute to any given death.
While the numbers show that heroin — with its known dangers — is killing more people than synthetic opioids, those opioids also kill people on a regular basis. There's consensus that many people who are prescribed opioids legally, end up switching to heroin after becoming addicted and having their prescriptions run out.
Of the 29 overdose deaths reported in Schenectady County, for example, 17 were caused by heroin and 10 by other opioids, which include drugs like Fentanyl, oxycodone and hydrocodone; there wasn't an explanation for the other two deaths listed as being due to overdose. There were 120 emergency room visits in Schenectady County for overdose treatment.
Fulton County, on the other hand, saw four overdose deaths: two each due to heroin and other opioids. Fulton County also saw 21 emergency room admissions for overdoses. Saratoga County reported eight overdose deaths, all due to other opioids, though heroin was a factor in two of those, according to the report. The county had 112 visits to emergency rooms for overdoses.
"It's about a half-dozen calls [for overdoses] a week at this point," said Mike McEvoy, Saratoga County's emergency medical services coordinator. "We're starting to see it level off after the summer of last year. Is is dropping off? No. Is that disconcerting? Yes."
The report also says naloxone was administered by authorized personnel or prevention programs more than 9,500 times across the state in 2016.
"The number of naloxone reversals is skyrocketing," Amedore said.
Naloxone, when administered quickly, can reverse an overdose, and police and medical personnel now frequently carry it. Drug addiction treatment programs have also made it available to family members of addicts.
'Heavy emotional toll'
While the state statistics don't count instances when the antidote is administered by a family member, McEvoy said using it — especially when the same person needs it repeatedly — takes a toll on EMTs.
In 2016, Saratoga County saw 159 uses of naloxone by EMTs, and 16 by law enforcement.
"I see it taking a heavy emotional toll on our police and ambulance and fire [personnel], and that's because it's frustrating and sometimes you go back again and again and again until one time you go and the person is dead," McEvoy said. "That's very devastating."
According to the report, Schenectady County in 2016 saw 242 uses of naloxone by EMTs (which in Schenectady includes firefighters), and six by law enforcement personnel.
But one official cautioned that not everyone given Narcan has overdosed.
"Narcan is a drug you use for an unconscious, unresponsive person," said Schenectady Assistant Fire Chief Michael Gillespie. "It's been one of the tools in the tool box for a long time. Have the numbers changed over time? Absolutely. Are they on the upswing? Yes, and I don't think it's stabilized yet."
Stuchin, at the Prevention Council, said there needs to be more availability of naloxone, and also the treatment programs for someone who may be motivated to quit after overdosing.
"Every time when we bring back a nearly fatal overdose is a chance to get them into treatment, but only if the treatment programs are there," she said.
Amedore said the Senate task force is probably going to make a report before the end of the state budget cycle, looking at the social services costs, health care costs, law enforcement costs, and what he said is the unappreciated cost in terms of lost workforce productivity. It is likely to have recommendations in all those areas, including increasing penalties for drug dealing when death is involved.
"We have to go after the drug dealers who are selling this poison on the streets," Amedore said, though he added that addiction treatment programs also need to be expanded.
"This is something we should not be afraid to talk about," he said. "We need the faith-based community involved. We need the business community involved. We need the private sector involved. We need the public sector involved."
By the numbers
deaths in 2016
|Opioid overdose-related outpatient
emergency room visits in 2016
|Times naloxone was administered
by EMS in 2016
|State (outside NYC)||1,990||6,675||7,028|