Bright Spots amidst Dark Trends in New York's Overdose Crisis

Ever wondered how a small shift in data could signal a turning point in a crisis? Join me, Jerry Gretzinger, on "Addiction the Next Step" as I sit down with OASAS Commissioner Dr. Chinazo Cunningham to unpack some promising news in the battle against overdose deaths. For the first time in five years, national figures are showing a decline—a beacon of hope in an ongoing struggle. Learn why this drop, though small, is significant and how it underscores the importance of continued vigilance in combating the deadly combination of fentanyl and xylosine in the drug supply.

But the conversation doesn’t stop there. Dr. Cunningham brings to light a troubling new trend: the rising fatalities linked to stimulants like cocaine and methamphetamine, particularly in New York. As we peel back the layers of this data, we discuss strategic approaches needed to tackle this emerging crisis within the broader context of substance abuse. This episode is a vital reminder that while progress is being made, our battle against overdose deaths is far from over. Tune in for an essential discussion on adapting our efforts to save lives in an ever-evolving landscape.

Transcript

Isabel Byon: 0:00

The New York State Office of Addiction Services and Supports, or OASAS, provides this podcast as a public service. Thoughts and opinions expressed do not necessarily represent or reflect those of the agency or state.

Jerry Gretzinger: 0:20

Hey everybody, Jerry Gretzinger, your host for Addiction: T he Next Step. Thanks for joining us for this episode of the podcast. And you know we're talking about something, we like sharing positive news, we like sharing good things, and this is a good thing. If you saw, recently there were some national figures that were released that talked about

Jerry Gretzinger: 0:37

a decline in overdose rates, overdose deaths nationwide, and it's the first time we've seen something like this in five years and

Jerry Gretzinger: 0:44

that is exactly the kind of news we like to report on. So we're going to get down into it a little bit here to kind of, you know, work out the good news and and see if you know, the job is over. Of course it's not, but we're going to talk about that with OASAS Commissioner, Dr. Chinazo Cunningham, thanks for sitting down with us again.

Dr. Chinazo Cunningham: 1:00

Absolutely Jerry.

Jerry Gretzinger: 1:01

And so, yeah, let's start with the positive. Here I mean good news. Any reduction that we see in this number is a great story to tell.

Dr. Chinazo Cunningham: 1:08

Yes, absolutely. So we know that the number of overdose deaths has been steadily increasing, really, you know, and we've seen that tremendously over the last five years and we've worked really hard to understand what was happening, you know, across New York State and to make sure that we were giving people the tools so that they could reduce their risk of overdose death. So you know, this is good news. As you said, the job is not anywhere near being done. I mean, we still have a lot of work to do and people are still dying of overdose death at, you know, a very high rate. But this is a good sign.

Jerry Gretzinger: 1:46

And we should should mention too. I mean, the information that was released by the CDC was provisional data, but it's all pointing in the right direction that we want to talk about and you know, we'll hope that the final tallies that come out tell a similar or even better story.

Dr. Chinazo Cunningham: 1:58

Yes, exactly.

Jerry Gretzinger: 1:59

And so you know, we talk about the job being far from over, certainly because a reduction is great, but we haven't eliminated it entirely, and really that's the end game we'd like to shoot for. But so where are we at, do you think, with the xylazine drug supply? I don't think that these reductions are suggesting it's any safer.

Dr. Chinazo Cunningham: 2:16

Right. So the reduction is pretty small. It's a 3% reduction across the country. But, as you mentioned, the direction, we're going in the right direction.

Dr. Chinazo Cunningham: 2:27

We we know is that the drug supply continues to be very deadly. We know that the drug supply has fentanyl, a very potent opioid, 50 times potent than heroin, and that still puts people at very high risk of overdosing and dying. We also know that xylozine, you know, which was never meant for human consumption, it's a veterinary sedative is also in the drug supply and also contributing to overdose deaths, and there's probably going to be more, you know, in the future. Who knows what's going to pop up. But we don't expect this to be the end of the story by any means, and so we are constantly monitoring the data to see if we see, you know, any sort of unusual activity or new substances that are sort of showing up, so that we can be prepared to make sure that the public is aware and then have the right tools to be able to address that. So you know, we definitely expect and are monitoring for, you know, continued changes that are constantly evolving in the drug supply.

Jerry Gretzinger: 3:31

We guess it's safe to say, like you know, maybe we could say we've turned the tide, but there are still waves on the way.

Dr. Chinazo Cunningham: 3:37

Absolutely.

Jerry Gretzinger: 3:37

Absolutely we have to prepare for those. So when we talk about areas of continuing concern or, you know, heightening concern, where would you say that is? .

Dr. Chinazo Cunningham: 3:46

Absolutely, so when we look more closely at the data, what we see is that actually the number of overdose deaths related to stimulants is continuing to increase. So stimulants like cocaine and methamphetamine really are driving that. In New York it's mostly cocaine and you know, I think in some ways that that hasn't served us so well because you know people who use stimulants may think that they're not affected by what's going on, but we know that fentanyl gets in, is in cocaine and in methamphetamine, and so we have to make sure that people who use stimulants know that they're at risk, know that fentanyl is really anywhere and in any substance and any counterfeit pill, and so they need to, you know, take the precautions that are necessary, access the naloxone and fentanyl test strips and xylosine test strips, and you know and just really understand that they are at risk.

Jerry Gretzinger: 4:55

Yeah, and that's part of the continued messaging on our part that I mean we have to keep doing to make sure people know and know the information to remain safe.

Dr. Chinazo Cunningham: 5:02

Absolutely.

Jerry Gretzinger: 5:03

As far as you talked about the test strips and the naloxone, I mean you know we'd like to think certainly there's been such a focus on getting these supplies out there that that is a part of any reduction that people don't know it's available, they know how to use it, but again, not that we want to stop sharing that information.

Dr. Chinazo Cunningham: 5:24

Right, and you know we've done a you of work to really make sure that the public is aware of fentanyl and that there are tools right and so on our OASAS website people can go on and can order naloxone, fentanyl test strips and xylosine test strips, and we know that there's a huge need and interest because we've shipped over 100,000 naloxone kits out to New Yorkers, along with nearly 16 million test strips for either fentanyl or xylosine. So that is available. People should continue to use those resources. That is available. People should continue to use that. You know those resources and you know we really believe that that has contributed definitely to this.

Dr. Chinazo Cunningham: 5:59

You know improvement that we're seeing because we know there's an immediate impact right, naloxone saves lives immediately, you know. So that's important. Those are harm reduction tools that are really important. And then, in addition, you know really expanding services in general across New York State so that people, you know, have more opportunities to be involved in prevention, programming, more access to treatment, particularly methadone and buprenorphine. We know those medications are very effective at reducing overdose death, you know, enhancing and supporting recovery as well. So really making sure that the whole continuum of services of, are available know, to all New Yorkers.

Jerry Gretzinger: 6:40

And you know we talk a lot about. You know the , availability and the naloxone, but, as you, as you point out, the other services making them accessible, and I think of mobile medication units, which continue to roll out across the state of New York. How much of a help that is.

Dr. Chinazo Cunningham: 6:57

Yeah. so you know really reaching people where they are. You know this is a principle of harm reduction and mobile medication units do that right, we literally bring treatment to where people are that might be in jails, that might be in prisons, that might be, you know, on the streets in, you know, at a homeless shelter, right. And so that is, you know, a very important tenant in guiding principle for us. And then you know really thinking about also how are we leveraging some of the changes in the federal regulations. So with COVID, you know, we had to change everything right Very, very quickly, and so there were these changes in regulations at the federal level that allowed us to really be more flexible with the way that we deliver treatment.

Dr. Chinazo Cunningham: 7:35

So, so now those regulatory changes have been made permanent and so we are really, you know, pushing and working with our programs to make sure that we're taking advantage of some OASAS those changes. And really, you know, providing flexible treatment, and so that looks like the mobile medication units, that looks like telehealth, right, and so then urban, rural areas of the state, you know, can access treatment through telehealth. You know that means more flexible dosing, particularly for methadone. That means more access to buprenorphine. So same day access. So there are a lot of you know efforts in place to both you know leverage those changes and the federal regulations and really bringing treatment to where people are.

Jerry Gretzinger: 8:24

So to eliminate some of those barriers that used to exist. OASAS N

Dr. Chinazo Cunningham: 8:26

Yes.,

Jerry Gretzinger: 8:27

so. yeah you I want to point out we talked about the resources available, people being able to order them. They are still available on our website. You go to oasas dot ny dot gov, right on the homepage. It'll give you a link to go and order those harm reduction supplies. And, as you say, commissioner, the work isn't finished, but it is nice to start seeing things move in a better direction.

Dr. Chinazo Cunningham: 8:47

Yes , yes. So we're very proud of that and we're continuing to move ahead and make sure that people are aware of what's happening, they have access to supplies that are lifesaving and then also to the services across the whole continuum.

Jerry Gretzinger: 8:59

Great Thanks good, for sitting good. with us today.

Dr. Chinazo Cunningham: 9:01

Great Yes thank good, you. .

Jerry Gretzinger: 9:02

Yes like having these positive things to talk about.

Jerry Gretzinger: 9:04

This is good this is good,

Dr. Chinazo Cunningham: 9:05

yes, we do.

Jerry Gretzinger: 9:05

We'll do more of this. Hey, thanks everybody for joining us for this episode of Addiction. The Next Step. I'm Jerry Gretzinger. We will talk to you and see you next time.