Monroe County Department of Public Health reports a 43 percent drop in overdose deaths in 2024 marking the lowest total since 2020

Monroe County, New York – Monroe County is reporting a dramatic drop in drug overdose deaths, marking one of the most hopeful shifts in years for a community that has been deeply affected by the opioid crisis. According to the latest figures from the Monroe County Office of the Medical Examiner, the county recorded 292 overdose fatalities in 2024, down from 512 in 2023. That represents a decline of 43 percent—placing the total at its lowest level since 2020.

The improvement stands out not only locally but nationally. Federal data from the Centers for Disease Control and Prevention indicates overdose deaths across the United States fell by nearly 27 percent last year. By comparison, Monroe County’s 43 percent reduction is even more striking, suggesting that county-led programs, community partnerships, and sustained outreach efforts are having a measurable effect.

“Each life cut short by drug overdose is a tragedy, and every life saved matters,” said Monroe County Executive Adam Bello. “This report shows that our prevention and harm-reduction efforts are making a difference. The Monroe County Addiction Services IMPACT team is connecting people to care, reducing stigma around treatment, expanding naloxone access and warning about the dangers in today’s illicit drug supply. These numbers demonstrate progress is possible when we work together, and we are committed to building on this success.”

Signs of Progress, But a Crisis Still Unfolding

While the new numbers point toward progress, health officials caution that the drug epidemic is far from over. The county’s Public Health Commissioner, Dr. Marielena Vélez de Brown, welcomed the decline but stressed that deep inequities remain in who the crisis affects.

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“The drop in overdose deaths is encouraging, but this crisis isn’t over. It continues to disproportionately affect communities of color and people living in poverty,” Dr. Vélez de Brown said. “With the County Executive’s support, and the work of our Addiction Services IMPACT team and community partners, we will keep ensuring naloxone, test strips and treatment reach the people who need them most.”

The latest report reveals not only fewer deaths, but also shifting drug trends. Cocaine now plays a more central role in overdose cases than in past years. In 2024, it appeared in 82.5 percent of deaths, surpassing opioids as the most frequently identified substance. Two-thirds of those cases involved both cocaine and opioids, while 66 deaths were attributed to cocaine alone.

Despite the gains, fentanyl continues to cast a long shadow. It was found in nearly three-quarters of overdose cases. Experts note that fentanyl and its chemical cousins—known as fentanyl analogs—remain difficult to monitor because their formulations are constantly changing. These substances are designed to skirt regulation and often evade standard toxicology screenings. In response, Monroe County is collaborating with a national toxicology lab to keep up with the evolving landscape of novel psychoactive substances.

A Closer Look at the Numbers

The county’s Medical Examiner documented several important trends in the 2024 report:

• Opioid-related deaths were cut in half. A total of 216 deaths involved heroin, fentanyl, or fentanyl analogs. That’s a significant reduction from 433 the year before.
• Polydrug use remains widespread. More than 70 percent of cases involved at least two substances, most commonly a combination of opioids, cocaine, and alcohol.
• Xylazine is becoming a bigger concern. Once rare, the veterinary sedative showed up in 26 percent of overdose cases last year, continuing a steady rise since 2021.
• Demographic shifts highlight both gains and challenges. The percentage of overdose deaths among Black residents dropped from 39.6 percent in 2023 to 31.2 percent in 2024. That reduction is encouraging, but still disproportionate compared to their 16.5 percent share of the county’s population. At the same time, overdose deaths among Hispanic residents rose from 10.4 percent to 14 percent—again exceeding their representation in the broader community.
• Men continue to be hit hardest. Nearly three-quarters of those who died were male, and while overdoses span every age group, the median age of victims has climbed to 52, up sharply from 38 just six years ago.

Taken together, these findings show both progress and persistent danger. While fewer people are dying, the types of substances involved are shifting, requiring constant vigilance from health officials and local providers.

County Leadership Pushes Lifesaving Measures

Monroe County’s response has been multi-pronged, with County Executive Bello prioritizing overdose prevention since taking office. He has overseen the creation of an opioid settlement trust fund, ensuring that money recovered from lawsuits against drug manufacturers and distributors is directed solely toward prevention, treatment, and recovery efforts. He also spearheaded the Opioid Fatality Review Initiative, which brings together experts from multiple fields to analyze individual cases of overdose, identify gaps, and adjust strategies accordingly.

On the ground, the county has expanded both its infrastructure and public messaging campaigns:

• Hotline support. A 24-hour crisis line—(585) 753-5300—now offers immediate help, including harm reduction supplies and support for families.
• Nalox Boxes. More than 630 emergency naloxone kits have been installed in public locations across Monroe County. Later this year, the boxes will also provide fentanyl and xylazine test strips to help users detect dangerous contaminants.
• IMPACT team. The county’s Addiction Services IMPACT team provides round-the-clock outreach, post-overdose follow-ups, harm reduction education, and distribution of supplies. In the last year alone, they handed out more than 33,800 naloxone kits and nearly 25,000 test strips.
• Public awareness campaigns. Efforts like “Stop the Stigma. Start the Conversation” are challenging misconceptions about substance use disorder and encouraging individuals to seek help without shame. Campaigns also highlight the state’s Good Samaritan Law, which protects people who call 911 during an overdose emergency.

These initiatives are rooted in the understanding that addiction is not a moral failing but a medical condition—one that can be treated and managed with the right tools, resources, and community support.

National Implications

Monroe County’s experience could serve as a model for other regions grappling with similar challenges. The combination of local government leadership, community-based outreach, data-driven strategies, and harm reduction measures appears to be moving the needle in a meaningful way.

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While nationwide overdose deaths are trending downward, experts warn that gains can be fragile. New synthetic drugs, shifting usage patterns, and lingering social inequalities all have the potential to reverse progress. That’s why local officials emphasize the importance of sustaining momentum and continuing to invest in prevention.

As Bello noted, the numbers are not just statistics—they represent people whose lives were saved and families spared from grief. For those on the front lines of this crisis, the decline is both a validation of hard work and a reminder that the fight is ongoing.

Looking Ahead

The county plans to continue building on its progress. By fall 2025, naloxone distribution points will double as testing hubs for fentanyl and xylazine, an effort aimed at empowering individuals to make safer decisions. Public health officials also intend to expand partnerships with schools, workplaces, and neighborhood groups to ensure resources reach every corner of the community.

At the same time, addressing the racial and economic disparities in overdose deaths remains a priority. While Black residents saw some relief in 2024, the increase among Hispanic residents signals the need for targeted outreach and culturally informed strategies. Officials acknowledge that stigma, poverty, and limited access to healthcare still pose significant barriers.

The message from county leaders is clear: lives are being saved, but there is still much work to do.

Addiction, or substance use disorder, is a treatable medical condition. Recovery is possible, but it requires compassion, persistence, and broad community involvement. For those seeking help or information about treatment, naloxone, or test strips, resources remain available at monroecounty.gov/addiction or through the hotline at (585) 753-5300.