New York is getting a long-awaited reprieve from its overdose crisis, with deaths falling by nearly a third in the last year. But persistent racial disparities and expected federal funding cuts for substance use disorder programs could threaten the state’s progress.
Overdose deaths statewide dropped from 6,688 in 2023 to 4,567 in 2024, according to new provisional data published by the U.S. Centers for Disease Control and Prevention. The decline marks the second year in a row that deaths have declined following years of worsening overdose rates, consistent with nationwide overdose trends.
But state health officials have struggled to reduce overdoses among Black New Yorkers, who experienced the highest unintentional overdose rate of any racial or ethnic group in the first half of 2024, according to state data that is set to be presented to the opioid settlement fund advisory board on Thursday. The unintentional overdose rate, which tracks accidental overdoses, among Black New Yorkers was 48.1 per 100,000 people – more than double the rate among white New Yorkers, the data shows.
Potential funding cuts to Medicaid and federal substance use programs could reverse gains, experts say.
“There is no doubt at this point that there are going to be cutbacks and an increased focus on law enforcement,” said Dr. Noa Krawczyk, associate director of the Center for Opioid Epidemiology and Policy at NYU Langone. “It would be completely devastating to the progress we’ve made.”
New York, like other parts of the country, saw overdoses skyrocket during the pandemic, as fentanyl became ubiquitous in the drug supply and individuals struggled to access prevention and treatment services. The state has attempted to reverse rising overdose deaths by widely distributing harm reduction tools such as the overdose-reversing medication naloxone and fentanyl test strips, and funding new programs with $400 million in opioid settlement dollars, which come from litigation with drug manufacturers and distributors.
House Republicans have proposed major cuts to Medicaid and the Essential Plan, a basic public health insurance option funded under the Affordable Care Act. Those cuts could kick 1.5 million people off their insurance, according to the governor’s office, taking away coverage for addiction treatment medications or behavioral health care, Krawczyk said. The pending Medicaid cuts add to a mass restructuring and layoffs in the U.S. Department of Health and Human Services, which oversees substance use disorder programming.
Looming cuts could perpetuate the racial disparities in overdose deaths. Black communities are still hit harder by the overdose crisis – a trend that’s perpetuated in part by “resting on our laurels,” said Tracie Gardner, a member of the state’s opioid settlement fund advisory board and executive director of the National Black Harm Reduction Network, a nonprofit that advocates to make harm reduction tools more accessible in communities of color.
The crude overdose rate decreased among Black New Yorkers in 2024, but disparities persist, said Danielle De Souza, a spokeswoman for the Department of Health. The persistent disparities indicate a need to provide more targeted programming to communities of color, Krawczyk said.
