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Fatal opioid and cocaine overdoses on the rise in Monroe County

Deborah Leach the Addiction Services Outreach Supervisor for Monroe County stocks Naloxone at Nick's Super Stone on Monroe Ave. in Rochester. The store is in a high opioid use area and one of the business that provides the community access to the counties free Naloxone to reverse the deadly effects of opioids.
Max Schulte
Monroe County has installed naloxone distribution boxes in businesses and public places to help prevent people dying from opioid overdoses.

Monroe County saw a record-breaking number of opioid overdose deaths in 2022, a grim trend laid out in a report released Thursday by the county Medical Examiner’s Office.

Opioid overdoses killed 346 people last year, an almost 14% increase over 2021, according to the report. That year, 293 people died from opioid overdoses — the previous annual record.

County officials noted another troubling trend developing alongside the opioid crisis: a spiking rate of cocaine overdose deaths. Of last year’s fatal overdoses, 253 involved both opioids and cocaine, while 60 overdose deaths were attributed to cocaine without the presence of opioids.

So far this year, there have been 82 deaths attributed to cocaine without opioids, though the county cautions that those numbers are unconfirmed and likely represent an undercount because of the technicalities of testing for cocaine in the body.

A news release from the county Public Health Department framed the rise in cocaine overdoses as reflecting “an overdose epidemic that goes beyond opioids.”

“Substance users often view cocaine as a safer alternative to fentanyl,” Dr. Michael Mendoza, the county’s public health commissioner, said in a statement. “In reality, it is not. Cocaine is now a major contributor to our overdose epidemic. It is commonly tainted with fentanyl, but street cocaine can be highly pure and deadly on its own.”

Monroe County is no outlier when it comes to cocaine overdose deaths. The Centers for Disease Control and Prevention has reported that nationally, cocaine overdoses have been on the rise since 2012 and that from 2020 to 2021, the number of fatal cocaine overdoses jumped 22% — or an additional 24,000 deaths.

In New York state, the number of fatal cocaine overdoses rose by 5% between June 2022 and June 2023, according to the CDC.

To account for the changing trends, the county is revamping its Opioid Overdose Dashboard to be an overall overdose dashboard. It will now display information on cocaine and opioid overdoses.

Mendoza said that while the number of opioid overdoses increased compared to last year, they rose at a lower rate than they had from 2020 to 2021. That, he added, is likely due to awareness campaigns, street outreach, and efforts to distribute more naloxone in the community.

Opioid overdoses still occur disproportionately among Black people, the report said. While Black people make up roughly 17% of the county’s population, 34% of the people who died from opioid overdoses were Black and 37% of the people who died from cocaine overdoses were Black.

Jeremy Moule is a deputy editor with WXXI News. He also covers Monroe County.