As Heroin Overdoses and Deaths Rise, Is More Legislative Action on the Horizon in New York?

June 2017

AUTHOR
Jim Malatras

As Heroin Overdoses and Deaths Rise, Is More Legislative Action on the Horizon in New York?

As the 2017 New York legislative session comes to a close, it was recently reported that the executive and legislature have been attempting to finalize another package to combat the growing opioid crisis. Over the past several years, including this year’s state budget, the state had adopted various programs, policies, and laws to combat the problem in New York.

Recently, the Rockefeller Institute of Government released The Growing Drug Epidemic in New York. Using federal Centers for Disease Control and Prevention data, the report found that drug deaths increased 71 percent from 2010-15 in New York. The report, in part, spurred additional activity from law enforcement and policymakers, especially in one specific area: heroin.

All across the country, governments continue to grapple with drug addiction, especially synthetic opioids and heroin, and in New York State opioid-related overdoses continue to rise. In 2013, the New York State Department of Health (DOH) found on average there were two deaths a day in New York from heroin overdoses.

Using recent provisional DOH data that has more specific information about synthetic opioid and heroin use in New York State reported by counties, there have been significant increases in opioid-related deaths in New York State. The data show that no area of the state is immune from the ravages of drug misuse and people living with addiction. Looking at indicators — including use of anti-overdose medication, hospitalizations, and even death — shows that New York is still grappling with this problem. And as the Rockefeller Institute of Government’s recent report pointed out, New York is hardly unique — this is a national problem though other areas of the nation face an even larger problem.

Overall, the data show that the state’s heroin problem is widespread, hitting different regions (e.g., rural/urban, upstate versus downstate). The number of outpatient emergency visits, hospitalizations, and death are up across the board because of heroin. The provisional DOH data show that heroin overdose deaths increased 54 percent, the number of outpatient emergency department visits increased 50 percent, and hospitalizations increased 13 percent.

Heroin Overdoses in New York State, 2014-15


	2014	2015	Percent Change
Deaths	454	698	54%
Outpatient Emergency Department Visits	2,162	3,240	50%
Hospitalizations	549	619	13%

Note: Data are provisional and may change. This is the latest data from DOH and should be interpreted as an early indicator.

Sources: 2015 data: New York State — County Opioid Quarterly Report published April, 2017 (Albany: NYS Department of Health, n.d.), https://www.health.ny.gov/statistics/opioid/data/pdf/nys_apr17.pdf. 2014 data: New York State — County Opioid Report: 2014 Supplement published October, 2016 (Albany: NYS Department of Health, n.d.), https://www.health.ny.gov/statistics/opioid/data/pdf/2014_opioid_report.

A note of caution on the DOH data. Given it’s provisional, the current numbers haven’t been finalized. Moreover, the DOH has previously stated that the numbers may be underreported so data from these quarters may change as the data become more complete. As the reporting systems and processes improve in some counties, the numbers could also change from year-to-year[2]. However, the DOH data does take an alarming snapshot of the current problem.

Just looking at the provisional data show that the problem crosses the entire state. In terms of crude death rate (i.e., the number of deaths for every 100,000 people within a county), Lewis County reported the most heroin deaths in 2015, followed by Sullivan, Allegany, Greene, Essex, Orange, Cayuga, Chenango, Suffolk, and Dutchess counties.

Snapshot of Provisional DOH Data of Heroin Death Rate by County, 2015


Lewis	14.8
Sullivan	13.4
Allegany	10.5
Greene	10.5
Essex	10.4
Orange	10.3
Cayuga	10.2
Chenango	10.2
Suffolk	9.1
Dutchess	9.1

Note: Data are provisional and may change. It is meant to illustrate that it is a statewide problem.

Source: New York State — County Opioid Quarterly Report published April, 2017 (Albany: NYS Department of Health, n.d.), https://www.health.ny.gov/statistics/opioid/data/pdf/nys_apr17.pdf.

For emergency department visits, Erie County has the highest rate, followed by Broome, Niagara, Onondaga, Schenectady, Oswego, Suffolk, Sullivan, Dutchess, and Chautauqua counties.

Snapshot of Provisional DOH Data of Rate of Emergency Department Visits from Heroin by County, 2015


Erie	78.4
Broome	65.1
Niagara	60.2
Onondaga	49.7
Schenectady	48.5
Oswego	38.3
Suffolk	37.0
Sullivan	36.1
Dutchess	35.5
Chautauqua	35.2

Note: Data are provisional and may change. It is meant to illustrate that it is a statewide problem.

Source: New York State — County Opioid Quarterly Report published April, 2017 (Albany: NYS Department of Health, n.d.), https://www.health.ny.gov/statistics/opioid/data/pdf/nys_apr17.pdf.

Moreover, there has been an increase in the administering of anti-overdose medication. Naloxone, also known by designer drug names, such as Narcan, is a medication that can reverse opioid overdoses, including heroin. It is an important way to prevent overdose deaths in that it reverses an overdose by blocking opioid receptors in the brain for up to 90 minutes.

In 2006, New York State expanded those able to administer the drug, specifically nonmedical individuals, to try to prevent drug overdose deaths. Per DOH data, for the latest years available, in one year alone there was a 45 percent increase in the number of times the anti-overdose drug was administered statewide. Outside of New York State the increase was 30 percent and in New York City the increase was 64 percent. While more individuals are getting life-saving treatments, the data appear to reinforce that overall there is an increase in heroin use.

Naloxone Administration by Region, 2015-16


	Total 2015	Total 2016	Change
New York State (excluding New York City)	7,017	9,157	30%
NYC	5,227	8,571	64%
NYS Total	12,244	17,728	45%

Note: Data are provisional and may change. It is meant to illustrate that it is a statewide problem.

Source: New York State — County Opioid Quarterly Report published April, 2017 (Albany: NYS Department of Health, n.d.), https://www.health.ny.gov/statistics/opioid/data/pdf/nys_apr17.pdf.

There is more work to be done to address the crisis and policymakers are undoubtedly focused on curtailing the epidemic. As a new legislative package may come together in the remaining days of the legislative session, it’s incumbent upon researchers to help focus on those strategies that are working and that can move the dial, including getting more accurate data for policymakers. Collectively, we still have work to do to help lawmakers find solutions and that is an effort that the health policy researchers at the Institute are undertaking now.

Appendix


County	Heroin Overdose Indicator	2014 Number	2014 Crude Rate	2015 Number	2015 Crude Rate

Albany	Deaths	7	2.3	16	5.2
	Outpatient emergency department visits	44	14.3	51	16.5
	Hospitalizations	9	2.9	12	3.9

Allegany	Deaths	0	0.0	5	10.5
	Outpatient emergency department visits	s	s	14	29.5
	Hospitalizations	s	s	s	s

Broome	Deaths	9	4.6	13	6.6
	Outpatient emergency department visits	95	48.1	128	65.1
	Hospitalizations	14	7.1	18	9.2

Cattaraugus	Deaths	0	0.0	2	2.6
	Outpatient emergency department visits	s	s	23	29.5
	Hospitalizations	0	0.0	s	s

Cayuga	Deaths	2	2.5	8	10.2
	Outpatient emergency department visits	18	22.8	24	30.7
	Hospitalizations	s	s	6	7.7

Chautauqua	Deaths	8	6.1	7	5.4
	Outpatient emergency department visits	33	25.0	46	35.2
	Hospitalizations	s	s	s	s

Chemung	Deaths	0	0.0	4	4.6
	Outpatient emergency department visits	7	8.0	17	19.5
	Hospitalizations	s	s	s	s

Chenango	Deaths	1	2.0	5	10.2
	Outpatient emergency department visits	7	14.2	15	30.7
	Hospitalizations	s	s	s	s

Clinton	Deaths	3	3.7	4	4.9
	Outpatient emergency department visits	s	s	s	s
	Hospitalizations	s	s	s	s

Columbia	Deaths	1	1.6	4	6.5
	Outpatient emergency department visits	11	17.7	10	16.3
	Hospitalizations	s	s	s	s

Cortland	Deaths	2	4.1	4	8.2
	Outpatient emergency department visits	8	16.3	14	28.9
	Hospitalizations	s	s	s	s

Delaware	Deaths	0	0.0	2	4.3
	Outpatient emergency department visits	8	17.2	s	s
	Hospitalizations	s	s	s	s

Dutchess	Deaths	19	6.4	27	9.1
	Outpatient emergency department visits	96	32.4	105	35.5
	Hospitalizations	12	4.0	19	6.4

Erie	Deaths	37	4.0	67	7.3
	Outpatient emergency department visits	278	30.1	723	78.4
	Hospitalizations	37	4.0	57	6.2

Essex	Deaths	0	0.0	4	10.4
	Outpatient emergency department visits	s	s	s	s
	Hospitalizations	0	0.0	0	0.0

Franklin	Deaths	0	0.0	0	0.0
	Outpatient emergency department visits	s	s	0	0.0
	Hospitalizations	s	s	0	0.0

Fulton	Deaths	0	0.0	3	5.6
	Outpatient emergency department visits	s	s	7	13.0
	Hospitalizations	0	0.0	s	s

Genesee	Deaths	0	0.0	4	6.8
	Outpatient emergency department visits	14	23.7	15	25.5
	Hospitalizations	s	s	s	s

Greene	Deaths	4	8.3	5	10.5
	Outpatient emergency department visits	10	20.8	15	31.5
	Hospitalizations	6	12.5	s	s

Hamilton	Deaths	0	0.0	0	0.0
	Outpatient emergency department visits	s	s	0	0.0
	Hospitalizations	s	s	0	0.0

Herkimer	Deaths	0	0.0	4	6.3
	Outpatient emergency department visits	10	15.7	8	12.7
	Hospitalizations	s	s	s	s

Jefferson	Deaths	5	4.2	5	4.3
	Outpatient emergency department visits	20	16.8	34	28.9
	Hospitalizations	s	s	s	s

Lewis	Deaths	0	0.0	4	14.8
	Outpatient emergency department visits	0	0.0	0	0.0
	Hospitalizations	0	0.0	s	s

Livingston	Deaths	0	0.0	1	1.5
	Outpatient emergency department visits	16	24.8	8	12.4
	Hospitalizations	s	s	s	s

Madison	Deaths	3	4.1	2	2.8
	Outpatient emergency department visits	26	35.9	24	33.4
	Hospitalizations	s	s	s	s

Monroe	Deaths	38	5.1	45	6.0
	Outpatient emergency department visits	203	27.1	167	22.3
	Hospitalizations	77	10.3	34	4.5

Montgomery	Deaths	0	0.0	2	4.0
	Outpatient emergency department visits	s	s	8	16.1
	Hospitalizations	s	s	6	12.1

Nassau	Deaths	51	3.8	71	5.2
	Outpatient emergency department visits	153	11.3	134	9.8
	Hospitalizations	87	6.4	65	4.8

Niagara	Deaths	9	4.2	13	6.1
	Outpatient emergency department visits	31	14.5	128	60.2
	Hospitalizations	7	3.3	10	4.7

Oneida	Deaths	21	9.0	16	6.9
	Outpatient emergency department visits	39	16.7	64	27.5
	Hospitalizations	15	6.4	22	9.5

Onondaga	Deaths	26	5.6	40	8.5
	Outpatient emergency department visits	126	26.9	233	49.7
	Hospitalizations	19	4.1	34	7.3

Ontario	Deaths	0	0.0	6	5.5
	Outpatient emergency department visits	42	38.3	20	18.3
	Hospitalizations	s	s	7	6.4

Orange	Deaths	37	9.8	39	10.3
	Outpatient emergency department visits	73	19.4	105	27.8
	Hospitalizations	23	6.1	31	8.2

Orleans	Deaths	0	0.0	1	2.4
	Outpatient emergency department visits	6	14.3	10	24.0
	Hospitalizations	0	0.0	s	s

Oswego	Deaths	2	1.7	9	7.5
	Outpatient emergency department visits	26	21.5	46	38.3
	Hospitalizations	s	s	s	s

Otsego	Deaths	2	3.3	2	3.3
	Outpatient emergency department visits	14	22.9	15	24.7
	Hospitalizations	s	s	s	s

Putnam	Deaths	4	4.0	5	5.0
	Outpatient emergency department visits	8	8.0	24	24.2
	Hospitalizations	s	s	s	s

Rensselaer	Deaths	1	0.6	9	5.6
	Outpatient emergency department visits	34	21.3	41	25.6
	Hospitalizations	s	s	6	3.7

Rockland	Deaths	6	1.9	12	3.7
	Outpatient emergency department visits	19	5.9	14	4.3
	Hospitalizations	7	2.2	11	3.4

St. Lawrence	Deaths	1	0.9	2	1.8
	Outpatient emergency department visits	13	11.7	11	9.9
	Hospitalizations	s	s	7	6.3

Saratoga	Deaths	6	2.7	8	3.5
	Outpatient emergency department visits	27	12.0	49	21.7
	Hospitalizations	8	3.6	s	s

Schenectady	Deaths	1	0.6	4	2.6
	Outpatient emergency department visits	31	19.9	75	48.5
	Hospitalizations	s	s	20	12.9

Schoharie	Deaths	0	0.0	0	0.0
	Outpatient emergency department visits	s	s	s	s
	Hospitalizations	s	s	s	s

Schuyler	Deaths	0	0.0	0	0.0
	Outpatient emergency department visits	0	0.0	s	s
	Hospitalizations	0	0.0	0	0.0

Seneca	Deaths	0	0.0	1	2.9
	Outpatient emergency department visits	6	17.2	s	s
	Hospitalizations	s	s	s	s

Steuben	Deaths	0	0.0	2	2.0
	Outpatient emergency department visits	6	6.1	6	6.1
	Hospitalizations	s	s	s	s

Suffolk	Deaths	98	6.5	137	9.1
	Outpatient emergency department visits	414	27.5	556	37.0
	Hospitalizations	108	7.2	124	8.3

Sullivan	Deaths	7	9.2	10	13.4
	Outpatient emergency department visits	16	21.1	27	36.1
	Hospitalizations	s	s	8	10.7

Tioga	Deaths	1	2.0	2	4.0
	Outpatient emergency department visits	11	22.1	8	16.2
	Hospitalizations	s	s	s	s

Tompkins	Deaths	4	3.8	3	2.9
	Outpatient emergency department visits	20	19.1	15	14.3
	Hospitalizations	9	8.6	s	s

Ulster	Deaths	6	3.3	15	8.3
	Outpatient emergency department visits	34	18.8	63	35.0
	Hospitalizations	7	3.9	9	5.0

Warren	Deaths	1	1.5	0	0.0
	Outpatient emergency department visits	s	s	9	13.9
	Hospitalizations	s	s	s	s

Washington	Deaths	0	0.0	1	1.6
	Outpatient emergency department visits	9	14.4	10	16.1
	Hospitalizations	s	s	s	s

Wayne	Deaths	0	0.0	0	0.0
	Outpatient emergency department visits	11	11.9	11	12.0
	Hospitalizations	s	s	s	s

Westchester	Deaths	31	3.2	41	4.2
	Outpatient emergency department visits	49	5.0	79	8.1
	Hospitalizations	18	1.9	37	3.8

Wyoming	Deaths	0	0.0	2	4.9
	Outpatient emergency department visits	s	s	s	s
	Hospitalizations	s	s	0	0.0

Yates	Deaths	0	0.0	0	0.0
	Outpatient emergency department visits	6	23.8	8	31.9
	Hospitalizations	0	0.0	0	0.0

Bronx (NYC)	Deaths	53	3.7
	Outpatient emergency department visits	79	5.5	87	6.0
	Hospitalizations	91	6.3	104	7.1

Kings (NYC)	Deaths	80	3.1
	Outpatient emergency department visits	142	5.4	161	6.1
	Hospitalizations	84	3.2	82	3.1

New York (NYC)	Deaths	51	3.1
	Outpatient emergency department visits	53	3.2	67	4.1
	Hospitalizations	70	4.3	69	4.2

Queens (NYC)	Deaths	49	2.1
	Outpatient emergency department visits	54	2.3	88	3.8
	Hospitalizations	37	1.6	57	2.4

Richmond (NYC)	Deaths	32	6.8
	Outpatient emergency department visits	71	15.0	84	17.7
	Hospitalizations	64	13.5	39	8.2

Note: Data are provisional and may change. This is the latest data from DOH and should be interpreted as an early indicator.

s: Data for indicators related to hospitalizations and emergency departments are suppressed for confidentiality purposes if there are less than six discharges (https://www.health.ny.gov/statistics/opioid/data/pdf/ros_jan17.pdf).

Source: New York State — County Opioid Quarterly Report Published April, 2017 (Albany: NYS Department of Health, n.d.), https://www.health.ny.gov/statistics/opioid/data/pdf/nys_apr17.pdf.

Notes

[1] I wish to thank Urska Klancnik, research scholar at the Rockefeller Institute, for her help and assistance with data collection for this post as well as Thomas Gais for his invaluable comments.

[2] For the limitations in the data, see New York State – County Opioid Quarterly Report For Counties Outside of New York City Published January, 2017 (Albany: NYS Department of Health, January 2017): 5-6, https://www.health.ny.gov/statistics/opioid/data/pdf/ros_jan17.pdf

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