Monroe County Department Of Public Health Reports 43% Fewer Overdose Deaths In 2024

September 12th, 2025

Local decline exceeds 27% national decrease, lowest total since 2020

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New data from the Monroe County Office of the Medical Examiner shows a significant reduction in drug overdose deaths last year. According to the Medical Examiner's 2024 Overdose Deaths report, 292 individuals died last year from a drug-related overdose, a 43% decrease from the 512 deaths reported in 2023. This marks the lowest total within the county since 2020. Centers for Disease Control and Prevention data show overdose fatalities nationwide fell nearly 27% in 2024, making the county's 43% drop even more notable. The progress comes as Monroe County has made critical investments to increase access to naloxone and strengthened community education efforts about the dangers of drug use.

"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."

"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," said Commissioner of Public Health Dr. Marielena Vélez de Brown. "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."

Key findings from the 2024 report include:

• A shift toward cocaine-involved deaths: Cocaine was present in 82.5% of overdose death cases, surpassing opioids as the most common drug involved. Approximately two-thirds of cases involved both cocaine and opioids, while 66 deaths (22.6%) involved cocaine alone.

• Fentanyl remains a major driver: Fentanyl or fentanyl analogs were present in 72.9% of overdose deaths. Fentanyl analogs are part of a broader category of novel psychoactive substances (NPS) - compounds designed to mimic controlled substances while evading detection and regulation. Because their chemical structures change frequently, NPS are difficult to detect with standard toxicology tests, requiring laboratories to frequently update their methods to address current trends. In a handful of cases, the Medical Examiner suspects an unknown NPS may have been involved, but could not confirm this with currently available methods. To address this, the office is proactively working with a nationally-recognized toxicology lab to analyze suspected cases, identify potential NPS and support development of new testing methods.

• Opioid deaths cut in half: 216 deaths involved heroin/morphine, fentanyl or fentanyl analogs (or other NPS opioids), down 50% from 433 in 2023.

• Multiple drugs in most cases: 17.8% of individuals had opioids, cocaine and alcohol together and 70.5% had at least two of these three drug types in their system.

• Xylazine on the rise: The veterinary sedative Xylazine has appeared frequently in overdose deaths in the last few years. Rising notably in 2021, it appeared in 14.1 to 17.2% of overdose deaths between 2021 and 2023, and 26% of those from 2024.

• Disparities show progress and new challenges: The share of overdose deaths among Black or African-American residents declined from 39.6% in 2023 to 31.2% in 2024. This is a positive shift, though still nearly double their 16.5% representation in the general population. At the same time, disparities are worsening for Hispanic residents, whose share of overdose deaths rose from 10.4% to 14%, above their 10.1% share of the overall population of Monroe County.

• Men most affected: Nearly three-quarters (74.6%) of overdose victims were male. Ages of overdose victims ranged from under 20 to 97 years old, with a median age of 52, up from 38 in 2018, illustrating that overdoses affect people of all ages.

Addressing the opioid overdose crisis has been a top priority for Monroe County Executive Adam Bello. He spearheaded legislation to create a trust fund to ensure all dollars earmarked for the County from various opioid settlements will be used responsibly and exclusively for lifesaving efforts. Bello also created an Opioid Fatality Review Initiative, a multi-disciplinary team that reviews data related to specific overdose deaths in order to identify emerging trends and existing barriers to prevention. With his support, the Department of Public Health and Addiction Services staff have carried out several initiatives that are saving lives and supporting families, including:

• Established a 24-hour hotline, connecting residents to crisis services, delivery of harm reduction supplies and family support at (585) 753-5300.

• Installed more than 630 publicly accessible Nalox Boxes in locations across the county to increase access to naloxone. By the end of September 2025, test strips that detect the presence of fentanyl and xylazine will be available in all Nalox Boxes in indoor locations, encouraging individuals struggling with Substance Use Disorder (SUD) to test their supply for these potentially deadly adulterants. Find a box here: monroecounty.gov/health-narcan-map.

• Implemented the Addiction Services IMPACT Team, whose focus is countywide street-level outreach, crisis support, post-overdose response, harm reduction and community education. The team offers 24/7 services, 1:1 support for individuals who have experienced an overdose, customized trainings and events and harm reduction supplies. They are known for meeting the community where they are, working closely with community partners to identify trends and adapt responses as needed. Each year, the team has expanded its impact, connecting with hundreds of overdose survivors, education thousands of community members, and this year distributing 33,862 naloxone kits and 24,757 test strips since January 1, 2025.

• Launched a "Call to Action" media campaign aimed at improving public awareness of naloxone availability, highlighting the state's Good Samaritan Law, reducing stigma around SUD, urging those who use street drugs to test them for potentially deadly contaminants, and promoting the Monroe County Opioid Hotline as a resource for help and treatment. The campaign includes "Stop the Stigma. Start the Conversation" which challenges stereotypes about addiction and encourages open dialogue about treatment and recovery.

Addiction, or substance use disorder, is a medical condition. Treatment can help and recovery is possible. It's time to Stop the Stigma. Start the Conversation.

For information on treatment options, naloxone or test strips, visit monroecounty.gov/addiction or call (585) 753-5300 anytime.