Terrell Jones, a longtime resident of the Bronx, was pointing to the locations where overdoses occurred as he drove through the East Tremont neighborhood, the car passing small convenience stores, rowhouses and schools.
“This is sometimes where people are being found, in their houses, dead,” said Mr. Jones, 61, looking toward a housing project along 180th Street. “Especially in the South Bronx, you have so many people in housing who overdose. To actually sit there and witness this whole thing? You’re watching this person turn all different colors. You know what I’m saying?”
The dramatic rise in opioid-related deaths has devastated communities around the United States in recent years, and has stirred concern among law enforcement and public health officials alike in New York City.
PhotoTerrell Jones, left, and his colleagues at the New York Harm Reduction Educators hand out information about opioid deaths, offer free naloxone, and operate a syringe exchange program.Here, the reports about the epidemic and its ravages have mostly centered on Staten Island, where the rate of deaths per person is the highest of the five boroughs. But perhaps nowhere in the city has the trajectory of opioid addiction been as complex as in the Bronx, where overdose deaths were declining until a new surge began at the turn of the decade, and where more residents are lost to overdoses than anywhere else in the city. On Bronx streets, the epidemic’s devastation is next door, down the street, all around.
The increase in deaths — now at the highest levels since the city began collecting the data in 2000 — has been fueled by social forces that have left some Bronx residents especially vulnerable: a history of high drug use in the area; a growing supply of cheap heroin on the streets; and the proliferation of a deadly synthetic opioid, fentanyl.
Mr. Jones said he never leaves his apartment in Hunts Point without a dose of naloxone, a medication that can be used to reverse opioid overdoses. The antidote — whose brand name is Narcan — has become a necessary stopgap to prevent deaths that happen in public spaces. Mr. Jones, who has himself struggled with drug addiction in the past, now works with New York Harm Reduction Educators to help drug users.
“Regardless of how they died, it wasn’t an intentional death. Nobody woke up and said, ‘Today I want to die of an overdose,’” he said. “People have issues and reasons they’re using drugs, and it’s not for us to judge.”
PhotoThree hundred and eight Bronx residents died of drug overdoses in 2016. That’s more than double its 2010 total of 128.In 2016, 1,374 people died from overdoses in New York City, up from 937 in 2015, according to the New York City Office of Chief Medical Examiner. The vast majority of those lethal overdoses involved opioids, a drug classification comprising prescription painkillers like Oxycodone and Percocet, morphine, and the illegal street counterpart, heroin. An additional 344 overdose deaths were reported across the city from January to March of this year, according to preliminary data made available by the New York City Health Department.
More Bronx residents died of drug overdoses in 2016 than any other New York City borough — 308. That’s more than double the number in 2010, 128. Fatal overdoses in the borough are now at their highest rates since at least 2000, as far back as official data is available. Eighty-five percent of those deaths involved opioids, and about 76 percent involved heroin or fentanyl specifically.
Of the five neighborhoods with the highest opioid-related overdose rates in 2015 and 2016, four were in the Bronx — Hunts Point-Mott Haven, Crotona-Tremont, High Bridge-Morrisania and Fordham-Bronx Park — and one was in Staten Island, South Beach/Tottenville.
The crisis in the Bronx stems, at least in part, from a surge of opioids in a place where some residents have long struggled with addiction. Heroin has become much cheaper in recent years as the supply in the United States has grown, according to the Office of the Special Narcotics Prosecutor for the City of New York, and individuals with histories of drug abuse are particularly vulnerable to relapse amid a surge of cheap drugs. It has also become significantly more potent.
The cheaper, stronger heroin has been made even more dangerous by the proliferation of fentanyl, which is 50 times more powerful than heroin. Interviews with nearly 200 drug users conducted by the city health department suggest that most users are not directly seeking fentanyl; narcotics experts say the drug is likely being mixed into heroin batches, often without the dealers themselves knowing, let alone users. As effective as naloxone can be in reversing overdoses and restoring breathing, fentanyl overdoses are often too extreme for the antidote to work. And naloxone is ultimately a Band-Aid to a broader, systemic addiction crisis across the city.
TO CONTINUE STORY:
https://www.nytimes.com/2017/10/12/nyregion/bronx-heroin-fentanyl-opioid-overdoses.html?ref=todayspaper