Most Common Preventable Deaths: Overdose
Overdose deaths surpass homicides and traffic fatalities combined
Sources: NYC Office of the Chief Medical Examiner and NYC DOHMH Bureau of Vital Statistics (Unintentional Overdose) 2000–2015 Historical Comfinal Data, 2006–2014 Shooting & Homicide Database (Homicide) NYC DOT & NYPD (Traffic Fatality)
Drug overdose deaths impact every neighborhood and demographic in New York City.
- Rates of drug overdose deaths increased by 42% between 2010 and 2014.
- In 2014, nearly all overdose deaths involved more than one substance, with 79% involving an opioid.
- Heroin was involved in 458 deaths, or 57%.
- Prescription opioid painkillers were involved in 216 deaths, or 27%.
- Benzodiazepines were found in 54% of deaths involving prescription opioids.
This epidemic did not develop overnight and it’s not going to end overnight. To prevent addiction, we need to reduce the easy access to drugs, appropriately punish those who profit from the drug trade, and rehabilitate the victims of this tragic epidemic.
Curbing the Epidemic
While SNP has prosecuted dozens of corrupt medical professionals, most pills found on the black market are prescribed by doctors who are not criminals. For decades, patients have been prescribed far more pills than medically necessary, and much of the excess is stolen, shared or sold.
The Centers for Disease Control and Prevention (CDC) Recommendations for Prescribing Opioids for Chronic Pain provide a road map to responsible doctors committed to easing patients’ pain, while protecting them from the harmful effects of addictive drugs. They offer physicians guidance on:
- Determining when to initiate or continue opioids for chronic pain
- Opioid selection, dosage, duration, follow-up, and discontinuation
- Assessing risk and addressing harm
(Recommendations do not apply to active cancer, palliative, and end-of-life care.)
Medical societies and local and state health departments should provide leadership by adopting these voluntary guidelines. Unless this compliance is widespread, mandatory restrictions may be the next option.
With profit as the only motive, tactics employed by international criminal organizations to flood the U.S. with heroin are cunning and brutal. Heroin commonly crosses over the Southwest U.S./ Mexican border and is trucked to New York City. Overdose deaths are fueled by a cheap, available supply, and the money associated with the trade fuels violence. Law enforcement must redouble efforts to stem the flow.
- Federal authorities should develop a comprehensive plan to apprehend major traffickers, seize narcotics and profits, and collaborate with state and local authorities on regional strategies.
- State enforcement must identify links between regional distribution operations and local drug sellers.
- Local focus on dismantling street-level networks, including leadership, is critical.
Opioid CrisisNew York Daily News, April 5, 2015
Overdose deaths are tragic, but unless we curtail the flow of heroin and prescription opioid painkillers they are inevitable. The dual problem of the abuse of illegal and legal drugs impacts every neighborhood and demographic in New York City, from the Bronx to Staten Island, the young and the old, every race and income bracket.
As SNP’s seizures demonstrate, heroin continues to flood the streets of New York City at an alarming rate. Investigations with law enforcement partners led to the recovery of over 364 kilograms of heroin (800 lbs.) in 2015, and 342 kilograms (750 lbs.) in 2014. These annual totals are triple the amount of heroin seized by SNP in any prior year.
Heroin Seizure Breaks Records
A single, record-breaking case in May 2015 led to the recovery of more than 70 kilograms
of heroin (150 lbs.) from a vehicle and an apartment in the Fieldston section of the Bronx. This was the largest seizure recorded in the history of the U.S. Drug Enforcement Administration’s (DEA) New York Division and the fourth largest by DEA nationwide. Immediately following this investigation, conversations recorded in unrelated wiretap cases suggested heroin distribution groups were experiencing a shortage of supply. This is the impact we hope to have, and extending the drought is an achievable goal.
Opioid Crisis: Fentanyl
The potent synthetic opioid fentanyl has been linked to hundreds of deaths in the U.S. and it is taking lives here in New York City. As of the writing of this report, data on fentanyl-related fatalities in New York City is not available. However, we understand fentanyl overdoses are increasingly common here.
Recent SNP investigations uncovered bulk shipments of fentanyl coming into the city. Fentanyl is up to 100 times more potent than morphine, and as much as 50 times stronger than heroin. Medically, it is used to treat patients with severe pain and in the final stages of cancer. However, Mexican drug cartels are now producing fentanyl in clandestine laboratories and shipping it over the border.
Fentanyl is particularly dangerous because the people who use it aren’t always aware of the strength of the drug that they’re taking. In Suffolk County, L.I., fentanyl-related deaths doubled between 2014 and 2015. A rash of roughly two dozen fatalities in Buffalo over 10 days in February 2016 was attributed to fentanyl-laced heroin. In Connecticut, 186 fentanyl-related overdose deaths were reported in 2015, a 148% increase over the previous year.
On the black market, fentanyl is added to heroin to increase its intoxicating effects. It is also pressed into pills and sold as counterfeit opioid medication or even Xanax, a benzodiazepine used to treat anxiety that can be lethal when taken with opioids.
SNP investigations resulted in several large seizures of three to five kilograms of fentanyl (6 to 12 pounds) over the past year, with a kilogram selling for approximately $60,000 wholesale. DEA seized just two kilograms of fentanyl in New York State in
Opioid Crisis: Prescription Drugs
Prescription opioids continue to be easily obtainable, despite efforts to educate doctors and regulate prescribing. Last year marked a record high for the number of oxycodone prescriptions filled by New York City residents. (Oxycodone is the opioid drug most commonly sold on the black market.) In an effort to better understand the scope of the epidemic, SNP has tracked data from the New York State Department of Health over the past several years.
The number of prescriptions for oxycodone filled by city residents escalated rapidly from 2007 to 2012, more than doubling, and then began to level off. Unfortunately, last year saw a 4% increase.
Several investigations conducted by the Prescription Drug Investigation Unit (PDIU) began with a report of an overdose, either in New York City or another jurisdiction. Important evidence gathered at the scene of the death led to arrests of prescribers. In February 2016, Staten Island District Attorney Michael McMahon and the NYPD announced an Overdose Response Initiative. Going forward, overdose deaths on Staten Island will trigger an investigation to determine, when possible, the source of supply and whether criminal charges can be brought.
PDIU has emerged as a leader in its ability to track the source of illegal drugs and determine how pills are making their way onto the black market. As a result we have prosecuted dozens of medical professionals. In 2015, PDIU launched over 70 investigations and brought charges against four doctors for selling prescriptions for addictive medications in exchange for cash. These physicians practiced in the Upper West Side, Chinatown, Astoria and at JFK International Airport. One doctor worked as a senior aviation medical examiner, and determined whether pilots were physically fit to fly. Also in 2015, a doctor and a hospital pharmacy director were each sentenced to five years in prison for separate multi-million dollar schemes.
We have learned that state medical boards will not reliably revoke a doctor’s license after conviction on a felony related to the practice of medicine. As a result, in some cases involving less extensive or egregious criminal conduct, we have offered a doctor a sentence of probation in exchange for a guilty plea to a felony charge and an agreement to forfeit his or her medical license. In this way, we prevent recidivism and future illegal prescription sales.
Violent Street Gangs
In an era of historically low homicide rates, all of law enforcement is determined to keep crime down. The city has focused on violent recidivists, or individuals who are responsible for repeated violent criminal acts. A small number of criminals, particularly those associated with street gangs, can wreak havoc on a neighborhood’s sense of security. Gangs make money through illicit trade in drugs, property crimes and fraud. Money is used to buy guns and to support a flashy lifestyle. Violence is employed in defense of turf and reputation.
Violence Reduction Target Initiative
SNP participates in an NYPD initiative to build narcotics cases against Violence Reduction Targets (VRTs) with the goal of reducing violence. Since 2014, SNP has arrested, indicted and/or issued arrest warrants for dozens of VRT targets and associates. Additionally, SNP incorporates an emphasis on crimes involving violent recidivists, as well as traffickers dealing in both weapons and drugs, into all cases. A Violent Felony Offenders (VFO) reporting system monitors outcomes. Tracking tools provide arrest notifications from the NYPD for individuals associated with violence.
GS9 Members on Trial
In April 2016, two members of a violent gang “GS9” were convicted at trial in Manhattan Supreme Court on charges of conspiracy, homicide and other serious crimes. These gang members carried out shootings from New York City to Miami. They were among 21 charged, including Ackquille Pollard.