Cortland is on pace to far exceed the number of drug overdoses, and overdose fatalities, set last year, city police statistics show, with 47 overdoses and four fatalities so far this year.
In just one week this month, Cortland police officers responded to four overdoses, one of them fatal. In all of 2020, city police were called to just 55 overdoses, said Deputy Police Chief David Guerrera.
On July 6 alone, city police responded to three overdose calls, Guerrera said, two of them with two different people at the same place within 20 hours. They administered naloxone to a third found unconscious in a south Main Street home.
Cortland police responded to four overdose deaths since January, police data show, a pace about on par with 2020 — when they dealt with seven — but far beyond the one fatality it handled in 2019, and none in 2017 or 2018.
However, police statistics reflect only the number of overdoses where city officers were called for help — not where other agencies, or friends and family, dealt with the overdose, such as by adminstering naloxone. It doesn’t include responses by sheriff’s officers or state police, either.
“There are a lot of other cases where people go to the hospital and we aren’t involved and they die,” Guerrera said. “I wonder how much there is out there that we’re not aware of?”
What is clear is that city overdoses are up sharply from 2020’s record-setting year — 55 overdoses, seven fatal.
“We’re definitely going to smash that record,” Guerrera said.
However, state Health Department statistics released this month show that opioid overdoses are dropping slightly in Cortland County, despite a national trend toward an increase. It recorded eight overdose deaths, down from nine in 2019, but still above four in 2018. It peaked with 14 overdose deaths in 2017 after eight in 2016.
Overdoses started rising in 2014, states an April report by Cortland Area Communities That Care, a coalition of community, government and non-profit groups.
“From 2009 to 2014, there were less than four opioid-related overdoses per year in Cortland County,” the report states.
Matt Whitman, executive director of Cortland Area Communities that Care, said he suspects the state numbers are low. The state needs three years to finalize the data, because the preliminary numbers need to be verified by toxicology and reporting agencies have been swamped with work for more than a year.
Add to that, he continued, Cortland County’s two coroners have retired since December, leaving only assistants to do the work.
“Everything we know anecdotally from local sources is that there’s an increase,” Whitman said.
Guerrera theorized that the population concentration of the city — 39% of the county’s population, according to the U.S. Census Bureau — makes it a lightning rod for overdoses, compared with the entire county.
Self-isolation, economic worries and health concerns likely contributed to the national rise in overdose deaths during the COVID-19 pandemic, the Journal of American Medical Association Psychiatry reported in February.
“This cross-sectional study of almost 190 million ED (emergency department) visits found that visit rates for mental health conditions, suicide attempts, all drug and opioid overdoses, intimate partner violence, and child abuse and neglect were higher in mid-March through October 2020, during the COVID-19 pandemic, compared with the same period in 2019,” its report states, an added 1,300 emergency room visits for opioid overdoses, a 32% increase.
Heroin, fentanyl & bath salts
About 60% of city overdose calls involved heroin, while bath salts accounted for another significant portion, Guerrera said. However, what is thought to be heroin often includes other substances, such as fentanyl or brorphine, which increase its risk.
“They might buy heroin. They might get heroin, but you don’t know,” Guerrera said. “It could be heroin, it could be bath salts, and, unfortunately, it could be fentanyl.”
“Most overdoses are poly-substance,” Whitman said, perhaps 60% or 70% of them.
Fentanyl is a synthetic opioid that is 80 to 100 times stronger than morphine, according to the federal Drug Enforcement Administration.
“Fentanyl is added to heroin to increase its potency, or be disguised as highly potent heroin,” states a DEA fact sheet. “Many users believe that they are purchasing heroin and actually don’t know that they are purchasing fentanyl — which often results in overdose deaths.”
Bath salts, also known as Molly, are also powerful drugs and can induce violent behavior in overdosing individuals, Guerrera said.
“We do see a lot of people become aggressive after being given Narcan,” he said. “(They’re) more likely to be aggressive with bath salts.”
“There’s an increase in DWI-drugs, too,” Guerrera said. “People have been using and driving.”
How to respond?
Cortland needs a multi-faceted approach to halt the drug overdoses, including both policing and treatment, Guerrera said.
However, in 2019, the Common Council voted to leave a federal partnership with the Drug Enforcement Administration. Retired Police Chief F. Michael Catalano and Lt. Michael Strangeway urged the council not to leave the partnership, noting it provided tools to keep drugs from Syracuse from flowing into Cortland. It also brought seized drug money into city coffers and provided federal funding for officer overtime.
While the partnership aided the city, policing alone cannot solve Cortland’s drug problems, Guerrera said.
“Any enforcement is helpful,” he said. “It’s just going to take more than enforcement.”
City residents’ profound drug addictions need to be addressed through treatment programs, as well, Guerrera said.
“I think we need more treatment,” he said. “We have some seriously addicted people.”
Whitman can list a variety of steps Cortland County can take — or has already taken — to reduce the threat.
“Our position is based largely around harm reduction,” he said. “You have to keep people alive, you have to stabilize them.”
Among his ideas:
— Wide distribution of naloxone kits can help stop overdoses, giving an overdosing person another chance at life and perhaps treatment.
— Making fentanyl test strips widely available would let opioid users at least know whether they would face increased risk.
— Disposal kiosks — Cortland County has several — to allow people to get rid of used or unwanted needles, medication or illegal drugs.
— A syringe exchange program, to assure users don’t also face the risk of hepatitis or HIV.
— The Centers for Treatment Innovation program, operated by Family and Children’s Counseling Services. It offers mobile outreach and services and supports families during treatment and recovery.
Beyond that, Whitman and Cortland Area Communities that Care have been working to create a real-time overdose mapping program. “If there’s a spike in Onondaga, we would know in Cortland,” he said. That would give agencies greater awareness, for example, if a particularly lethal load of opioids are circulating, giving them time to prepare a response.
After that, Whitman said, longer-term support and treatments would be necessary to keep people from using the drug: help with housing and transportation, for example. Or perhaps education or job training to get lives back on track.
But first, reduce the harm, Whitman said. “We have to stop the dying.”
Managing Editor Todd R. McAdam contributed to this report.