Alliance Alert: New data show that while overall opioid overdose deaths in New York are declining, this progress is not reaching everyone — especially Black and brown communities. In fact, older Black and Hispanic New Yorkers continue to die at disproportionately high rates, and many advocates on the frontlines are sounding the alarm: the system is failing the very people it has harmed and neglected the most.
At the Alliance for Rights and Recovery, we believe this is unacceptable. We cannot claim success in addressing the opioid crisis while our most vulnerable communities are still dying at accelerating rates. The data is clear.
Disparities Persist Despite Available Funds
Although New York has received over $1 billion in opioid settlement funds, the state has spent only a fraction of it. Over $100 million remains unspent while overdose deaths persist — especially in communities of color.
As Tracie Gardner, executive director of the National Black Harm Reduction Network, put it:
“To see this as deaths continue unabated among Black folks is bordering criminal.”
These delays are costing lives. Funding must move swiftly and intentionally into communities that data shows are hardest hit — including older Black men, people experiencing homelessness, and those with co-occurring mental health challenges.
Equity Must Guide Every Dollar
We agree with advocates who say the current approach to funding is too broad and too slow. The policy must be simple: follow the data and prioritize the people most at risk. We echo calls for more targeted initiatives that:
- Invest in community-based organizations rooted in and trusted by Black and brown communities
- Expand harm reduction and outreach efforts in underserved areas
- Ensure culturally responsive, voluntary services that affirm dignity and trust
- Shift resources away from punitive systems and into supportive services that work
As StartCare’s George Jones reminds us, recovery starts with compassion, empathy, and relationships — not bureaucracy and delay.
Time for Urgency and Accountability
We stand with the Opioid Settlement Fund Advisory Board, frontline workers, and countless advocates who are demanding action. We also call on state leaders and agencies to immediately accelerate the distribution of opioid settlement funds and ensure they are directed intentionally and equitably. Our communities cannot wait.
The Alliance is committed to continuing the fight to end overdose deaths and promote recovery for all New Yorkers, especially in communities that have been historically ignored or underserved. Racial equity is not optional. It’s essential to saving lives.
We must stop the delays, follow the data, and act like lives depend on it — because they do.
NY’s opioid overdose deaths have dropped – but not for everyone
By Raga Justin | Times Union | July 20, 2025
ALBANY – In the early 1980s, George Jones was a youthful New York City native in his 20s looking for a good time. When his friends introduced him to heroin, the narcotic sparked a nearly three-decade struggle with addiction.
Jones, 65, finally began his recovery in 2010, just as the deadly synthetic opioid known as fentanyl was beginning to permeate the drug supply across the country, especially in New York. It was a “long and arduous journey,” he said, noting there was days he would look in the mirror “and not recognize myself anymore.”
Now an employee of the New York City-based organization StartCare, which serves some of the neighborhoods hit hardest by the opioid crisis, Jones will often visit people in the throes of their own addiction as part of an outreach team. And that work has a visible impact on highly vulnerable residents who are the most at risk of dying from a fatal overdose, Jones said.
“As you begin to engage with these people, you’re building a relationship and they come to you,” Jones said. “They see the concern and the love and the compassion and the empathy that you have for them where they’re not used to having it.”
The work people like Jones do is frequently touted by state health officials, who this year are cautiously celebrating sharp decreases in opioid overdose death rates, a welcome sign of relief after decades of a steadily worsening addiction crisis.
But many of those celebratory statements don’t fully capture an unsettling truth: older Black, indigenous and Hispanic men are dying at rates faster than the state’s average. For them, advocates say, the accolades for any progress can ring hollow.
“If you look around, you know, it’s us that’s suffering the most, and it’s us that’s dying the most,” Jones said.
The disparity, state officials have acknowledged, underscores how complex it is to treat and prevent substance use disorders, even as New York has started to see some success; Gov. Kathy Hochul has touted an over 30 percent drop in overall opioid deaths in 2024 compared to 2023. And while the drop is significant, more New Yorkers have died in recent years than at the start of the epidemic, which has raged for decades but which started rapidly increasing through the early 2000s. New York deaths reached a peak in 2017 and spiked substantially higher in 2020 and 2021.
“We can’t say overdoses are down and not mention that they’re not down everywhere,” said Jonnel Doris, who leads StartCare, a New York City-based organization that serves primarily some of the neighborhoods hit hardest by addiction.
Advocates say the disparity also highlights the ongoing struggle around disbursement of hundreds of millions of dollars in opioid funding through legal settlements. The distribution of those funds has appeared to overwhelm the state, which relies on an advisory board to offer suggestions on where money should go.
Although nearly $400 million is available, members of that advisory board have heavily criticized the slow distribution of funds to community organizations that often serve on the front lines for people with substance use disorders.
They say New York agencies, including the state Department of Health and the Office of Addiction Services and Supports, have been slow to deliver available funds to health care providers, even as the epidemic still rages across New York.
OASAS Commissioner Chinazo Cunningham cautioned that specific racial data from the decline has not yet been released, and disputes claims that the settlement dollars have not been distributed quickly enough. She also said the agency maintains a strict emphasis on the principles of health inequity and noted that she has made that a focus of her tenure.
“We know that a lot of the drug policies in this country have been racist. We know that, and we have to work against that,” Cunningham said. “I take this very seriously.”
The question of why certain demographic groups experience overdoses at higher rates than others is “a million dollar question,” Cunningham said, pointing to an overrepresentation of Black and Hispanic individuals in treatment programs.
“It’s not simply just saying more treatment in these communities or more treatment to these populations. It’s not that simple,” Cunningham said. “If it were that simple, we would have solved these problems.”
‘You’ve got a problem’
For decades, increasing pollution of the drug supply – especially with synthetic opioids like fentanyl – has led to adverse consequences among all demographic groups and regions in the state.
But the problem has nearly always been exacerbated among Black and brown communities, leaders of which say older Black and brown men are still dying at rates much higher than other racial and age groups in New York. Many have questioned why officials have not dedicated a proportionate share of the billions of settlement dollars to the needs of the state’s most vulnerable.
According to 2023 demographic data from the Centers for Disease Control and Prevention – the latest data that includes a racial breakdown – overdose deaths are unevenly distributed across New York, with Black New Yorkers having the highest rate of overdose deaths.
“Align the deck,” said Tracie Gardner, a member of the Opioid Settlement Fund Advisory Board who now heads the National Black Harm Reduction Network. “If your overdose mortality is still happening among your Black community, and your Black community is like 3 percent of your population, you’ve got a problem that you’re not addressing correctly.”
Settlement dollars are collected by the state attorney general’s office through legal agreements with the opioid manufacturers, distributors and marketers that drove the opioid addiction and overdose crisis.
The racial disparities are frequently invoked at meetings of the Opioid Settlement Fund Advisory Board, where members have often internally fought over how, exactly, they should advise the state to spend its settlement dollars. Recommendations, proffered to Hochul annually, are not binding.
The board has identified “priority populations” including members of the LGBTQ community, those involved in the criminal justice system, and communities of color. But Gardner said that has not yet translated to specific, concentrated action yet.
“We cannot just pat ourselves on the back about what we’ve done,” Gardner said. “That’s not our job to be satisfied, right? It’s to keep you doing what you need to do to reduce the suffering.”
New York’s uneven drop among overdose deaths is not uncommon – it’s a phenomenon across the country.
But Gardner pointed to other states that may have successfully been more limber in directing funds instead of the Byzantine rollout that she said has characterized New York’s approach to its own settlement cash.
Virginia, for example, has a designated “Opioid Abatement Authority,” a body created by the state’s legislature in 2021 that distributes funding across the state and operates separate from a state agency. In June, that authority announced it had moved to release funds specifically to seven communities where death rates among Black residents had increased over 100 percent between 2019 and 2023.
Evan Frost, a spokesman for the Office of Addiction Services and Supports, said the agency has implemented several initiatives to address that high rate, including establishing new treatment facilities in underserved areas and investing in street outreach services that try to connect people to treatment.
“While OASAS develops the specific initiatives funded by this money, we have been supportive of expanding and enhancing services to meet the needs of underserved New Yorkers, with a focus on communities of color,” Frost said. “All procurements issued by OASAS include a requirement that an applicant show a commitment to ensuring diversity, equity, and inclusion.”
Doris, who formerly worked in New York City’s Minority and Woman-owned Business Office, suggested an approach similar to that program, which sets aside a portion of publicly-funded projects for business owners who identify within certain demographic categories.
He referenced his own struggle competing for settlement dollars through grant proposals and said a priority designation could help steer money towards organizations that are exclusively focused on the New Yorkers most vulnerable to drug overdoses – older, Black men who often are experiencing housing and economic instability or mental health conditions concurrently.
“The policy should be based on need. That’s where the resources go,” Doris said. “I don’t know the formula that’s being used….Follow the data and then allocate it to those communities and individuals that way, not broadly. (The funding) needs very specific and intentional application.”
Beyond racial disparities, there are also some concerns with geographic distribution of opioid deaths: while New York City has the highest number of overdose deaths, health officials pointed to a higher rate of deaths occurring in western New York.
NY’s opioid overdose deaths have dropped — but not for everyone
State has spent a fraction of opioid settlement funds, records show
By Amanda D’Ambrosio | Crain’s Health Pulse | July 21, 2025
State officials appear to be sitting on more than $100 million in opioid settlement funds as the overdose crisis continues, new data shows.
The state’s Office of Addiction Services and Supports, which distributes the opioid settlement funds, has received approximately $505 million from litigation with drug companies, according to the agency. Though it’s made more than $400 million available through procurements since 2022, $145 million was delivered to providers and companies leading prevention and treatment programs during that time, according to comptroller’s office data obtained through a freedom of information request submitted by former OASAS general counsel Rob Kent and shared with Crain’s.
In addition to the $145 million spent on vendor contracts, the state has allocated $138 million to counties, leaving more than $100 million unspent.
The data, which includes all state contracts funded by settlement dollars from 2022 to 2025, shows a gap between the amount of money the state has allocated and what has gone out the door. The lag in spending has sparked concerns among advocates and elected officials, who say the state should expedite resources to solutions that prevent overdoses and assist people in recovery.
“These funds were won to save lives, and they’re not doing that sitting in an account,” Assemblyman Phil Steck, who represents parts of Albany and chairs the committee on alcoholism and drug abuse, said in a statement.
A spokesperson for the Office of Addiction Services and Supports did not respond to a request for comment by press time.
The money that flows through the Office for Addiction Services and Supports is not the only funding the state is getting from opioid litigation. In addition to the $500 million the state has received for prevention and treatment programs, approximately $498 million that does not flow through OASAS has gone to local governments, agency spokesman Evan Frost previously told Crain’s.
Elected officials and members of the opioid settlement fund advisory board have criticized the state for rolling out the funds too slowly as it continues to combat the overdose crisis. Deaths have declined since the state started spending settlement funds in 2022, falling 32% between 2023 and 2024, preliminary federal data shows. Still, more people still die from overdoses compared to before the pandemic and the crisis continues to disproportionately impact Black and Hispanic communities.
Advocates have continued to call on the state to expedite spending of the settlement dollars, which will flow until 2040, after the federal government passed widespread Medicaid cuts that are expected to reduce resources for substance use prevention and treatment even further.
Tracie Gardner, executive director of the National Black Harm Reduction Network and a member of the opioid settlement fund advisory board, said that the slow rollout of funds as overdoses persist is “heart-breaking.”
“We suspected that this was true, and to see it as deaths continue unabated among Black folks is bordering criminal,” Gardner said.