Overdose deaths in Monroe County rose by more than 25% last year compared to the year before, according to an annual report.

According to the county, there were 512 overdose deaths in 2023. That continues a three-year trend of increase from 346 in 2021 and 406 in 2022.

The medical examiner says opioids and cocaine were responsible for most of the deaths.

“These numbers aren’t just statistics — they represent lives lost, families grieving and communities struggling with the devastating impact of substance use disorder,” said Dr. Marielena Vélez de Brown, Monroe County commissioner of public health. “Each death is a tragedy and every one of these lives mattered. This crisis requires both compassion and action. By providing tools like fentanyl and xylazine test strips and naloxone, supporting treatment and recovery, expanding partnerships that target prevention efforts aimed at young people and disproportionately affected communities, and fostering understanding rather than stigma, we can save lives and give people the chance to recover.”

The report outlines the following trends:

  • Fentanyl or its analogs were present in approximately 83% of all opioid and cocaine overdose deaths
  • Alcohol was present in approximately 31% of opioid and cocaine overdose deaths
  • Xylazine, a non-opioid veterinary sedative not approved for human use was present in approximately 14% of opioid and cocaine overdose deaths
  • 335 overdose deaths involved both opioids and cocaine — a 32% increase from 253 in 2022
  • 114 overdose deaths involved opioids independent of cocaine
  • 63 overdose deaths involved cocaine independent of opioids

The data shows that nearly 40% of all those who died were Black or African American, despite only making up 17% of the county's population. Nearly three times as many men as women died from overdoses and overdoses among individuals over the age of 60 are on the rise. The median age of overdose victims is now 50 years old.

To help prevent overdose deaths, the Monroe County Department of Public Health Addiction Services Division offers free naloxone and test strips for fentanyl and xylazine. For more information, call (585) 753-5300 or visit monroecounty.gov/health-impact for a map of NaloxBox locations and resources.