Justin Meyers, Chief of Operations, Office of Public Safety: Welcome and thank you for joining us for this week's public safety briefing. Every Friday, we hold these discussions so that New Yorkers can hear from various different folks within the public safety team here in the City of New York about what we're working on and what Mayor Eric Adams is working on to better protect this city on every single type of front that you can think of. So sometimes, we talk with law enforcement, sometimes we talk with the fire department. Today, we have some really great guests to join us for the briefing to talk about some different subjects that we haven't touched on yet. So today, we've got Department of Health and Mental Hygiene Executive Deputy Commissioner of the Division of Mental Hygiene Deepa Avula. Next week marks Overdose Awareness Week in the US, which culminates in International Overdose Awareness Day on August 31st. Unfortunately, our country is in the grips of an opioid overdose crisis, and New York has certainly not been spared.
So Commissioner Avula, as well as Harm Reduction Training Coordinator, Herbert Quinones, are here today to give us some insight into the issue of overdoses, including what is causing them, and most importantly, what we can do if we're ever in a situation where someone is suffering from an overdose.
Many of you have heard of the overdose reversal drug called naloxone or Narcan, and we are going to give an actual demonstration today so that you can see exactly what that looks like and how you might be able to save someone's life. I'm also joined here today by the executive director of the Mayor's Office for the Prevention of Hate Crimes, Director Hassan Naveed. Under Hassan's leadership, and of course under the leadership of Mayor Adams, the Office for the Prevention of Hate Crimes has been taking a really creative approach towards reducing our implicit bias and fostering strong relationships in our communities. They're doing that through a program called Breaking Bread, Building Bonds, which is something that everyone watching can and should get involved in. We can only tackle the issue facing our city when we work together, and this is a program that brings different perspectives to the table to do just that. So in just a few moments, Hassan will tell us about how that program works and how you can sign up to be a part of it.
So as I mentioned, first we're going to start off talking as we lead into National Overdose Awareness Week next week. It's a time to remember the lives that have been lost to the drug overdose epidemic that is occurring across this country. It's a time to fight against the stigmas that still exist around substance use disorders, and it's a time to strengthen all of our efforts to prevent overdose deaths however we can. I think as a community, we've evolved a lot over the years to really understand substance use disorder and recognize that it really can strike anyone and any community at any time.
I know a lot of folks watching are probably thinking, "Oh, well, I don't use drugs," or, "I never would do that. I wouldn't be engaged in that," but the reality is that opioid overdose-related deaths has now become the leading cause of death in this country for people age 18 to 49 years old. That is a spectacular statistic. And if you think about what that really means is it means that this is an epidemic that is impacting every single community across this country. Absolutely no one is immune to this epidemic. In 2000, we had 20,000 overdose deaths in this country. In 2010, we had 21,000. Last year, we had 105,000 overdose deaths in this country, and 88 percent of them are believed to be linked to synthetic opioids like fentanyl. So, this is a very serious issue.
I can tell you personally, I have multiple family members — and I'm someone who works in public safety, someone who works on these issues on a daily basis — I have multiple family members who became addicted to opioids through prescription drugs following surgeries or other medical events. They had a legitimate prescription from a doctor, when that prescription expired, they had grown an addiction to that drug and they went out and sought to purchase it themselves. They struggled with that addiction for many years and were able to break it. I personally did not know the entire time that that family member of mine was suffering from that. So we're really here to bring awareness to this issue because it can happen to anyone in any community, and it's important to recognize the signs of it, and be prepared to help folks in need in the event you need to step in.
Powdered fentanyl is often added to other drugs like heroin, cocaine, or even we're seeing Adderall and other prescription drugs or things that look like prescription drugs ending up with fentanyl in it. And the reason why is because fentanyl is much more powerful than these other drugs, and it's also very cheap to get your hands on it. So, what drug traffickers do is they purchase the synthetic opioid fentanyl, they mix it together with whatever else they might think the market is going to purchase from them, and then they put it out to market. And consumers can sometimes be... And of course, this is the illegal illicit drug market, of course, not a pharmacy or prescription drugs, but the illegal illicit market, even when you're buying something that looks like a prescription drug can now sometimes have fentanyl in it, and it takes less than the amount of fentanyl that you can fit on a pinprick: literally that little fentanyl can kill a human being.
So even in small doses, it can be deadly, and even in circumstances where you don't recognize that you're taking fentanyl, it is possible if you've bought those drugs in the illicit market that it's possible that you could be consuming fentanyl. So in a few moments, we will have an actual demonstration on how to administer the lifesaving overdose reversal drug naloxone, also known as Narcan, as well as information on where you can obtain it here in New York City. Commissioner Avula will also be providing some information to help us understand the gravity of the opioid and fentanyl crisis right here in the city of New York, and give us some insights into the department's efforts to address this issue head on, including resources available for those seeking help. So whether you are someone who either uses drugs yourself, you have a friend or loved one who uses drugs, or you're simply a concerned citizen, parent, grandparent, or someone who just wants to be prepared in the event that you witness a drug overdose at some point, we're here to bring this discussion to you today. It's about raising awareness, understanding the problem, and most importantly, learning how we can all be a part of the solution. So I'd like to turn it over to Commissioner Avula so you can share a little bit more about the work that the Department of Health and Mental Hygiene is doing here in the City of New York to combat the Fentanyl crisis.
Executive Deputy Commissioner Deepa Avula, Department of Health and Mental Hygiene: Great. Thank you so much, Chief Meyers. As the chief mentioned, opioids are a significant issue in our city and across the country. We recognize that too many lives are being lost to opioid overdose deaths. In 2021, 2,668 New Yorkers lost their lives to opioids. In the preliminary data for 2022, we have half a year of data, and that suggests we're going to tragically surpass the milestone in 2021. What we know is the time to act is now. The Health Department has taken this very seriously. We have prioritized addressing the opioid overdose crisis across our city. The good news is that there are effective and evidence-based treatments available for individuals with substance use disorder, in particular opioid use disorder. There are treatments that are life-saving treatments for individuals who may be struggling with opioid addiction today and wish to stop their use. There are millions of people across the country who have successfully stopped opioid use with the help of medications such as methadone and buprenorphine.
The other good news, when we talk about opioids in the context of public safety, and we talk about our community and what our community members can do, as the chief mentioned, no one is immune to this crisis. It's among all of us, our families, our friends, our neighbors, our coworkers, people we see every day. And again, because of the stigma, people may be afraid to talk about that. And one of the things we're also doing at the health department is making sure that we're breaking down those barriers. We're making this something that people are not afraid to talk about because again, the good news on this is there is a life-saving drug out there that the chief also referenced, known as Naloxone. Naloxone is used to reverse the effects of an opioid overdose. And I think what we want to do is today is really make sure that all New Yorkers understand how very easy it is to actually administer Naloxone.
I know it could sound a little bit scary thinking about intervening at the point of an overdose and what that might look like, but we want to make sure just as New Yorkers and other people across the country have taken CPR training or have taken other training to intervene in a moment where you're experiencing a potential public health or public safety crisis of a loved one or of a stranger even. We want to make sure that New Yorkers across the city understand that Naloxone is one, easy to get. You can get it from the Health Department at no cost to you, and it's also very easy to use. And again, we want every New Yorker to feel safe and comfortable if they have to be in a situation where Naloxone has to be used. So what I'd like to do right now is I would like to demonstrate how easy it is for Naloxone to be used.
So my colleague, the Harm Reduction Treatment Coordinator Herbert Quinones is going to join me in demonstrating the use of Naloxone. Again, as I mentioned, Naloxone kits are available from the Health Department free of charge. In that kit, you will see a Naloxone packet. So essentially the first thing you need to do is recognize the signs of an overdose and how do you recognize those signs? What do you look for? So when you see an individual who is unconscious, who is unresponsive, who maybe has a change in color of their lips or their fingers, who has shallow breathing, potentially having gurgling sounds or snoring, that individual may be experiencing an overdose. So what's the first thing that you should do? The first thing that you should do is see if you can get the person to respond. One way to do that we advise is that you shout loudly.
If the person still does not respond, now you know this person is unresponsive and it is time to call for help. So this again, should be treated as an emergency. You should call 911 and immediately notify the dispatcher of your location and notify the dispatcher that you are experiencing a person who is not breathing and who is unresponsive. Now it's time to administer the Naloxone. So what you're going to do is you're going to take out the Naloxone, the medication, you're going to peel the back of the packet. You're going to remove the Naloxone from it. You're going to take two fingers, your pointer finger and your middle finger. You're going to place your fingers on either side of the nozzle. You will then insert the nozzle into the nostril of the person who is experiencing overdose, and you will press down. You press down only once. It will administer the full dose.
So one thing that's very important here, do not test the medication. The plunger should only be pressed when you are ready to dispense the medication. Again, do not test the medication. Once you do that, you wait two minutes. If the person is still unresponsive, you can give a second dose in the other nostril. As you are waiting for the person to respond, you should also begin rescue breaths. So if you were trained in CPR, you can begin to administer CPR. If you're not quite sure how to do CPR, we have a face shield in the Naloxone kit. You're going to place that face shield on the person's mouth. You're going to pinch the nose of the person and breathe slowly into the mouth of the person. You're going to do this twice, and then you're going to repeat those rescue breaths, a single breath every five seconds.
While you are neither administering Naloxone nor doing rescue breaths, you should place the person on their side to avoid choking. So again, these sound like very simple steps and they sound like very simple steps because they are very simple steps. So we want everyone to be comfortable and confident in the administration of Naloxone should you run into an emergency situation. We also want you to know there's more help available. Again, via the Department of Health and Mental Hygiene, we offer virtual trainings. We offer free Naloxone kits. We want to, again, make sure all New Yorkers are comfortable in the administration of a Naloxone.
One of the things that's also important, once the Naloxone is fully administered, Naloxone takes about 30 to 90 minutes to go away from a person's system. So the person, if they are successful, if the overdose is successfully reversed, they may appear agitated. They may appear angry. This is okay. This is something that comes with the administration of Naloxone, because the person might be experiencing withdrawal symptoms. You want to calmly explain to the person that they experienced an overdose. You want to really work with the person to see if you can get them to seek medical attention after this overdose. If they're unwilling to seek medical attention, that's also okay, but please do not leave the person alone. Please stay with them. We want to make sure that, again, individuals are brought to a point of full safety before they're left alone. Essentially, the message here is that Naloxone saves lives. Every one of us can be trained on how to use it. And there is really no reason that in 2023, anyone has to die of an opioid overdose. We have this extremely effective life-saving medication that is available to us, all of us, at any time. So I very much encourage you to get your Naloxone kit, take additional training, and really again, seek us out. We're here to help. We will do anything we can to make sure that Naloxone is distributed far and wide across the city, in all communities. We have opioid overdose prevention programs that are equipped with Naloxone. We make sure that they are distributed again as widely as possible. Once again, Naloxone is one of the major strategies that we use at the health department. We really take a comprehensive approach to addressing the opioid crisis. Again, we want to see a day when nobody dies of an opioid overdose. Thank you.
