January 3, 2025

Earlier this year David Holtgrave was appointed to serve as a Senior Policy Advisor to DoH Commissioner John McDonald.  News releases stated that Holtgrave had been appointed to advise Commissioner McDonald on matters related to New York’s ongoing overdose crisis, and to advise the Department on matters related to substance use disorder policy in New York. 

Here’s more on Holtgrave: https://www.health.ny.gov/press/releases/2024/2024-08-15_executive_leadership.htm

Today the Albany Times Union published a story focused on a recently published academic paper published in HealthAffairs Scholar, co-authored by Holtgrave and McDonald. It focuses on national trends and importantly, credits (in part) drug treatment programs across the nation and in NYS, withhaving reduced the incidence of overdose.  I have attached a file that includes the Research Letter related to the Academic Paper.

Here’s the citation and a link to the HealthAffairs article:Health Affairs Scholar, Volume 2, Issue 12, December 2024, qxae172, https://doi.org/10.1093/haschl/qxae172

Published: 12 December 2024

And here’s the Albany Times Union article published this morning:

N.Y. officials optimistic for decrease in fatal overdoses in 2025

New York has experienced thousands of opioid overdose deaths in recent years. But public health responses appear to at least partially work.

By Raga Justin, Capitol Bureau

Jan 3, 2025

ALBANY — The new year could bring a long-awaited decrease in opioid overdose deaths, a widespread and complex public health. Data from the U.S. Centers for Disease Control and Prevention shows an over 12 percent decrease in fatal deaths in the one-year period that ended in May — a significant metric, health officials say. It brings them cautious optimism that the existing drug treatment programs and drug-screening services that New York has prioritized over the past few years have proven to be effective.

A recent academic paper by Dr. David R. Holtgrave, a senior policy advisor with the state Department of Health, and co-authored by Dr. James McDonald, the state’s health commissioner, cited federal data indicating that New York was able to avert 1,768 fatal overdoses in 2024. The state experienced a 12.3 percent decline in fatal overdoses, similar to a national decline of 12.7 percent. 

With “scaling up” of effective programs and policies, the paper suggests, the milestone of a “zero-overdose generation” is within reach.

“That’s really a substantial number of New Yorkers who thankfully are here with us, with their families, with their friends, in their communities, that would have otherwise been lost to fatal drug overdoses,” Holtgrave said. “That’s really important. But of course, the real question is how do we keep going?”

The paper, published in early December, cites a national goal released by the National Drug Control Strategy under the administration of President Joe Biden that has a target to contain the number of overdoses at fewer than 81,000 this year. According to estimates Holtgrave provided, the country is on track to hit 82,534 fatal overdoses this year.

And while Holtgrave said he recognizes that number is still too high, it represents a sharp decrease in the opioid overdose death rate of recent years, which had been steadily increasing throughout the 2010s and through the coronavirus pandemic. 

Still, drug policy advocates have urged experts and state officials to maintain a focus on protecting state investments into harm reduction programs, with some citing an unknown political landscape in the coming months. 

“There’s a difference between seeing the data as a decrease versus a dip,” said Toni Smith, the New York director of the Drug Policy Alliance. “We don’t know yet whether those decreases will be sustained. … Our priorities are for legislators to protect what we have and to make sure that current investments stay at least where they are now, so that any indication of progress is not met with a kind of pulling back of financial support.”

Holtgrave credited at least some of the recent declines to various initiatives, like an emphasis on providing access to buprenorphine, a form of drug treatment. He also called New York a national leader in drug screening, which involves widespread access to test strips for users that can detect the presence of fentanyl or the animal tranquilizer known as xylazine.

Last year, the state developed a pilot program that places specialized technical machines called Fourier-transform infrared spectrometers in eight locations across New York. Those machines, viewed as a tool to inform drug users exactly what’s in their narcotics, can measure a sample the size of half a grain of rice and provide the names of all the different drugs that may be present. 

Lawmakers have long been criticized for political inertia on the overdose crisis, though a recent budget proposal put forward by the New York State Black, Puerto Rican, Hispanic, & Asian Legislative Caucus included a series of drug policies the caucus wants to see action on during the upcoming legislative session. They include the authorization of overdose prevention centers, or clinical facilities that allow drug users to consume illegal substances under close supervision of medical staff. 

The caucus also supports investing funds from the Opioid Stewardship Fund into recovery services, as well as extending criminal immunity to drug checking services.