No one wakes up in the morning and says, “I want to die of an opioid overdose today.”

Sadly, at least 298 Erie County residents died from an opioid overdose in 2022, an increase from 286 deaths in 2021. With 20 cases pending, the 2022 total will likely exceed the 301 deaths confirmed in 2016. That high-water mark sparked the creation of the Erie County Opiate Epidemic Task Force, whose work led to a three-year decline in opioid-related deaths.

Erie County Executive Mark Poloncarz, Erie County District Attorney John Flynn, Erie County Sheriff John Garcia and Commissioner of Health Dr. Gale Burstein presented the most recent data from the Erie County Medical Examiner’s (ME) Office on opioid overdose deaths at a press conference today.

Through early March 2023, the ME’s Office has tracked 97 confirmed and probable opioid overdose deaths. This is double the number of opioid-related deaths seen in the same time period in 2022.


“There is no time to waste here,” said Commissioner of Health Dr. Gale Burstein. “As a community we have done a solid job in establishing evidence-based treatment and harm reduction strategies. Stigma around substance use disorder remains a massive barrier between people and the treatment that will help them manage this chronic disease.”

  • Analysis from the Erie County Department of Health epidemiologists found that about three quarters of opioid overdose deaths in 2022 occurred in or in close proximity to the individual’s residence. “In so many cases, these individuals are dying at home,” Dr. Burstein explained.
  • Since 2018, data shows that the proportion of deaths for 40-49-year-olds and 50-59-year-olds has increased, and these age groups are overrepresented in case totals.
  • Between 2018 and 2022, the proportion of Black persons in opioid overdose death data increased from 10% to 28% – also signaling a population that is overrepresented in case totals. At the same time, the proportion of White persons in these data decreased from 79% to 68%; this population is underrepresented in case totals based on U.S. Census population estimates.
  • Xylazine, also known as tranq, is part of the local illicit drug supply. This powerful animal tranquilizer was detected in 13 opioid-related deaths in 2022. This drug, often injected, is increasingly found added to illicit drugs, and causes major toxicity in humans. Rapid onset coma, cardiac failure or respiratory depression/arrest from a xylazine poisoning requires immediate treatment and supportive care, which could include ICU admission and intubation. Repeated use can cause disfiguring skin ulcers and infections that can lead to gangrene and limb amputation. Xylazine is not an opioid, and Narcan or naloxone will not reverse a xylazine poisoning.
  • Erie County Central Police Services (CPS) performs a forensic (lab) analysis of substances from fatal and non-fatal overdoses in Erie County. CPS confirms what has been seen throughout this epidemic: polysubstance use, an abundance of fentanyl and an increase in the amount of deaths associated with cocaine and fentanyl.

In 2022 56% of opioid-related deaths involved cocaine; this proportion has steadily increased since 2016, when cocaine was involved in about 16% of opioid-related deaths.

“The opioid crisis never ended, but it has changed. Individuals who were never at risk of an opioid overdose are dying almost every day,” said Erie County Executive Mark C. Poloncarz. “Prevention agencies, clinical treatment providers, families and consumers, and our partners like District Attorney Flynn and Sheriff Garcia – we are all united in efforts to prevent these unnecessary deaths.”

“Opioid overdose deaths will not be a silent epidemic in Erie County. Too many lives have been lost and we will continue to spread awareness about the dangers of drug use as heroin, cocaine and other drugs can be laced with deadly fentanyl. I encourage anyone who is struggling with addiction to seek help immediately,” said Erie County District Attorney John J. Flynn.

“In 2022, my administration instituted the Medication Assisted Treatment program in the jails,” said Erie County Sheriff John Garcia. “Today, over 100 individuals are participating in the optional program. This participation rate indicates to me that the opioid addiction epidemic continues its upward trajectory with no decline in sight. The Sheriff’s Office continues to focus on treatment and interdiction operations to choke the supply of fentanyl and fentanyl lace narcotics. Every person that gets into a treatment program and every grain of this deadly drug we get off the streets is a life saved.”

We want to keep you alive.

Reduce your risk of overdose and death if you choose to use opioids, cocaine or other risky substances.

  • Seek treatment. Local hospital emergency departments can connect patients to immediate medication assisted treatment, a long-term care provider and a peer who can help with every stage of recovery. Ask for NY MATTERS.
  • Seek support. The Buffalo & Erie County Addictions Hotline is available 24/7 with referrals for individuals and their families. Call (716) 831-7007.
  • Carry Narcan, and know how and when to use it. Text (716) 225-5473 to have Narcan mailed to you for free.
  • Never use alone. Have Narcan and a friend with you who is not using drugs, or contact a service like Never Use Alone (
  • Test your drugs for fentanyl even if you think it is cocaine or another substance that is not an opioid. Free test strips available from the Erie County Department of Health. Call (716) 858-7695.
  • Bars, restaurants and other public establishments can order free materials from ECDOH, as available. Visit for order form or call (716) 858-7695.

Words matter. To learn more about terms to use when talking about substance abuse disorder, as well as terms to avoid using, click here .

Erie County would like to thank the U.S. Drug Enforcement Administration and HIDTA (High Intensity Drug Trafficking Areas (HIDTA) program for their work in compiling data and producing maps that show the scope and scale of drug trafficking and production in our region.