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Syracuse Speaks: A deep dive into the evolving opioid epidemic in Onondaga County

Oxycodone prescriptions are among those blamed for sparking the opioid epidemic.
Oxycodone prescriptions are among those blamed for sparking the opioid epidemic.

The impact of the opioid epidemic continues to be felt in Onondaga County, but the crisis is constantly changing. Everyone from law enforcement and health officials to treatment and recovery agencies are trying to keep up. In this episode of Syracuse Speaks, host Bob Beck takes us through the various perspectives.

Law Enforcement's View: Fentanyl Takes Center Stage 

Syracuse Police Chief Joe Cecile has been in law enforcement for nearly four decades, so he's seen many waves of illegal drugs. But he says this is different because of the unknown. Cecile spoke with WAER's John Smith.

"Right now, it's probably the worst I've seen, especially with fentanyl," Cecile said.

The extremely potent, addictive, and fatal additive is being increasingly mixed with heroin, cocaine, and other drugs. He says fentanyl is a major driver of both direct and indirect confrontations officers face, from overdoses to drug-related crimes. 

Prevention and Education Efforts: Adapting to a Changing Landscape

According to the Onondaga County Health Department and the medical examiner's office, the opioid crisis claimed 113 lives in the first three quarters of 2023. But that was down from a peak of 186 deaths 2021. Data show that Fentanyl, either alone or mixed with heroin, is increasingly contributing to fatalities, while unintended prescription opioid deaths have seen a dramatic drop.

To better understand the evolving patterns, WAER's Scott Willis spoke with Onondaga County Health Commissioner Dr. Katie Anderson and Substance Use Initiatives Program Coordinator Mariah Senecal-Reilly. Anderson highlighted the rise of fentanyl, its often-unseen presence in other substances like cocaine, and the challenges in preventing overdoses.

“For example, someone may think today that there's that they're using heroin, but there's hardly any heroin to be found. It could be fentanyl and xylazine, and who knows what else is to come," Anderson said. "So keeping our fingers on the pulse of what's in our community and supporting people to be safe as they navigate, hopefully a path to their recovery and certainly staying alive through their drug use.”

Anderson and Senecal-Reilly detail their prevention and education efforts, emphasizing harm reduction and crisis management. They team emphasized the importance of listening to the community, learning from individuals' experiences, and tailoring prevention strategies based on real-time feedback.  

Treatment and Recovery: Fentanyl Poses Lethal Risks

Experts like Helio Health Medical Director Dr. Ross Sullivan say the drug scene is extremely active and worsening. He told WAER's John Smith that for many experimenting with illegal drugs, their first time using is often lethal because of the potency.

"We’re seeing a new crop of people in the last several years who are not opioid users who are dying from fentanyl… because fentanyl is in the cocaine. It’s in the pills. And they’re dying. They don’t have any tolerance to it.”

Dr. Sullivan says Helio Health's treatment often includes mental health medications in combination with counseling and therapy.

“Our goal is to get people on these medicines and then we make an informed decision with the patient, once they are stable, what is best for that patient. Some patients can maybe come off the medications, most cannot.”

He says the continuous prescribed medication approach to detoxify maximizes the best chances for success in a patient’s recovery from drug addiction. 

The Path to Addiction: Opioid Prescriptions

Some 7,000 New Yorkers are expected to die of opioid overdoses this year, most from fentanyl, says Rob Kent, who was the former general counsel for the New York Office of Addiction Services and Supports, and also helped shape policy for the White House.

Kent says one of, if not the most direct path to fentanyl isn’t heroin or cocaine — but decades of unregulated prescription opioids. Over the years, the country has been flooded with hundreds of millions of prescriptions, often for pain that doesn’t need such addictive narcotics.

Less than ten years ago, says Kent, the numbers in New York were staggering. He spoke with WAER's Natasha Senjanovic.

"There were 13 million prescriptions for 19 million New Yorkers, for opioids, and when you broke it down, only about three-and-a-half million...were the ones getting prescriptions," Kent said. "So three-and-a-half million New Yorkers are getting 13 million prescriptions." 

Kent says New York and other states have taken actions to regulate prescriptions, and lawsuits against the opioid makers are piling up — settlements for New York alone are $2.6 billion and counting. But the damage continues, says Kent, at a scale that is unfathomable to the rest of the world. Indeed, government data has shown that the U.S. consumes 80 percent of the world’s opioids, and 99 percent of all hydrocodone, the main ingredient in Vicodin.

Opioid Settlement Funds: Using Data to Drive Investment

It’s been a little over a year since Onondaga County received its first installment of funding from settlements of lawsuits against pharmaceutical companies blamed for sparking the opioid epidemic. Organizations involved in prevention, treatment, recovery, and harm reduction were invited to apply for pieces of the $3.7 million pot of money. An advisory committee of experts recommended six organizations which were ultimately awarded the funding. County Executive Ryan McMahon told WAER's Scott Willis that they monitor progress using data, but it can also be hard to come by.

"What's difficult with this type of anything in public health, you don't necessarily know how well you're doing because it's hard to track. When things work, it's hard for us to track every time," McMahon said. "Somebody gives Narcan to a loved one and saves their life, right? You're not mandated to report those incidents. But the Narcan that came through any of our partners in any of our outreach and one of our trainings is an amazing success story that is worth every dollar that you've invested."

McMahon says they'll continue to listen to key partners and see if they need to do things differently based on new data, best practices, and changing conditions.

As Onondaga County and Syracuse continue to battle the evolving opioid epidemic, it's clear from those we talked to that the collaboration between law enforcement, public health officials, and community members is crucial. Their collective efforts aim not only to curb the immediate crisis but also to address the systemic issues contributing to the opioid epidemic.

Scott Willis covers politics, local government, transportation, and arts and culture for WAER. He came to Syracuse from Detroit in 2001, where he began his career in radio as an intern and freelance reporter. Scott is honored and privileged to bring the day’s news and in-depth feature reporting to WAER’s dedicated and generous listeners. You can find him on twitter @swillisWAER and email him at
John Smith has been waking up WAER listeners for a long time as our Local Co-Host of Morning Edition with timely news and information, working alongside student Sportscasters from the Newhouse School.
Natasha Senjanovic teaches radio broadcasting at the Newhouse School while overseeing student journalists at WAER and creating original reporting for the station. She can also be heard hosting All Things Considered some weekday afternoons.
Kat is WAER's anchor/producer delivering local news content and hosting NPR's "All Things Considered."
Bob Beck, a veteran media professional, currently serves as a part-time editor/host at WAER Public Radio and an adjunct professor at Syracuse University. Beck retired as News Director at Wyoming Public Radio in 2022 after 34 years. During his time, Beck won 5 regional Edward R. Murrow awards and 5 Public Media Journalists Association awards for reporting. He also won 11 PMJA awards for the news and public affairs program Open Spaces. He was awarded the Wyoming School Bell award for education reporting and was part of two Emmy Award winning television productions. You can find him on X under the name @butterbob.