The opioid crisis is improving, but we can't let up

The numbers are encouraging. Opioid use has declined significantly on Long Island and across the country, and the rate of overdose deaths, which has taken the lives of more than 800,000 Americans, has fallen with it. On Long Island, fatalities dropped by more than half between 2022 and 2025.

For nearly two decades, the news was the same. More deaths than the year before. Fentanyl — potent and cheap — turning up everywhere. Families burying loved ones after being denied treatment. The overdose epidemic killed more Americans than most wars, and we somehow grew more accustomed to the rising body counts.

The data is moving in the right direction and that matters. Those responsible for bending the curve — law enforcement personnel, first responders, health care professionals, treatment providers, recovery coaches, family advocates and the individuals who fought their way back from the edge — deserve our praise.

People are alive today because naloxone revived them, because drug treatment and medications for opioid use disorder became more available, because the legal and clinical machinery that had for so long worked against them finally began to work for them. 

Whether this is the beginning of a genuine and sustained reversal, or just a temporary dip in a 20-year chart that will soar to new heights depends squarely on what we do next.

Drug dealers — whether they be multinational cartels, bathtub chemists or the still-addicted kid financing his daily habit — aren't standing still while we celebrate. They're engineering the next big thing.

The opioid crisis has always been a moving target — from overprescribed painkillers to heroin, from heroin to fentanyl, and now into a foreboding fourth wave defined by fentanyl analogues and a lethal combination of synthetic opioids and stimulants.

Suffolk County, for example, recently alerted residents about medetomidine — a synthetic sedative used in veterinary practice that is 200-300 times stronger than xylazine, another veterinary sedative found in the illicit drug supply.

Medetomidine is not an opioid, but dealers are mixing it with fentanyl anyway, along with a growing list of adulterants, each one extending the high and deepening the danger.

For now, naloxone — the overdose reversal medication that has become synonymous with second chances — still works, but that could change as non-opioid synthetic compounds flood the market. Monitoring the drug supply is critical.

The opioid epidemic is one of the worst public health disasters in American history. It didn't arrive overnight. It won't leave that way either.

But promising data has a way of becoming a political exit ramp, as grant programs begin to sunset without renewal, treatment slots disappear and nonprofits quietly close.

We owe survivors more.

Despite the gains we've seen, only about 20% of people who need addiction treatment actually get it. Addiction recovery is a lifelong process, shaped by housing stability, good jobs, community support and ongoing access to care — none of which exist at an adequate scale on Long Island or anywhere else in America. The person who survived last year's overdose still faces decades of navigating a health care system that's continually threatened by ill-conceived policy changes and arbitrary funding cuts.

Every life saved is a victory. But in public health, the most dangerous moment is often the one that feels like progress — when the celebrations start, attention drifts, funding erodes, the scaffolding comes down and the epidemic quietly reorganizes itself for the next wave.

The drop in deaths means that we've bought ourselves some time. Let's use it well.

This guest essay reflects the views of Jeffrey L. Reynolds, president and CEO of the Garden City-based Family & Children's Association (FCA).