One-on-one with the NYS commissioner fighting the ‘worst overdose epidemic ever on record’

Several rashes of deadly overdoses hit the Capital Region this summer, including five suspected deadly overdoses the week of Aug. 20 in Schenectady.

13 Investigates dug deeper into why New York state and providers are using harm-reduction strategies that promote safe drug use, speaking with providers and the New York State Office of Addiction Services and Supports (OASAS).

Fentanyl and other drugs like it have made the drug supply more toxic than ever. Around 20 people died of an overdose every day in 2022, state data showed. That’s roughly one person every hour.

Xavier McDaniel leads a support group and provides peer support to people at New Choices Recovery Center in Schenectady. McDaniel himself is in recovery from substance use disorder, helping some of the same people he struggled with on the streets of Schenectady years ago.   

“Fourteen days, two months and 27 years I’ve been in the process,” he said.

 New Choices offers free Narcan training and test strips that detect fentanyl and other deadly substances.

13 Investigates asked McDaniel how he sees those strategies working for people battling substance use disorder.

“I’ve worked with individuals…they have a desire, but they’re just not there yet. They’re like either in that contemplation or pre-contemplation phase of wanting to get help. And so, while they’re in that place, right, it’s important for them if they’re going to continue to use, we want to make sure that they’re safe and at least aware of what they’re using,” he said, explaining that the center is there for people before and during recovery.

OASAS Commissioner Dr. Chinazo Cunningham said everyone has to be part of the solution to the drug crisis, but that it requires a shift in how people understand addiction.  

“Given that we’re in the worst overdose epidemic ever on record, a lot of the reducing harms is focused on keeping people alive,” Cunningham said.

13 Investigates met Commissioner Cunningham at the Addictions Care Center of Albany in a rehabilitation building where women and their children live during recovery.

This year, the state made test strips for fentanyl and xylazine available for free online.

So far, people and providers have ordered 1.2 million tests for fentanyl and 350,000 for xylazine.

“So that’s a clear indication that there’s a need, and we’re able to address that need,” Cunningham said.

13 Investigates asked how to measure whether harm reduction is working. OASAS measures success by the response to free test strips and training.

According to the National Institutes of Health, decades of research back up the practice’s public health benefits. But it’s still controversial.

13 Investigates asked Cunningham to address the skepticism in regard to the practice.  

“I would start out by saying that harm reduction isn’t new. That’s the first thing. It’s been around for decades. A lot of harm reduction came from HIV. And so now it’s moved from HIV into substance use,” she said. “Many other countries around the world use harm reduction and there’s decades of research to show that harm reduction is effective.”

Cunningham explained that the shift in strategy from encouraging abstinence to harm reduction reflects shifting attitudes in medicine about what drives substance use.

“The history of how we’ve addressed addiction in this country hasn’t been so great. A lot of it has focused on the individual person, saying, ‘This is your fault.’ That’s actually not accurate at all. We now really see addiction much more as a medical condition, which is what it is. So we have to kind of unlearn the messages that we’ve heard growing up to really embrace the evidence that this is a medical condition and then using evidence-based strategies to address it,” she said.

Cunningham’s approach as commissioner follows her own career path as a physician trained in addiction medicine who worked to care for people on the streets of the Bronx. The office is funding street outreach like mobile medication units. OASAS is partnering with the New York State Department of Health to expand harm reduction practices.