ROCHESTER, N.Y. — Overdose deaths in Monroe County have fallen by 53% since 2023, but cocaine is making up a growing share of deaths, according to a report from the county’s medical examiner.
The report says 243 people died from an overdose last year. That’s a drop from 292 deaths the year before and 512 deaths in 2023.
At least 135 of the overdose deaths last year involved opioids such as fentanyl, heroin, or morphine. The report says that’s the lowest number of deaths involving those opioids since 2015. However, overdose deaths from cocaine mixed with other drugs are making up a growing percentage.
Cocaine was involved in 196 of last year’s deaths, just over 80%. For cocaine mixed with opioids, it made up 43% of deaths. Overall, most deaths involved multiple substances. In a statement, Public Health Commissioner Dr. Marielena Vélez de Brown said it’s no longer enough to focus on opioids alone when it comes to overdose prevention:
“Cocaine can be deadly, especially when it is combined with alcohol or other drugs. If you use street drugs, test your supply, avoid using alone and keep naloxone nearby. And if you are ready for treatment, we are ready to help.”
Other findings from the report
The report says overdoses involving xylazine also remain an issue. As News10NBC has covered, xylazine is an animal sedative that’s increasingly being found in counterfeit pills and often mixed with fentanyl. Xylazine was involved in 31% of deaths and was always found with fentanyl or a fentanyl analog. In addition, alcohol contributed to 27% of deaths.
Over 70% of people who died of an overdose in 2025 were men. The county says the median age of overdose deaths has increased over the years. Last year, the median age was 58.
Monroe County makes test strips available
The county has aimed to prevent overdose deaths by providing people with test strips to determine if their drugs contain fentanyl or xylazine. The test strips have been available in all indoor naloxone boxes since December. The county has also expanded access to naloxone, a potentially lifesaving drug that can reverse an overdose.
If you or a loved one is struggling with addiction, you can call the county’s hotline at 585-753-5300 and learn about services available here.
Report: Overdose deaths decline in Monroe County, cocaine involved in most deaths WHEC.com.
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