Fatal heroin and painkiller overdoses fell on Long Island last year, county records show, offering a glimmer of hope to besieged addiction treatment organizations and police departments battling an opioid epidemic, officials said.

Some local addiction experts expressed skepticism over the decrease, saying it did not reflect the rise in heroin abuse and opioid-related deaths they'd seen through their work at treatment facilities in 2014. Others in the field said they were surprised the numbers weren't lower, given the widespread use of the lifesaving intranasal overdose antidote Narcan.

Fatal heroin overdoses recorded on Long Island fell from 145 in 2013 to 137 last year, according to data recorded by both county medical examiners. Overall fatal opioid overdoses -- which included deaths from heroin and pain pills such as Vicodin and Percocet -- also fell, from 375 in 2013 to 341 in 2014, those records show. In Nassau, there were 51 fatal heroin overdoses recorded in 2014 -- up from 44 in 2013 and the county's highest total in at least 10 years, records show. Suffolk County recorded 86 fatal heroin overdoses in 2014, down from 101 the prior year, county records show.

However, Suffolk officials say the 2014 numbers have not yet been finalized, meaning their overdose totals could increase.

"These numbers are definitely good news, but this is a very precarious and multifaceted problem," said Steven Chassman, executive director of the Long Island Council on Alcoholism and Drug Dependence, an addiction treatment and outreach organization based in Mineola. "Unfortunately, this [the lower overdose total] is not reflective of what we're seeing in our day-to-day operations."


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Stigma may affect data

Because social stigma still surrounds use of heroin, many families are hesitant to acknowledge its role in their loved ones' deaths, or to permit autopsies that might detect it, treatment experts said. That means the number of fatal overdoses could be higher than reported. "We don't want to quell optimism, but the stigma has an impact," Chassman said.

Addiction experts and government officials involved in treatment programs said they tend to focus more on Islandwide overdose totals, rather than county numbers, because a user can purchase heroin in Nassau and die from it in Suffolk, or vice versa.

Dr. Jeffrey Reynolds, president and CEO of the Mineola-based Family and Children's Association, said he'd expected the 2014 fatal overdose numbers to be even lower due to wider use of Narcan, which reverses the effects of opioid overdose.

Source: Nassau and Suffolk medical examiner's offices

"I am happy to see the numbers are finally moving in the right direction after years of significant increases," said Reynolds, whose organization runs several treatment centers on Long Island. He stressed that increased Narcan availability was probably the primary driver behind the decrease in fatalities, as opposed to better access to treatment or an overall decrease in opioid addicts.

"This should reinforce that we still have a ways to go," said Reynolds. "We haven't yet turned a corner."

There continues to be a shortage of slots for patients in detoxification programs throughout Nassau and Suffolk, experts said, and overall addiction-related care has not kept pace with surging heroin use in recent years.

Those shortfalls were highlighted by the deaths of several heroin addicts initially saved by Narcan in 2014, who succumbed to fatal overdoses in the weeks that followed, Reynolds said.

Since Jan. 1, 2014, 258 overdosing opioid users in Nassau have been saved by Narcan, county officials said. In Suffolk, Narcan rescues increased from 475 in 2013 to 493 in 2014, county officials said. Thousands of police, paramedics and non-law enforcement responders have been trained to use the antidote, with more training classes being scheduled each month.


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Treatment to help addicts

In an effort to cut even deeper into official overdose totals, authorities in both counties have announced new funding and initiatives aimed at helping addicts.

Last month, Nassau County Executive Edward Mangano announced a trial treatment program in which opioid addicts receive monthly injections of the anti-addiction medication Vivitrol -- which blocks the euphoric effects of opioids and is not itself addictive -- in conjunction with addiction counseling.

"It offers the brain time to heal and has the potential to save lives while decreasing recidivism and incarceration," Mangano said.

Suffolk County Executive Steve Bellone announced a similar program in January, encouraging the use of Vivitrol at drug court, through the probation department, at the county's jails, and at nonprofit drug and alcohol treatment centers.

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The dip in official Islandwide overdose numbers offers some vindication for the work done by the Nassau and Suffolk police departments, they said. Besides arresting hundreds of drug dealers, the departments said, officers give treatment referrals to drug users and administer Narcan. Several recovering heroin addicts who lost friends to overdoses in 2014 also expressed optimism about the data.

Seth Joyner, 32, of the Town of Islip, who used Vivitrol to beat his heroin addiction last year but also lost two friends who fatally overdosed, said that increased access to Vivitrol and Narcan might help begin to roll back the Island's opioid epidemic in 2015.

But, he and other ex-addicts cautioned, officials are a long way from being able to declare victory.

"We are making progress as a society in battling this type of addiction, but that progress is happening in baby steps, not giant leaps," Joyner said. "We have to do better if we want to stop seeing hundreds of our friends and neighbors dying every year."