Opioid use and overdoses plummet on Long Island. Here's why.

Far fewer people are using opioids than a decade ago, surveys indicate, and substance use experts and former opioid users say that — along with increased use of the anti-opioid nasal spray naloxone — has led to a sharp drop in the number of Long Islanders dying of overdoses.

Several hundred Long Islanders still die from opioid and other drug overdoses every year. That's nearly twice as many who die from vehicle crashes.

But addiction experts say the decrease in people using opioids and dying from them shows that years of efforts to tackle the opioid crisis are bearing fruit.

"It took a long time, and a lot of people died in the process, but I think we're finally starting to see the payoff," said Jeffrey Reynolds, president and CEO of the Garden City-based Family and Children’s Association.

Illegal use of opioid medications like OxyContin and Vicodin has plummeted since the 2000s and early 2010s, with heroin use also lower for most age groups, data shows.

Six Long Island addiction and substance use experts told Newsday they’ve seen the drop in opioid use, and they credit stricter opioid prescription controls, more addiction treatment options and more concerted education and prevention efforts.

People were also scared off using opioids as they heard of the mounting number of people who died of overdoses from prescription drugs and heroin that were spiked with fentanyl, a powerful and deadly synthetic opioid, said Tricia Ragusa, 47, of Massapequa, who has been in recovery from opioid addiction for the past decade and regularly talks with those more recently entering recovery.

"People are well aware of the fact that what’s out there is killing people," she said.

There's also more awareness of how addictive opioids can be, said Angela Piccininni, associate director of clinical services for YES Community Counseling Center in Massapequa. 

"From prescribers to consumers, people know the risks now associated with opioid use, and there's not a Big Pharma push anymore to prescribe prescription medications," she said.

Piccininni is optimistic that, because of more stringent prescription laws, expanded treatment and more effective prevention, it's unlikely that opioid use levels will return to the high levels of 15 to 20 years ago, when nearly 1 in 10 young adults and high school seniors were illegally using them.

Drugs go up or down in popularity, but the precipitous drop in opioid use over the past 15 years is virtually unparalleled.

The percentage of young adults who said they used prescription opioid medications such as oxycodone and codeine without a prescription in the previous year was 18 times lower in 2024 than in 2010 — dropping from 9.2% to 0.5%, according to data from an annual University of Michigan study funded by the National Institute on Drug Abuse. Heroin use, which is much less common, also fell significantly in that period.

Older adults and adolescents also are much less likely to use opioids than a decade ago, according to the study, which surveys tens of thousands of people each year.

A separate federal study, the National Survey on Drug Use and Health, also showed significant declines in the misuse of prescription drugs in recent years, on Long Island and nationwide.

The start of the opioid crisis

Illegal use of prescription opioids spiked in the late 1990s and 2000s, as pharmaceutical companies more aggressively marketed the medications and prescription opioid sales skyrocketed. As awareness grew and laws were strengthened, use began declining in the 2010s, surveys show.

Overdoses, though, continued rising as fentanyl was added to pills and to heroin. Numbers on Long Island initially peaked in 2017, dropped before the pandemic, then reached a new high in 2021 before falling again.

Even longtime users of heroin were dying because their bodies could not tolerate the fentanyl that had been added, said Tina Wolf, executive director of Community Action for Social Justice, which works on overdose prevention throughout Long Island. Others who died had switched from prescription opioid medications to heroin because of the stricter prescription laws, she said.

The 414 Long Islanders who died from overdoses from all substances in the 12 months ending June 2025 is less than half the 840 who died in the year ending June 2022, according to provisional Centers for Disease Control and Prevention data. The most recent 12 months may not include all deaths.

Even so, Reynolds said, "That's still one a day. That means as you and I talk today, some family is going to wake up in the morning and have to start making funeral plans for a loved one, and their lives will forever be changed."

The number is similar to how many Long Islanders were dying in the early 2010s, but still much higher than in the early 2000s.

Although use is down, fentanyl-spiked drugs remain a problem, and there are still many Long Islanders who continue to use opioids or other drugs, or who relapse during recovery, Reynolds said.

"We didn’t get into this mess overnight, and we’re not going to get out of it overnight," he said.

In addition to fewer people using opioids, the growing use of the anti-overdose nasal spray naloxone is a key reason for the decline in overdoses, said Patricia Hartley-Ferrandino, senior director of clinics for the Huntington-based Family Service League.

"There are tons of people who are alive now that wouldn't have been alive had they overdosed 15 years ago, when Narcan (a device for administering naloxone)  wasn't so widely available and distributed," Wolf said.

Promising signs 

Comparing opioid use over time on Long Island is difficult because of the paucity of precise data. But there are promising signs. For example, misuse of prescription pain relievers among young adults in Nassau and Suffolk fell by nearly 60% between 2016-18 and 2021-23, according to National Survey on Drug Use and Health estimates. And the number of people receiving outpatient opioid-related overdose treatment in emergency departments on Long Island fell from 913 in 2023 to 641 in 2024, and to 190 in the first six months of 2025, according to state Health Department data.

Alex Membreno, 43, of East Meadow, got hooked on heroin in the 2010s after first developing an addiction to oxycodone. He has been sober for the past eight years.

Membreno now works as a peer advocate at Hicksville-based CN Guidance & Counseling Services, helping others in their recovery. He said one reason for the drop in opioid use may be the increase in programs that link people in recovery to jobs, housing and food. That gives people hope that "if the drugs brought you so far away from the opportunities you had a long time ago, there are still avenues to get back to that," he said.

Although heroin use by adolescents had either been decreasing or remaining level for years, it suddenly increased nationally in data that was collected in the spring of 2025, to 0.9% for 12th graders.

"It was a surprise to everyone that heroin increased," said Richard Miech, a research professor at Michigan and principal investigator of the drug and alcohol use surveys.

Reynold said his organization is not observing a rise in heroin use among young people, or overall, on Long Island.

But, he added, "The jump is also a reminder that the public health gains we are making in this area through prevention and access to treatment are precarious, and now is not the time to relax our efforts."

Reasons for drop

Expanded and more convenient treatment options that experts say are less stigmatized than in the past are a major factor in the drop in opioid use.

Drugs that reduce opioid cravings are now "the standard of care" and don't require inpatient treatment that compels people to put their lives on hold for weeks, Reynolds said.

In addition, the number of programs on Long Island offering methadone, which has been used for decades to prevent cravings, has risen from five to 11 in the past five years, according to the state Office of Addiction Services and Supports.

There also is a greater focus on bringing treatment directly to people, CN Guidance CEO Jeffrey Friedman said. A mobile recovery unit links people with addictions to services, and another program embedded in hospital emergency departments connects with patients after overdose treatment, he said. 

In December, CN Guidance opened a 24-hour-a-day center in Hicksville that stabilizes people in drug or mental health crises and connects them with services. The $12 million in operating expenses for the next four years will come primarily from a fund established with money from opioid manufacturers, who as part of a legal settlement agreed to contribute billions of dollars nationwide to drug treatment and prevention. The fund is helping finance other Long Island programs as well.

Prevention efforts are more widespread and targeted, and they now often begin in elementary school, Piccininni said.

Doctors are more aware of the high potential of addiction after medically authorized use of opioids and are more cautious about prescribing them, Hartley-Ferrnadino said. Laws now more closely monitor and restrict opioid prescriptions.

That, along with law enforcement efforts, has made it harder to find illicit opioids on the street, Reynolds said.

Mixed signals

Piccininni is worried some people may be substituting other drugs for opioids. She has seen more adults with cocaine addiction at YES in the past year to 18 months.

"There’s always a waxing and waning of certain substances," she said.

The Michigan survey showed an increase in adolescent cocaine use in 2025 after years of decline, and its 2024 adult survey — 2025 adult data is not yet available — showed a steady increase in cocaine consumption among adults 35-50 over the past several years, although a decline among younger adults.

Use of most other drugs among adolescents, though, has been falling, including for marijuana, and especially for alcohol, the Michigan survey shows.

Wolf said if people switch from opioids to drugs that have less or no potential for fatal overdoses, that means they have a better chance to survive and to enter recovery.

"People using cocaine have an opportunity to change their life at some point that people using opioids sometimes don't get," she said.

Experts and people in recovery from addiction say that the only way to ensure that more people don’t turn to opioids, or use alcohol, marijuana or other drugs excessively, is to treat the root of the problem: anxiety, depression and other mental health problems.

Ragusa began her opioid addiction to cope with her father dying from terminal brain cancer.

"I was medicating to not feel," she said. "Once we learn that we’re safe to feel, I think everything changes."

Her mother is now battling brain cancer, but she has been able to stay sober.

"It shows other people that no matter what life gives us, we don’t have to use," she said.