ALBANY COUNTY — On Friday morning, as the county executive announced $1.5 million in opioid settlement funds that will be invested in programs to stem the crisis, Wanda Willingham told an arresting story.

Willingham, a Black woman who has represented Arbor Hill for a quarter-century, is now the deputy chairwoman of the county legislature.

“Let me tell you what addiction looks like,” she said towards the end of the Jan. 3 press conference.

She spoke haltingly but firmly as she told of receiving a phone call, saying, “I need you to come. Right away.”

Her voice cracked with emotion as she went on, “You leave your home to go somewhere where you see a body in a house. And that person truly did not make it. You leave that house and go to another one to find the daughter of that person … who is also addicted to drugs.

“To take her to see her mother and to take from the house the child who is 8 years old who has been born addicted to drugs himself because of his mother, who is now leaving to go see his grandmother, who is lying dead from a drug overdose.

“Both of her parents were also addicted to drugs. This is what addiction looks like,” said Willingham.

She went on, “I faced the coroner that day.” She heard from him about the increasing number of overdoses and she learned, “We don’t have enough dollars; we don’t have enough resources.”

Willingham continued, “You need to take a real deep dive into what addiction does and what it costs us …. I had to paint for you the picture of what that looks like, and why these dollars are so sorely needed.”

Fatalities decline

The $1.5 million announced on Friday follows $2.3 million the county awarded to 14 community organizations to stem the tide of opioid addiction.

The money from opioid settlements with drug companies that promoted opioids is expected to continue through 2039, said Stephen Giordano, the county’s mental health commissioner.

While fatalities nationwide from opioid overdoses have declined 12 percent from 2023 to 2024, Girodano said, they have diminished by 33 percent in Albany County.

According to the Centers for Disease Control and Prevention, overdose deaths from June 2023 to June 2024 in the United States declined 14.5 percent.

In Albany County, as of Dec. 7, 2024, there were 83 recorded overdose deaths and the county predicts the final number will not exceed 85. That is compared to 126 deaths in 2023, and 131 overdose deaths in 2022.

Albany County had just 62 overdose deaths in 2019, and that figure increased consistently before peaking at 131 in 2022, which was more than triple the number of overdose deaths in 2015. 

The goal, said Albany County Executive Daniel McCoy on Friday, is to return to pre-COVID levels of overdose fatalities.

While Giordano termed the 33-percent decline in fatalities “marvelous,” he echoed McCoy’s words, “We can’t take our foot off the gas,” he said. “We don’t know if it’s a blip or a trend.”

The Enterprise reported in September, after a fatal overdose in Knox, on the myriad county efforts that have brought down the death rate.

Where the national and county trajectories on overdose deaths diverged was with the involvement of fentanyl — a highly potent and therefore highly dangerous synthetic opioid — and other opioids in the deaths.

Nationally, the number of opioid deaths fell by nearly 4 percent while the number of deaths from cocaine and meth went up. In Albany County, however, more of the deaths in 2023 — 89 percent — involved fentanyl than in 2022, where they were involved in 82 percent. 

In the first half of 2024, there had been 45 overdose deaths, 75.6 percent of which involved fentanyl. 

Albany County has been taking steps to address the increase in overdoses through various outreach efforts, with a particular focus on fentanyl due to its impact on the death toll. 

Drug-users often are not aware they’re taking fentanyl, which is packaged into other drugs to increase their potency or alter their effects.

A Johns Hopkins survey of drug-users found that a vast majority — about 85 percent — were both concerned about fentanyl in their drugs and willing to have their drugs checked for the substance.

Albany County, through its Mobile Outreach Treatment and Opioid Response initiative, known as MOTOR, distributed 390 fentanyl test strips and 390 xylazine test strips from January 2024 to August 2024, according to an Albany County release on the current distribution of opioid settlement funds.

During the same period, 498 Narcan units were distributed. Narcan, a brand name of naloxone, reverses an opioid overdose.

McCoy noted that the program was launched at the Guilderland Public Library in April 2023, when a dispenser for free Narcan was installed in the library’s lobby.

 “We put a case in there of Narcan, we’re putting that throughout the community, we’re helping people understand,” he said on Friday. “We give classes, we work with other organizations to effectively, you know, give them the tools they need.”

“This has been a long struggle and it is not anywhere near over,” Giordano said. “But the way I get through each day is to try to find reasons for hope and I think there are many here.

“Albany County is unique, I think, in its commitment — undying commitment — to folks struggling with” addiction and mental-health problems.

Currently, Giordano said, about 2,000 county residents are in treatment for addiction.

“Although we focus on fatality information,” he said, “which is important, those are 2,000 people who are not over-dosing today, 2,000 people who are getting care and treatment. Then there’s at least that amount in our mental-health system that are working towards improving the quality of their life.”

Allocations

Albany County is dividing it $1.5 million in settlement funds among these four county agencies

— The Department of Health is getting $619,402

The department will use funding for public-prevention campaigns, improving data collection and management, expanding opioid crisis response staffing, increasing harm reduction resources such as naloxone housing units and equipment, and connecting people at risk to treatment programs.

McCoy stressed the importance of public education, particularly for kids. “We have to remind people. We have to put it in their face,” he said.

Street dealers sell drugs that look like candies, McCoy said. “You think it’s candy; it’s scary,” he said.

The health department will also provide overdose spike alerts that will pair with the coroner’s data system, so that response to fatal overdoses is faster and the Mobile Outreach Treatment Overdose Response Unit is more efficient;

— The Department of Mental Health is receiving $436,240

The funds will be used to add a part-time nurse practitioner to oversee medication for opioid use disorder.

The department also plans to expand services provided by the MOTOR unit, which was launched in 2019. It operates as a mobile clinic, providing rapid crisis intervention, harm reduction, and support through peer specialists and counselors. The program responds to overdose referrals, conducts follow-ups, and ensures immediate linkage to care, aiming to reduce overdoses and improve health outcomes.

A second MOTOR team will extend service hours and reach underserved areas, using two new electric mobile office vans to effectively double outreach and service delivery.

Giordano said a MOTOR team follows up on every overdose call. Sometimes, he said, “People tell us, in no uncertain terms, ‘Get off my porch. I don’t want to see you again.’”

However, he went on, “Most people are saying, ‘I can’t believe you guys actually care’”;

— The Crime Victim and Sexual Violence Center is getting $200,000

The center will hire more staff to promote opioid-use-disorder education and prevention and will also provide education regarding how a trauma history can contribute to the use and misuse of substances to self-medicate. Linkages will be provided to services to address the trauma that occurred as the result of a crime.

The center will target youth and young adults between the ages of 10 and 24 as well as family members and community networks to provide education using a harm reduction framework; and

— The Coroners’ Office is receiving $260,400

The office will use the funds for a new system to improve data collection, organization, and case management and will add a staff member to handle the influx of cases associated with the opioid crisis and improve workflow.

“Now we can all get the data, good or bad,” said McCoy. 

He concluded, “We can’t do what we need to do if we don’t know what the hell we’re dealing with at times.”

Final thoughts

Joanne Cunningham, who chairs the county legislature, said at Friday’s press conference that it is important “for the taxpayers to see a group of leaders who work collaboratively on public policy, on programmatic change, and investment.”

She also said, “One thing I think is really, really important … is the continued commitment that the county is demonstrating to this public health crisis and law-enforcement crisis, and family crisis.”

She stressed the importance of addiction-prevention education, reaching kids in middle school and even elementary school as well as high school, and said she is proud of the way the county is looking at this "public health crisis in a holistic way.”

Lee Kindlon, the county’s new district attorney, said that the criminal justice system “should be the spot of last resort.”

“We should really be addressing these problems in a proactive way,” said Kindlon, “and that’s why I’m just so thrilled to find out about this ….because this addiction problem is one of those things that cuts across race and class and it affects every neighborhood in Albany County.”