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A Xylazine induced skin ulcer. Image via Discovery Institute/Jonathan Choe.

County Warns of Spike in Opioid-Related Fatalities

Tompkins County Whole Health has issued a community-wide alert following a surge in opioid-related deaths within the county. The Tompkins County Medical Examiner’s Office has recently provided updated data revealing an accelerating trend.

During the first six months of this year (January-June 2023), the county has already recorded a total of 17 reported deaths stemming from drug overdoses. This figure is markedly higher than the yearly averages from the preceding five years, pointing to a significant escalation in drug-related fatalities.

The historical annual overdose death totals for Tompkins County are as follows:

2022: 28 overdose deaths
2021: 25 overdose deaths
2020: 19 overdose deaths
2019: 17 overdose deaths
2018: 18 overdose deaths


An analysis of 911 call data spanning from the beginning of 2023 through July 31, 2023, reveals 226 calls related to overdoses and poisonings. To provide context, there were 385 overdose calls recorded in 2022, 383 in 2021, and 282 in 2020. While not all calls translate to fatalities, they serve as an indicator of the escalating concern.

Several contributing factors have been identified as influencing the rising overdose rate within the community. Among these are the growing prevalence of fentanyl and xylazine in illicit street drugs, a trend confirmed by Medical Examiner reports.

Fentanyl, a synthetic opioid known for its potent addictiveness, is often mixed with illicit street drugs to increase their potency, heightening the risk of overdose.

Xylazine, referred to colloquially as “tranq” or “tranq dope,” is a non-opioid animal sedative not approved for human use but frequently found in street drugs.

Injecting the drug is known to cause abscesses and skin ulcers requiring medical intervention and specialized wound care.

A Xylazine induced skin ulcer. Image via Discovery Institute/Jonathan Choe.

The opioid antidote Narcan does not counteract the sedative effects of Xylazine.

Instances of overdose are compounded when substances like fentanyl and xylazine are combined with other compounds.

This Xylazine and Fentanyl are frequently combines with other illicit street drugs such as heroin, cocaine, crystal methamphetamine, and counterfeit pills including benzodiazepines and other stimulants like Molly and MDMA.

Frank Kruppa, the Tompkins County Whole Health Commissioner, underscored the urgency of the situation, emphasizing the need for harm reduction.

Kruppa urged those who engage with street drugs to exercise caution by testing for the presence of fentanyl and xylazine, carrying Narcan (a medication that can reverse opioid overdoses), and avoiding drug use in isolation.

Kruppa also extended an invitation to those seeking assistance in reducing substance use to reach out to local substance use disorder programs for support.

The health alert can be read below.

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