Overdose deaths in Monroe County fell for the second straight year, according to the 2025 Overdose Deaths Report from the Monroe County Office of the Medical Examiner.
While overall deaths declined, cocaine remained involved in four out of five overdose deaths and cocaine-only involvement increased significantly.
The report shows there were 243 overdose deaths last year, which is a 53% decrease from the 512 overdose deaths in 2023. The decline continued from 2024 to 2025, with overdose deaths falling 17% from 292 to 243.
Out of the 243 deaths reported in 2025, those that involved fentanyl, heroin and related opioids fell 69% from the record high of 433 in 2023. This downward trend continued from 2024 to 2025 with a 38% decrease in deaths, from 216
to 135.
"These aren't statistics, these are people. Each death prevents a son or a daughter (returning) home to their parents, friend or to return a call to a loved one," Monroe County Executive Adam Bello said. "We will never forget that even one overdose in Monroe County is one too many."
Monroe County has received settlement funds from opioid manufacturers, including just over $6 million last year. Bello said they have taken those resources and put them to good use.
Some of the initiatives the county has carried out to save lives include expanding access to naloxone, fentanyl and xylazine test strips and other services, operating a 24-hour hotline, maintaining 637 publicly accessible naloxone boxes and deploying the Addiction Services IMPACT team, which provides crisis support, harm reduction and community education.
Despite the decline in overdose deaths, the report also showed that cocaine remained involved in four out of five deaths. Instances involving cocaine without opioids increased from 22.6% in 2024 to 37.9% in 2025.
Commissioner of Public Health Dr. Marielena Vélez de Brown said this report shows how overdose prevention can no longer focus on opioids alone.
"Cocaine can be deadly, especially when it is combined with alcohol or other drugs," Brown said. "If you use street drugs, test your supply, avoid using alone and keep naloxone nearby."
In order to get a broader and timelier look at local overdoses, the county is replacing its opioid-specific dashboard with the Overdose Surveillance Dashboard.
With this new dashboard, users can see where overdoses are occurring, examine rates by sex, age and race or ethnicity and compare Monroe County trends with neighboring counties and New York State.
The Monroe County Overdose Surveillance Dashboard can be accessed at https://www.monroecounty.gov/health-surveillance-data-dashboards.
Overdose report Monroe County NY
Here are some key findings from the report:
- Cocaine was involved in 196 deaths or 80.7% of all overdose fatalities. Around 43% involved both cocaine and opioids while 37.9% involved cocaine without opioids.
- Fentanyl or fentanyl analogs were involved in 131 deaths.
- Black or African American residents accounted for 26.7% of overdose deaths, a decline from 31.2% in 2024.
- Hispanic residents accounted for 9.9% of deaths, down from 14% in 2024.
- The median age continues to rise. The median age was 54, but this report shows those who died ranged from younger than 20 to 76.
— Kerria Weaver works as the Government and You reporter for the Democrat and Chronicle, with a focus on how government actions affect communities and neighborhoods in Rochester and in Monroe County. Get in touch at kweaver@gannett.com.
This article originally appeared on Rochester Democrat and Chronicle: Overdose deaths in Monroe County fall as cocaine remains widespread
