Drug users offer insight into record Buffalo-Niagara overdose deaths: 'People are trapped' (2024)

Nathaniel Carson’s oldest daughter got married last year but Carson couldn’t go. He was living in 4-day-old clothes, getting high at a crack house with bedbugs, roaches and menacing dogs.

Bryan Sullivan lost custody of his son after a breakup led to the end of eight clean years of drug recovery.

The record numbers of overdose deaths in the Buffalo Niagara region aren’t just told in numbers. Carson and Sullivan – two older men whose group comprises a growing segment of overdose drug deaths in this region – can paint the picture of desperation and loss in vivid detail.

Carson had been a lead welder for General Motors components plant in Lockport. He and his wife both had stable, full-time jobs, great credit and a family they raised together. Then Carson hurt his back and was prescribed prescription painkillers with months of automatic refills after a series of surgeries. Addiction soon followed.

He remembered standing in the dim bathroom and praying for deliverance.

“I stood in the mirror and said, ‘God, I ask that you just get me out of this. I’ve got to find some way to get out of this,’ “ he recalled.

In Erie and Niagara counties last year, roughly 500 people died of drug overdoses. That includes a record number of deaths in Erie County, and continued high numbers in Niagara County. The crisis isn’t new, but it’s the worst it has been in decades, with a pattern of growth that bucks national trend lines where overdose death numbers appear to finally be falling.

Erie County saw a 19% increase in confirmed opioid-related overdose deaths last year, and a 15% increase in all types of drug overdose deaths.

Niagara County health officials do not track their own overdose death data, but state data show that the overdose death rate for Niagara County has been consistently higher than for Erie County over the last three years. The state reported 70 overdose deaths in Niagara County each year in 2021 and 2022 and a worsening trend line through the first nine months of last year.

The age and circ*mstances under which people are dying from overdoses is changing, as well. Some victims appear to be recreational cocaine users who would not have described themselves as having any addiction problem at all.

Both Sullivan and Carson, Lockport residents recovering in a long-term residential rehab facility at the Horizon Village Campus in Sanborn, replayed the trauma and anguish that led them and their friends down a path that often ends in death. It’s not that they don’t feel regret or hunger for change, they said. But their cravings are being met with drugs that are more available and more lethal than ever.

That’s why even though Sullivan and Carson have relapsed multiple times, their rehab counselors don’t greet them with disappointment.

“They’re just so happy that you’re still alive,” Sullivan said.

Not too old to overdose

While overdose drug deaths kill people of all ages, the lowest percentage of deaths, 8%, occurred last year among those in their 20s, according to the Erie County Health Department. Meanwhile, those ages 50 and older made up half of all opioid-related drug deaths in 2023.

Sullivan and Carson are in their 40s and 50s. Both have laid down roots. For them, doing drugs isn’t about partying or living it up. It’s about coping with the tough realities of life as the illness of addiction clings to you, they said.

“It goes to sleep with you; it wakes up with you,” Sullivan said. “It’s always with you no matter how clean you get.”

Though drug addiction and overdoses occur among both men and women, 71% of all opioid-related overdose deaths in Erie County occur among men, according to the county Health Department. Those in addiction recovery say men are more likely to conceal their drug habit and to use alone.

Carson, 54, has seen drug dealers target lonely and divorced men, offering them a quick high, he said. It’s not a new story. What’s new is the dangerous potency of drugs that these users often don’t recognize, he said.

“People are trapped,” Carson said.

Sullivan, 48, was prescribed prescription opiates for pain when he worked in construction more than a decade ago, then moved onto street heroin, which was far cheaper. When he finally got clean in 2013, while in jail, he did well enough to gain primary custody of his then 8-year-old son.

He was living in Niagara Falls, where he had a strong support group of friends in recovery and regularly attended meetings. But he later moved to Lockport, where his son was going to school, and drifted from his recovery regimen. After a bad breakup, he relapsed, he said. It was also shortly after Covid had shut many things down. He felt isolated and “woke up the beast” after eight years of staying clean.

He and others also were not aided by bail reform laws, he said, since jail is one of the ways that drug users break the cycle of addiction, and those charged with drug-related crimes were quickly turned loose to continue using.

“I went to use one time, and two years of my life went like that,” he said, snapping his fingers.

His son was 11 when he started using again.

“I had an opportunity for him to never see me like that,” he said, “and I blew it.”

Cocaine’s hidden risk

Some recent overdose victims may not have had a history of abusing opioid drugs, a potent class of painkillers. But they have taken other illicit drugs that, unbeknownst to them, now often have synthetic opiates like fentanyl mixed into them. Others may have been addicted to opioid drugs but migrated over to alternative drugs that they considered safer, like cocaine, which actually still had opiates cut into the product.

Sullivan, for instance, said that after he got clean the first time around – after being forced to detox in jail – he learned to avoid heroin and similar opiates known to be physically addictive. But stimulants like crack cocaine and methamphetamine weren’t so bad, he figured.

“If I pick up, I’ll make sure that it’s something that won’t make me physically dependent,” he said. “At least that way, I’ve still got a chance because the desperation won’t set in. A mental addiction is something that’s bad enough, right?”

In 2019, cocaine laced with fentanyl accounted for barely a quarter of overdose drug deaths in Erie County. Now, it accounts for more than half.

The migration of addicts from opioid-related drugs like heroin and fentanyl to illicit stimulant drugs like cocaine makes sense, said Dr. Michael Manka, chief of emergency medicine at Erie County Medical Center.

Manka has spent 25 years in emergency rooms, watching the destructive evolution of the addiction drug crisis. He remembers when painkillers were widely prescribed and the subsequent crackdown. He’s seen a generation of chronic pain patients who became dependent on prescription painkillers then moved onto heroin and other opioid street drugs. He’s treated them all.

But in recent years, he has increasingly encountered overdose patients with no prior history or intention of using opioid drugs.

“The thing I’ve seen over the past probably five years, much more than ever, is the adulteration of other drugs, including cocaine,” he said.

Carson said the message that fentanyl has crept into all types of street drugs isn’t getting out clearly. As a man facing felony charges after he flipped some of his personal drugs to an informant for money to buy more, he said the drug culture is something he knows. Many users have close, yearslong relationships with their dealers and build a relationship of trust.

A user may be aware that others are overdosing on adulterated cocaine and other narcotic drugs, he said, but feel confident that their own drug contact sells better, safer stuff.

The fight for the future

In recognition of the evolving drug crisis and the need for better outreach to drug users, Erie County recently reorganized its Opioid Epidemic Task force and renamed it the Overdose Prevention Task Force. County programs that provide Narcan and fentanyl test strips free to drug users will continue, but the task force is looking beyond addressing just one class of addicting drugs.

“The name change broadens the scope of our work, extending into prevention and response for people who use cocaine and other stimulants, in addition to opiates,” said Erie County Health Commissioner Dr. Gale Burstein.

The nonprofit MATTERS Network (Medication Assisted Treatment and Electronic Referral Services), founded in Buffalo and expanded statewide, has also expanded its services. The latest includes new vending machines that offer Narcan and free test strips for fentanyl and xylazine, an abused drug developed as an animal tranquilizer.

Sullivan and Carson believe that despite their past failures, they finally have it in them to stay clean once they leave treatment.

“You pick up one thing and lose everything, or you can have everything and lose one thing,” Sullivan said.

Horizon staff point out that a system of drug addiction treatment options exist, starting with detox, then short-term and long-term rehab, outpatient therapy and halfway houses. The long-term inpatient treatment program at Horizon is just one option. Patients can stay for months, depending on their situation.

“I tried rehab once or twice during this time, and I just had not resolved within myself to be committed to being free,” said Carson, who completed his long-term rehab stay on Friday and will continue with outpatient care.

He’s renewed his commitment to God and faith to help him cope with his addiction and does not intend to miss any more of his children’s weddings.

“Definitely,” he said, “I have hope.”

RESOURCES

The county offers multiple resources to assist those struggling with drug addiction. They include: