Overdose Prevention Package Memo

August 17, 2021

The Honorable Kathy Hochul
Lieutenant Governor of New York State
NYS State Capitol Building
Albany, NY 12224

TO: Governor-to-be Kathy Hochul


On August 31st, for the last twenty years, the global community has observed International Overdose Awareness Day as a day to commemorate those lost to overdose, and to urge action on the accelerated crisis. 

This year, New Yorkers will honor the many lost to preventable overdoses this past year by calling for the Overdose Prevention Package passed this session to be signed into law. 

Like your family, soon-to-be Governor Hochul, communities across the state have experienced the insurmountable grief brought on by the loss of family members from preventable overdose. Signing these three bills into law on International Overdose Awareness Day will be widely celebrated by stakeholders across the state, and will mark a shift to a new era rooted in responding to this public health crisis with evidence-based solutions.


Our state is in an extreme overdose crisis. Overdose continues to kill more New Yorkers than car accidents, suicides, and homicides combined. The most recent CDC data devastatingly shows that over 5,100 New Yorkers died from a preventable overdose in 2020 – the worst year in recorded history. Every 1 hour and 48 minutes, a New Yorker dies from a preventable overdose. Overdose within Black and Brown communities in particular have continued to rise, and access to services remain fraught with barriers.

During the height of the pandemic, as overdoses surged, Governor Cuomo’s withholding of funds allocated under FY21 budget contracts to syringe service programs resulted in staff furloughs and a manufactured syringe/supply shortage that led to HIV clusters in areas of the state, and an increase of new hepatitis C infections across the state.  

During this legislative session, the Senate and the Assembly heeded the call for urgent action to address the overdose crisis by passing three long overdue overdose prevention bills that await the Governor’s signature. 


Decriminalize Syringes and Remove the Limit at Expanded Syringe Access Program (ESAP) S2523/A868 (Rivera/Gottfried)
Access to sterile syringes is a critical tool in drug user health, and has long been demonstrated to reduce HIV and hepatitis C infections, as well as abscesses and endocarditis that can be fatal and costly to treat. Despite New York State Health Department supporting syringe exchange services, New York has a draconian law that puts people at risk of being arrested for simply possessing syringes and limits the number of syringes people can purchase at a pharmacy. Many people are arrested each year for this charge in order to increase leverage during plea negotiations, and Black and Brown New Yorkers have the highest rates of arrests (despite comparable rates of use). Not only does this law undermine the public health law as well as CDC recommendations, it inevitably leads to the increase of sharing or reusing syringes and drives up infectious disease. 

Syringe decriminalization and expansion was proposed in Governor Cuomo’s New York State’s Blueprint to End the AIDS Epidemic and listed as a recommendation in the Joint Senate Task Force on Opioids, Addictions, and Overdose Prevention Report. This February, 116 harm reduction, recovery, health care, and community-based organizations from across the signed a letter of support for this bill.

Recent Press Coverage on S2523/A868

Medication-Assisted Treatment (MAT) in all NYS Prisons and Jails S1795/A533 (Bailey/Rosenthal)

New York State has historically prioritized criminalization over public health and harm reduction responses to substance use, leading to data showing that 80% of people in our state’s jails and prisons have a substance use disorder. People who are incarcerated in New York State are being forced into inhumane withdrawals, including from their medication-assisted treatment, which leads to increased risks of overdose both while incarcerated and when released from jail. Overdose is the leading cause of death for people with a substance use disorder following their release from incarceration. Enacting this bill would mandate MAT (methadone and buprenorphine) programs – the gold standard of treatment for opioid use disorder – in all New York State jails and prisons, allow people who are incarcerated an opportunity to this life-saving treatment at any point of their incarceration and for the entirety of their incarceration, and access once they are released via a collaborative reentry strategy between clinical and parole personnel.

MAT for incarcerated people, which was included in the Biden-Harris Administration first year priorities, has been hailed as a critical solution by the Acting Director Regina LaBell of the Office of National Drug Control Policy, and this NY bill was used to help create model legislation for states across the US. 

Recent Press Coverage on S1795/A533

Remove Prior Authorization for All Formularies of Medication-Assisted Treatment (MAT) Under Medicaid
S649A/A2030 (Harckham/Rosenthal)
Removing prior authorization for medication-assisted treatment for patients enrolled in Medicaid is estimated to save nearly 600 lives a year, create a cost savings of $51.9 million dollars annually, reduce inpatient admissions and emergency department visits by 42%, and would remove the burdensome administrative barriers allowing more providers to enroll patients in treatment. 

New York State has been at the vanguard of innovative policies to remove insurance barriers to address the overdose crisis. However, despite this bill passing with bipartisan support in the 2019 session, Governor Cuomo vetoed it on January 1, 2020 while signing the identical bill to remove prior authorization for commercial insurance – effectively creating a two-tiered treatment system. We must bring parity for these life-saving medications for New Yorkers without unnecessary administrative delays.

Recent Press Coverage on S649A/A2030


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