The first 911 call came at 8:18 am from the city of Buffalo. Not long after, there was another in neighboring Tonawanda, and then another from Lackawanna, just to the south. Eight minutes after that, a second call from Buffalo, just before another one from Tonawanda.

Seven deaths in less than five hours, all drug overdoses, and all within Erie County, the biggest population center in western New York state and the home of a surging and intractable drug problem. The spate of deaths, on June 17, pushed the county’s tally of overdose deaths this year past 200, putting it on track to match or surpass the grim record of 435 set last year, even as the United States saw a slight decline in such deaths. .

The crisis knows no bounds, officials say.

“This is from the wealthiest areas in Erie County, and the poorest sections of the inner city,” said John Garcia, the county’s sheriff. “This is black and white, male and female. It does not discriminate.”

Overdose deaths have touched cities across the country, including Baltimore, where 6,000 people have died over the past six years.

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In some ways, drug deaths have become so common that the Erie County toll of June 17 seemed to barely register beyond relatives, frontline workers and officials who have been fighting what they call “an epidemic.”

Elected officials say that Erie County’s struggle comes despite a yearslong effort to combat the problem, including an overdose prevention task force and access to anti-overdose drugs and addiction counseling.

“We had hoped for a greater reduction in the number of deaths,” said state Sen. Sean Ryan, a Democrat whose district was the site of most of the June 17 fatalities. “Any time we try to get our hands around it, it changes its shape.”

Toxicology tests on the victims — six men and one woman — are incomplete. But the suspected culprit is well known: fentanyl, the potent synthetic opioid that crashed into the nation’s drug supply about a decade ago, killing as it went.

The overdoses had other alarming elements, officials said. The victims were middle-aged, ranging from 43 to 61. Authorities said six of the seven cases also involved crack or powder cocaine, a stimulant, with only one linked to tainted heroin, an opioid, though here, too, crack was involved. Four days later, according to the sheriff’s office, another fatal overdose in nearby Grand Island claimed a victim in their late 50s, and again, likely from cocaine.

Emily Tout, a 28-year-old from Buffalo, lost her uncle, James Zimmerman, on June 17; he overdosed with a friend while the two men did cocaine. She said that while his death wasn’t necessarily a shock — he had long abused drugs — it had hit home with her and her extended family, which she said included “a bunch of addicts” whom she had tried to warn about the danger of the current drug scene.

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“This happens all the time,” she said, adding, “It could be their first time that they use and, you know, they’re at a party, and next thing you know, they’re dead.”

Dr. Gale Burstein, Erie County’s health commissioner, said that cocaine’s popularity has been rising, and that many users are not on guard for what it might be mixed with, including fentanyl; xylazine, a tranquilizer that can cause open wounds; or benzodiazepines, a class of sedatives.

“It’s not the same drug that they have used for years,” Burstein said. Officials said Erie County has made ample supplies of free test strips available.

Dr. Joshua Lynch, chief medical officer for Matters, which helps link people to treatment and provides access to medication and overdose prevention supplies, says some cocaine users go to the emergency room unaware that they are in opiate withdrawal because they don’t suspect fentanyl is in. their drugs.

“They just think that they’re sick,” he said.

Even before June 17, the situation in Buffalo had state and local officials, as well as nonprofit organizations, racing to distribute naloxone, often known by the brand name Narcan, which can counteract opioids.

Blue vending machines, small red “Narcan Emergency Kits” and repurposed purple newspaper boxes, all stocked with free doses of the drug, dot the city — outside corner delis and liquor stores, in bars and in public parks. So do testing strips for fentanyl and other drugs, popping up in coffee shops and community gathering places.

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Narcan is snapped up as soon as it’s dropped off, and those stockpiling it have harrowing stories of overdoses everywhere: unconscious victims found in city parking lots, in backyards and behind the wheel of a stalled U-Haul truck.

After the June 17 overdoses, Burstein said the county sent so-called “peer navigators” into the streets to spread the word about “very dangerous substances out there,” even as anti-drug workers warned that some users would seek out those exact drugs. .

“There’s people out here looking for what they died of,” said Rashone Scott-Williams, whose group, WNY Mobile OPS, delivers Narcan. “That’s the scary part.”

The nation as a whole saw overdose deaths decline in 2023, although they still topped more than 100,000. In New York, there is profound pessimism and concern; A Siena College survey released on the day of the Erie County deaths showed that 68% of New York residents polled knew someone who has abused opioids or died from an overdose — with more than one-third saying they knew of a death. And 72% said the situation has worsened in recent years.

Health officials, law enforcement authorities and addiction specialists say there are several reasons for the ongoing surge in the Buffalo area, such as an interweaving of entrenched poverty, generational addictions and fraying support systems. The coronavirus pandemic sparked an increase in addictive behavior and relapses, and rehab centers temporarily closed. Buffalo also suffers from proximity to Canadian border crossings, known drug trafficking routes.

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In the city, which has long been segregated, the rate of opioid overdose deaths among Black residents has been rising, health officials say, after years of such deaths being concentrated in white communities. Scott-Williams, who founded her organization in 2018 to address the drug problem in the Black community, said she has seen the trend firsthand: In the past year or so, she’s had two cousins ​​and a niece die.

Scott-Williams, 51, uses her own Jeep to take Narcan and testing strips to locations in Riverside, a north Buffalo neighborhood, including directly to drug dealers and women working as prostitutes. She funds her activities with a small state grant and has put tens of thousands of miles on her Jeep.

“We are desperate for volunteers, desperate for funding,” she said. “Because we have to make the kits available. We have to just get them out on the street.”

The state’s Office of Addiction Services and Supports has sent nearly 1 million fentanyl and xylazine test strips to Erie County since August 2022, and tens of thousands to neighboring counties.

While Buffalo is the area’s biggest city, the problem is regional: In May 2022, BestSelf Behavioral Health, a nonprofit that offers buprenorphine, a drug that reduces withdrawal symptoms, helped launch a 24-hour hotline in eight western New York counties. The hotline had 755 people ask for help in its first year. In the past 12 months, that number has more than tripled, to 2,485.

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Elizabeth Woike, president of BestSelf, said her organization can get people on buprenorphine within hours. What is harder, however, is retaining employees to spread the word “because it’s such high burnout work,” she said.

Other groups use volunteers, including Creative Restorations, which was founded last summer by Christopher Harzynski, a former addict who started it after two close friends overdosed.

Harzynski, who is 41 and said he has been clean for 16 years, works out of an office in a Buffalo church, adorned with a few shelves of used clothes, a picked-over pantry, and a poster displaying Maslow’s hierarchy of needs. But his main work is outside, distributing Narcan and cheap, waterproof pencil pouches packed with testing strips and brochures for help groups.

On a steamy Wednesday afternoon, just two days after the seven overdose deaths, demand was immediate: Even as Harzynski put the Narcan out — dropping it into plastic purple newspaper boxes, known as Grimace boxes for the McDonald’s character — residents walked up to ask for more.

One of them, Albert Baez, 63, said he’d watched a man overdose the day before, leaning against a chain-link fence on his property’s edge. People use drugs there every day, he said. “I want to have this, just in case, because they keep coming around,” he said.

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The story is the same up and down these blocks on the west side of Buffalo, with deli operators talking about spraying Narcan as though they were discussing selling ice cream. On a corner under the shade of a distressed tree, four men discussed the problems, including Earl Williamson, 68, who said he had been sober for 39 years, but still took a box of Narcan from Harzynski.

“Might be able to save someone’s life,” he said.

There have been no arrests in the June 17 overdoses, although Garcia puts the blame squarely on dealers who cut cocaine with cheap and plentiful fentanyl to make their profit margins larger.

“This is about greed, and nothing else but greed,” he said.

He added that it saddened him to think that some victims were old enough to have grandchildren. Erie County is “the size of a living room when it comes to knowing people,” he said.

“I’m sure that these seven people, there’s a couple degrees of separation from everybody else in Erie County,” Garcia added. “It’s traumatic for everybody involved.”