Drug Overdoses Spiked In Subway But Data Lag Hinders Action

By Ella Napack and Jose Martinez, The City

August 12, 2024

Alexis Aponte’s last stop was inside a Bronx subway terminal at Norwood-205th Street.

That’s where the 29-year-old Queens man was found dead aboard a D train on New Year’s Day 2021, officials said, after fatally ingesting fentanyl.

“I was going to have him as a best man at my wedding,” said Damien Gray, a childhood friend and a former opioid addict.

Aponte’s death was one of 41 fatal overdoses in 2021 within the New York City subway system, according to data obtained by THE CITY through a Freedom of Information Law request.

And that number nearly doubled the next year, the numbers from the Department of Health and Mental Hygiene reveal, when 79 people fatally overdosed in stations or on trains.

The 93% surge in deadly overdoses in the subway system in 2022 far outpaced the number of such deaths elsewhere across the city, which increased 12% over that same timeframe.

The 2022 figures are the latest available from the Health Department for location-based incidents and officials said last year’s numbers are unlikely to be available until later this year, citing “preliminary” findings. The official reports are typically released on a nearly 12-month delay.

That lapse makes for an incomplete picture of the state of drug use across the city’s sprawling transportation network, even as fire union and MTA officials acknowledge an enduring challenge that typically worsens in the coming cold months when more people seek shelter in stations and on trains.

EMTs respond to a person in distress on 125th Street in Harlem, July 20, 2021. Credit: Ben Fractenberg/THE CITY

Firefighters and EMTs are often the first to tend to the victims, but the FDNY was unable to provide data on overdose calls in the subway for any of the last five years, despite multiple requests from THE CITY.

Those on the front lines, however, say they are seeing the stark reality of the increase.

“We get these calls into the stations every day, multiple times a day,” FDNY EMS Lt. Anthony Almojera, vice president of the Uniformed EMS Officers Union, told THE CITY. “And I am getting more calls than I am used to.”

Advocates and first responders point to a growing housing problem for those struggling with addiction as a primary reason for the spike in subway overdoses, even as those in homes and other private indoor settings dropped in 2022.

Transit officials said that stations near safe injection centers have become a draw for drug users once those sites close.

“When they close, a lot of those people drift into the adjacent subway station and for lots of people, including people with kids, it becomes a less comfortable place,” Janno Lieber, MTA chairperson and CEO, said after the agency’s July board meeting. “And there’s also a ton of hypodermic needles that end up on the tracks.”

Almojera noted, however, that FDNY EMS crews frequently run out on drug-related calls to stations that are not near safe injection sites. He cited Third Avenue-149th Street in The Bronx, Atlantic Avenue-Barclays Center in Brooklyn and 34th Street-Penn Station as other hotspots.

“It happens in smaller stations too, it happens everywhere,” he said.

In the MTA’s January Customers Count Survey, the two lowest-ranked stops for safety were 116th and 125th Street stops beneath Lexington Avenue. First responders and outreach teams also point to these stations as hubs for drug use.

Participants of OnPoint NYC, the nonprofit that runs two various sites where individuals can use drugs under medical supervision, often find other places in the neighborhood to spend time after the doors of OnPoint close at 8 p.m. and before they open again at 6 a.m.

“When you are homeless, where else do you expect people to go if the weather is bad?” said Janet Marrero, a participant in the program at OnPoint’s East Harlem location on 126th Street, adding that she uses drugs in stations during rainstorms and colder months.

Overdoses have been the leading cause of death among homeless New Yorkers for the past three years, according to reports released by the Health Department.

MTA officials in 2022 specifically cited the stations near OnPoint’s safe-injection sites — 181st Street on the No. 1 and 125th Street on the Lexington Avenue line — as transit trouble spots for drug use, THE CITY reported at the time.

OnPoint also does daily 6 a.m. outreach in Upper Manhattan stations. The teams collect discarded syringes, hand out overdose-reversal medication and encourage participants to go to the centers.

“In the winter, it is basically an encampment in the station,” said Donnell Stengle, a member of the OnPoint outreach team, who spoke with THE CITY after a visit into the subway early Tuesday. “We hand out Narcan to anyone who will take it.”

Stengle recalled finding a man last winter who had apparently died of an overdose inside the 116th Street stop on the No. 6 line, his body already stiff and cold when the outreach team arrived.

“You have to have a real stomach for this job,” he said. “You can’t save everybody.”

Data Lacking

Setting-specific information, such as the public transportation overdose numbers obtained by THE CITY in July, is not included in the city’s annual reports on fatal overdoses.

In May, the Health Department produced a preliminary citywide report on overdoses through the first three quarters of 2023. Though the full report is still not available, it did confirm that fatal overdoses remained elevated in 2023, with 2,281 people that died through September, compared to 2,206 from the same period the year before.

The numbers have been steadily increasing over the past decade, with a dramatic ramp up after 2019 — when fentanyl became prevalent in the drug supply.

Jasmine Budnella, director of drug policy at VOCAL-NY, a nonprofit advocacy and outreach organization, pointed to limited public data availability as a reason issues surrounding fatal overdoses are slow to be addressed.

An OnPoint NYC van near the 125th Street 4/5/6 station, July 30, 2024. Credit: Alex Krales/THE CITY

“There are plenty of solutions for overdoses in the subway,” said Budnella. “But we are not going to solve it if we are always responding to data on the crisis from a year or two years ago.”

The city has yet to indicate measures to solve the long lag in overdose data, and as Gothamist reported last month, city medical examiners are no longer conducting autopsies for some suspected overdoses due to staffing shortages, potentially leading to less accurate assessments on deaths.

Budnella explained that although people on the ground can raise the alarms, the best way to get governing bodies and decision-makers on board with changes is with comprehensive data that’s not on a year lag.

“We are playing defense on the overdose crisis while thousands of people die every year,” said Budnella.

Partnering Up

Jason Beltre, OnPoint’s outreach director, said his team’s ability to respond to overdoses in the subway is limited without more buy-in from the MTA.

“The need is so high and so great,” he said. “The only way it’ll be successful is if we work together.”

Addiction-focused organizations like OnPoint and Alliance for Positive Change say they are eager to partner with the MTA or the city to expand resources in the subway.

Alliance and OnPoint representatives said they have offered services to the MTA, but noted that their proposals have not been accepted. The organizations are advocating for increased availability of the anti-overdose drug Naloxone in the subway system and kiosks to dispose of syringes left in stations and on tracks.

“There are trained people who can do this stuff, there are programs out there,” said Almojera of the FDNY EMS union.

In Boston and Denver, transit agencies have installed Naloxone kiosks in stations.

Homeless outreach workers speak with a man at Herald Square, Dec. 20, 2019. Credit: Ben Fractenberg/THE CITY

“MTA is not a social service agency, and they shouldn’t try to be,” said Marcus. “We are a social service agency, and we want to be, so we can provide that level of service.”

City Hall has long partnered with the Bowery Residents Committee for outreach in Manhattan subway stations, matching individuals with housing and resources. The organization, which in 2020 was flagged by the state comptroller for “shoddy” work on subway homelessness, did not respond to multiple requests for comment from THE CITY on how it helps those struggling with substance use.

Officers with the MTA Police and the NYPD Transit Bureau also carry Naloxone and respond to overdoses frequently, Lieber noted at the July Board meeting.

For Gray, the memory of Aponte’s death is a daily reminder of the deadliness of opioid addiction.

“I’ve been trying to move on but it’s really hard,” said Gray. “His death made me never want to touch the stuff again.”

This press release was produced by The City. The views expressed here are the author’s own.