NYC Overdose Data 2024: Full Breakdown
The headline numbers
The NYC Department of Health and Mental Hygiene (DOHMH), in partnership with the Office of the Chief Medical Examiner, released Epi Data Brief #150 in October 2025 covering 2024 overdose mortality. Headline findings: total deaths 2,192 (down 864 from 2023, a 28% decrease); fentanyl present in 73% of deaths (down from 80% in 2023); xylazine present in 21%; all five boroughs saw decreases. The first-quarter 2024 provisional figure (616 deaths) represented the lowest quarterly count since 2020, and subsequent quarters continued the downward trajectory. See the full brief at nyc.gov/assets/doh/downloads/pdf/epi/databrief150-unintentional-drug-death-2025.pdf.
Borough-level breakdown
Bronx residents continued to bear the highest borough-level overdose rate in 2024 — more than double Manhattan's rate (the borough with the second-highest rate). Bronx rates decreased 24% year-over-year but remain the highest. Staten Island saw the largest decrease, approximately 49%. Prior-year 2023 age-adjusted rates per 100,000 residents were: Bronx 78.0, Staten Island 40.1, Manhattan 36.0, Brooklyn 32.9, Queens 24.5 — with 2024 rates proportionally reduced across all five boroughs. For placement advisors and for callers trying to understand their local risk, the geography matters: the Bronx still carries a fundamentally different burden than Queens in the same city.
Neighborhoods bearing the greatest burden
Using the United Hospital Fund 42-neighborhood classification, the five neighborhoods with the highest 2024 overdose rates were Hunts Point-Mott Haven (Bronx), Highbridge-Morrisania (Bronx), Crotona-Tremont (Bronx), East Harlem (Manhattan), and Fordham-Bronx Park (Bronx). Four of the top five are in the Bronx. These neighborhoods have carried the highest rates for three consecutive years. Poverty-level analysis shows rate decreases in 2024 were larger in low-poverty (37% decrease) and medium-poverty (32%) neighborhoods than in high-poverty (27%) and very-high-poverty (23%) neighborhoods — meaning inequity widened even as the overall curve bent downward (DOHMH Epi Data Brief #150).
The substance mix
Fentanyl — still the dominant contributor, at 73% of 2024 deaths (down from 80% in 2023). Xylazine — present in 21% of 2024 deaths, up from 31% in 2023 per DOHMH 2024 reporting (ranges reflect provisional revisions across briefs). Cocaine and stimulants — sustained high contribution, often in combination with fentanyl due to supply contamination. Alcohol — underrepresented in overdose mortality but the leading driver of SUD treatment admissions statewide. The 2024 NYC Health Advisory #20 flagged carfentanil and medetomidine emerging in the NYC supply (nyc.gov Health Advisories). Medetomidine — another veterinary alpha-2 agonist like xylazine — has been appearing in drug checking samples.
Statewide context
At the New York State level, provisional CDC data (Healthbeat 2025) indicated approximately 4,567 overdose deaths in 2024 — a 32% decrease from 6,688 in 2023. About 77% of deaths involved an opioid. Governor Hochul's administration reported distribution of 13 million+ fentanyl test strips, 10 million+ xylazine test strips, and 296,000+ naloxone kits to residents, with an additional 537,600+ naloxone kits distributed through NY Department of Health channels between January 2024 and April 2025. The state's harm-reduction distribution scale is the largest it has ever been.
Frequently asked questions
Where does this data come from?
NYC DOHMH Bureau of Vital Statistics and the NYC Office of Chief Medical Examiner, published in Epi Data Brief #150 (October 2025). State-level figures from the CDC and the NY State Opioid Annual Data Report 2025.
How recent is this data?
2024 annual data (final) published October 2025. Quarterly 2025 data publishes provisionally; we update this page as new briefs are released.
What neighborhood breakdown is available?
The United Hospital Fund 42-neighborhood classification, reported annually in DOHMH Epi Data Briefs. Neighborhood-level rates are calculated using 2020 Census population estimates updated through 2023.
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