Addiction treatment and recovery in Rochester out in New York has produced a result residents can take to heart. Overdose deaths in Monroe County, which includes Rochester, fell for the second straight year in 2025, dropping to roughly half of the county’s deadliest year on record, according to a new report from the Office of the Medical Examiner.
It’s good news for residents in The Knickerbocker State as they take advantage of the programs that New York has to offer. However, many people continue to slip through the gaps in the system. Officials want to drive the numbers even further downward.
Addiction Treatment in Rochester Shows Results
The 2025 Overdose Deaths Report recorded 243 overdose deaths last year. That’s a 17% decrease from 292 deaths in 2024 and a 53% decrease from the 2023 peak of 512, the worst year in county history. Families in Rochester and the surrounding communities appreciate the good news. Nevertheless, each stat still means one grieving household.
County Executive Adam Bello credited the progress while observing the distance still to go.
“Fewer overdose deaths means fewer families receiving devastating news. That is progress, but 243 deaths are still far too many.”
Explaining the Decline
County officials point to a combination of expanded access and targeted outreach such as battling other substances and peer support. Nearly 135,000 naloxone kits have been distributed across Monroe County since 2023. About 8,000 residents have received hands-on naloxone training in the past two years.
The Addiction Services IMPACT team conducts street-level outreach in high-risk areas and a post-overdose follow-up program connects people who survive an overdose directly with treatment at the moment they’re most likely to accept help.
The Shifting Drug Supply
The report also documents shifts in the street drug scene, which affect how residents should think about risk.
Fentanyl is a synthetic opioid roughly 50x stronger than heroin. It remains the region’s most lethal opioid. Fentanyl-related deaths fell 69% to 135, the lowest figure since 2015. But fentanyl still appears in counterfeit pills and other drugs without the buyer’s knowledge. Signs of fentanyl exposure include drowsiness, slowed breathing and confusion.
Cocaine now appears in 80.7% of overdose deaths, surpassing opioids as the most common substance. In 37.9% of deaths, cocaine didn’t have any opioids mixed in, up sharply from 22.6% in 2024. Naloxone doesn’t reverse stimulant overdoses.
Xylazine is a veterinary tranquilizer increasingly mixed with fentanyl and was involved in 30.9% of deaths. It also doesn’t respond to naloxone and can cause deep sedation and severe skin wounds.
Addiction Treatment in Rochester & Beyond
Rochester residents concerned about a loved one have help. They can learn the warning signs of addiction and take preventive steps. The county urges anyone who uses street drugs to test their supply with fentanyl and xylazine strips, avoid using alone and keep naloxone nearby regardless of the substance.
The county also launched a new Overdose Surveillance Dashboard this month, replacing its opioid-only tracking tool with a broader view of local trends.
Our website also offers resources, starting with browsable listings of verified addiction treatment centers all across the country. Call
800-681-1058
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