STATEN ISLAND, N.Y. — Dangerous combinations of fentanyl mixed with cocaine, veterinary medications and other substances are causing overdoses on Staten Island and across New York City — a trend that prompted a warning from the borough’s Fentanyl and Overdose Task Force.
While the Island experienced a 49% reduction in accidental deaths from overdoses last year, fentanyl remains a serious threat to the health and well-being of people suffering from substance use disorders, according to the task force’s final report.
Fentanyl, a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine, is the leading cause of fatal overdoses on Staten Island and the rest of New York City.
A significant reduction in the flow of fentanyl into the United States from Mexico is noted in the report, which attributes this development to enhanced law enforcement and increased public awareness about the dangers of that opioid.
With the decrease in fentanyl availability, cocaine and heroin use is on the uptick citywide, according to the report.
Drug traffickers have reacted to the decrease in fentanyl by combining that opioid with other potentially deadly substances in order to maintain supply and potency, according to the report, which was issued at a news conference Wednesday at the office of District Attorney Michael E. McMahon.
The Staten Island Fentanyl and Overdose Task Force reveals its legislative agenda during a news conference Wednesday hosted by District Attorney Michael E. McMahon at his office in St. George on Wednesday, Nov. 12, 2025. Meagan Sills, president of Northwell Staten Island University Hospital, speaks at the podium.(Advance/SILive.com | Jan Somma-Hammel)
“Fentanyl remains present in nearly every street substance,” said Meagan Sills, president of Northwell Staten Island University Hospital.
She warned that more dangerous illicit opioids are on the horizon.
“Looking ahead to 2026, we expect to see new synthetic opioids emerge that are even more potent than what we’ve seen today,” Sills said.
When victims have more than one drug in their systems, it’s commonly referred to as polysubstance use.
“Polysubstance use is rising, which makes overdose response more complex and unpredictable,” Sills said.
The Staten Island Fentanyl and Overdose Task Force reveals its legislative agenda during a news conference Wednesday hosted by District Attorney Michael E. McMahon at his office in St. George on Wednesday, Nov. 12, 2025. Dr. Joel Idowu, chairman of the Department of Psychiatry and Behavioral Health Sciences at Richmond University Medical Center, speaks at the podium. Ileana Acosta, director of behavioral health at the Staten Island Performing Provider System, stands behind the podium. McMahon is on the right.(Advance/SILive.com | Jan Somma-Hammel)
Dr. Joel Idowu, chairman of the Department of Psychiatry and Behavioral Health Sciences at Richmond University Medical Center, said that his department requests the autopsy report for every client who dies. Sometimes he is “amazed and shocked” by the number of substances detected in one person.
“So that tells me that really there’s a lot of work to be done because we really haven’t gotten to the root of the problem,” Idowu said, adding that he is committed to working with the task force toward the goal of zero deaths from drug overdoses.
The NYPD and the city Office of the Special Narcotics Prosecutor were among the sources who contributed information about drug trends listed in the report.
NYPD Deputy Chief Amir Yakatally of Patrol Borough Staten Island speaks at the Staten Island Fentanyl and Overdose Task Force news conference at the office of District Attorney Michael E. McMahon in St. George on Wednesday, Nov. 12, 2025. Ileana Acosta, director of behavioral health at the Staten Island Performing Provider System, stands behind the podium.(Advance/SILive.com | Jan Somma-Hammel)
NYPD Deputy Chief Amir Yakatally of Patrol Borough Staten Island stressed that public safety is “a shared responsibility, a team effort among our law enforcement partners, neighboring agencies, health care providers, elected officials, and the people we proudly serve.”
He attributed the 49% decrease in fatal overdoses to the collaboration of the task force members.
“While we are proud of the progress we made, we know there’s still a lot of work to be done,” Yakatally said. “We will continue standing with our partners in law enforcement, public health, and throughout the community to reduce overdoses, support recovery, and keep Staten Island families safe.”
Dr. Joseph Conte, executive director of the Staten Island Performing Provider System, speaks at the Staten Island Fentanyl and Overdose Task Force news conference at the office of District Attorney Michael E. McMahon in St. George on Wednesday, Nov. 12, 2025. Ileana Acosta, director of behavioral health at the Staten Island Performing Provider System, stands behind the podium.(Advance/SILive.com | Jan Somma-Hammel)Fentanyl-cocaine on the rise
The report states that fentanyl-cocaine combinations are increasing. The district attorney’s office has “documented a notable rise in cocaine seizures throughout 2024 and into 2025, signaling an expanding trend with serious public health implications.”
Heroin, the veterinary sedative xylazine and microplastics are being mixed with fentanyl. Seeping into the illegal drug pipeline are even more potent medications designed for animals, including the sedative medetomidine and the opioid carfentanil, according to the report.
McMahon, who founded the task force in 2023 with Borough President Vito Fossella, said, “We continue to see fentanyl as a major driving factor in overdoses, but we’ve also seen the scourge of medetomidine and xylazine, as well as carfentanil.”
Carfentanil is a synthetic opioid 100 times more potent than fentanyl. “Even trace amounts can cause overdose, making elimination of this substance from the borough a top priority,” according to the report.
Kratom, a plant-based substance, remains legal and widely available at convenience stores despite its highly addictive opioid effect. The task force is striving to have Kratom added to the state schedule of controlled substances.
Adrienne Abbate, executive director of Staten Island Partnership for Community Wellness, speaks at the Staten Island Fentanyl and Overdose Task Force news conference at the office of District Attorney Michael E. McMahon in St. George on Wednesday, Nov. 12, 2025.(Advance/SILive.com | Jan Somma-Hammel)Fake prescription pills can kill
Fake prescription pills that look like their real counterparts are being peddled on the streets and on the dark web. The pills potentially contain deadly doses of fentanyl, according to the U.S. Drug Enforcement Administration’s One Pill Can Kill campaign.
“Counterfeit pills continue to pose a real danger, especially for young people who may believe that they are taking something harmless,” Sills said.
Seniors who purchase medications online are being targeted by criminals, according to the report.
Websites that falsely present themselves as legitimate pharmaceutical companies are selling fake prescription pills.
Additional speakers included Dr. Ginny Mantello, director of Health and Wellness at the Borough President’s Office; Jacqueline Filis, executive director of the YMCA of Greater New York Counseling Service; and Adrienne Abbate, executive director of Staten Island Partnership for Community Wellness.
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