Another November brings another report by the state Opioid Settlement Fund Advisory Board, a group of experts brought together to recommend how New York State should allocate the hundreds of millions of dollars awarded from opioid manufacturers, marketers and sellers. They reiterated, as we often do, a plea for a harm reduction approach, including the appropriate funding of overdose prevention centers. The board also made the case that Gov. Hochul should issue a public health emergency for overdose deaths, allowing the state to move more decisively to combat the crisis. A public health emergency is no small matter, but we can’t deny that this has been an escalating challenge that threatens to keep spiraling without focused intervention, and as always the costs of failures can be measured in lives indelibly impacted and lost. While the board did note that overdose deaths had ticked down ever so slightly in the last year, this comes after a sharp rise in the three years prior. Also, while deaths from opioids and heroin were down, deaths from cocaine and other stimulants were up, at least in part due to the frequent contamination of the clandestine drug supply, which has created new challenges in the fight against overdoses. The data also further spotlights a trend we’d already been seeing: Black New Yorkers are dying at far higher rates than any other racial and ethnic demographic proportional to their share of the population. From January to June of last year, 27% of the 6,000-plus overdose deaths in the state affected Black people, despite their being 14% of the population. Almost half of these were folks over 55, raising some questions not just about how we can deal with the aftermath but what is leading to these situations in the first place. Beyond the very big recommendations like the public health emergency, the board raised a number of operational concerns, among them that it was difficult for them to fully evaluate the success, performance and contours of the overall state opioid mitigation efforts and the opioid crisis without cohesive data monitoring and reporting. The best way of ensuring this pot of money — which is not recurring, like tax dollars, so once it’s gone, it’s gone — is having the maximum positive impact, state agencies and the board have to have up-to-date data and information, and have concerted long-term game plans that are responsive to what’s happening on the ground. Segmentation and siloing of government entities is anathema to all sorts of crucial functions, and the heavy task of preventing deaths and setting our fellow New Yorkers on a path towards recovery is no exception. It should also be said that, while the federal government has been slow but trending in the right direction with regards to things like harm reduction, we can probably expect that progress to disappear overnight when the Trump administration gets into place. If Biden-appointed Manhattan U.S. Attorney Damian Williams already threatened to take official action against NYC’s sanctioned overdose prevention centers, then you can bet that a Trump-appointed one will watch like a hawk. We are probably on our own, and while we can thank state Attorney General Tish James for the money continuing to roll in regardless, we’ll now have to think about fighting back against interference.