Every overdose victim in the city ends up at the medical examiner, where samples of tissues and blood are carefully extracted, then distilled into glass vials and stacked into trays dozens deep. Long after the bodies are released to family members, toxicologists do the work of figuring out exactly what killed them. Victims can be found with needles still in their arms, a once-rare phenomenon that is a sign of how quickly fentanyl can kill, Dr. Graham said. Family members sometimes say they didn't know to intervene, because they mistook the labored breathing of an overdose for snoring.
At least 815 homeless New Yorkers died in public spaces, shelters and hospitals during the 2022 fiscal year, the most on record, according to city data. Almost 600 of those deaths wound up in the medical examiner's office, which ruled 330 of them overdoses.