NEW YORK _ "Just Say No" _ the 1980s anti-drug slogan _ doesn't cut it here at the Brooklyn cabaret House of Yes.
Starting this month, House of Yes and dozens of other bars and nightclubs in the vibrant Williamsburg and Bushwick neighborhoods are handing out coasters and pinning up posters to warn people that the deadly opioid fentanyl might be mixed with their cocaine, and if it is, they could overdose and die.
"We know people are using drugs," said Allegra Meshuggah, the entertainment venue's costume director. "We're not trying to scare them. We just want to save a few lives."
Nationwide, overdose deaths among cocaine users, many of them occasional, have nearly tripled in the past five years for which data is available, rising from roughly 5,000 deaths in 2013 to more than 14,000 in 2017. The cause is fentanyl, data from the Centers for Disease Control and Prevention shows.
To stanch the death toll from fentanyl contamination in the illicit drug supply in New York City, the Department of Health and Mental Hygiene is working with House of Yes and other bars and clubs to encourage cocaine users to take these precautions when using the drug:
Never use alone, so someone will be there to help you if you overdose. Use a small amount of the drug at first to test for the presence of fentanyl. And make sure someone nearby has the overdose rescue drug naloxone.
Health departments in Pittsburgh, San Francisco and Seattle have similar collaborations with nightlife venues and festivals.
New York's collaboration with Brooklyn bars and nightclubs launched this month and will continue through August. After that, the health department expects the venues will continue posting fentanyl warnings and stocking naloxone behind the bar in case a patron overdoses. The agency will supply additional naloxone, coasters and other informational materials as needed.
The Brooklyn drug awareness campaign follows a test of the concept last May and June in the Lower East Side of Manhattan, another high-density nightlife area.
The spike in cocaine overdose deaths in recent years can be explained in part by an increase in cocaine use. But CDC data also indicates that opioids, including fentanyl, were involved in nearly 70% of the deaths.
Fentanyl's potency heightens the risk of overdose for people who regularly consume opioid painkillers or heroin. For cocaine users who do not regularly use opioids, the risk of overdose from trace amounts of fentanyl may be even higher, because they are unlikely to have developed a tolerance for opioids, a report by the New York City Bureau of Alcohol and Drug Use Prevention, Care and Treatment found.
In addition, occasional cocaine users who do not regularly use heroin or other illicit drugs are less likely to encounter harm reduction services or sterile syringe programs that routinely hand out naloxone kits and educate drug users about the presence of fentanyl.
Overdoses in bars and nightclubs are rare, the drug bureau report finds. The goal, New York City health research director Denise Paone said, is to help bar and club workers prepare for a potential overdose in their venues and, most important, inform their patrons about the risks of fentanyl and the importance of carrying naloxone.
