The addiction crisis continues to evolve rapidly The drug supply is growing increasingly unpredictable, with potent synthetic opioids and adulterants like xylazine and medetomidine contributing to overdose risk across populations.

Western New York remains profoundly affected. Erie County reported nearly 400 overdose deaths in 2023, making it the deadliest year on record, with nearly one person dying every day. While deaths began declining through 2024 and into 2025, nonfatal overdoses remain steady — and likely underreported — showing that risk remains high even amid slight improvements.

In this episode, host Allison Brashear, MD, MBA welcomes two experts in addiction and emergency medicine to discuss how emergency medicine–led innovations — including Emergency Department-initiated treatment, medication-assisted treatment pathways, and the MATTERS network — are reshaping access to care at a moment when both national trends and local realities demand urgent, coordinated response.

Joshua J. Lynch, DO, is a nationally recognized leader in emergency department-initiated medication-assisted treatment, he founded the MATTERS network in 2016, which links patients from emergency departments, jails, and community organizations to rapid-access treatment across New York State, Pennsylvania and New Jersey.

Brian Clemency, DO, professor of emergency medicine, is an authority in EMS and prehospital care. He has helped modernize overdose response protocols at a time when synthetic opioid potency and polysubstance involvement continue to intensify nationally and in Western New York.