Moving Forward: Alcohol and substance dependency 2026
Billy Strings, the GRAMMY-winning bluegrass sensation, lost his mother, Debra Apostol, to a drug overdose last year. In a recent interview with National Public Radio, the musician spoke of growing up with a loving and artistic mom, but one who was unable to properly care for him due to a life-long struggle with methamphetamines. They ultimately took her life at age 64.
His new album, “So Much for Goodbyes,” is dedicated to her. He says that he now understands that she had an illness that was beyond her control. Recently, a year after her death, Strings posted on his website, “It was the worst day of my life and it just seems like yesterday. It is just as sharp.”
The Island’s Annual Vigil of Hope is on Thursday, Aug. 27 at 6:30 p.m. Last year more than 100 community members came out — a tribute to the work of the Shelter Island Health and Wellness Committee and the Shelter Island Library. Everyone is invited to join this celebration of hope and remembrance that was initiated by Islander Gina Kraus six years ago.
The event has now become an important part of the Shelter Island summer, one hour of stories, songs, and tributes. Whether you own a house, rent one, or are just here for the weekend, all are welcome. Similarly, if you have been affected by substance abuse or not, please come to experience our beautiful community.
What is the current state of alcohol and substance use?
First the good news: Opioid deaths have decreased for the third year in a row. According to the CDC, last year there were an estimated 69,973 overdose deaths in the United States, a 14% decrease from 2024. New York State has experienced declines of approximately 44.5% since 2022. In real numbers, that is a difference of 5,000 New York lives. The use of Naloxone, (known by the brand name Narcan) and a massive multi-year education campaign have paid off.
There has also been a lot written recently about the decline in drinking in all age groups, particularly Generation Z (adults in their twenties). Still, an estimated 12% of adults 12-years or older experience alcohol use disorder according to a 2024 study. Alcohol, along with tobacco use, remains among the greatest preventable contributors to death.
Generation Z appears to be using fewer substances than previous generations. They are engaging in less risk-taking behavior including smoking. But nicotine vaping and cannabis use are on the rise. According to the National Institutes of Health, the legalization of pot has led to an increase in use, with many new daily users. While there’s no comparison to the dangers of opioids, frequent users can develop dependency and suffer adverse effects. Nicotine vaping is less lethal than smoking cigarettes but still causes addiction, health hazards, and is particularly dangerous to young people.
The Cato Institute reports a resurgence in heroin as fentanyl use has declined. They also suggest that there’s been an increase in smoking fentanyl rather than injecting it, which, while still incredibly harmful, is less lethal. For those of us growing up learning about heroin as the ultimate terrible drug, it’s hard to believe that today heroin is considered the less lethal option than fentanyl.
But the bad news is that the bad guys are always going to find a new drug, just as the current one is somewhat under control. First, we had oxycontin, then fentanyl, and now welcome to nitazene and cychlorphine. There’s no medical use for these last two synthetic drugs whose potency is frightening.
A recent New York Times article highlighted tiny Estonia where fentanyl deaths had been extremely high and then a concerted national effort reduced the deaths dramatically, only to be replaced by these new substances. According to the article, nitazenes are even more addictive and harder to treat than fentanyl. They have already caused over 1,000 deaths in Britain. And we can be certain that if it hasn’t reached our shores yet, it will soon.
One reason for diminishing deaths is harm reduction, or recognizing that when abstinence is not possible, techniques to reduce the possibility of death are necessary. This first became popular in the 1980’s with needle exchange programs to ensure that addicts were using sanitary needles. Distribution of Narcan is a modern example of harm reduction. Anyone can use it to try to save someone overdosing until medical help arrives. Registered Nurse Kelly Surerus gives Narcan lessons every year at Our Vigil of Hope. (When I’m in New York City, I carry Narcan spray in my bag. I have never had to use it, but there can always be a first time.)
While Narcan has now become universally accepted, other harm reduction measures continue to be controversial. According to a recent OpEd piece by Maia Szalavitz of The New York Times, the Trump Administration recently sent notice to state health departments informing them that certain harm reduction approaches would no longer receive federal funding. For example, methadone, long a safe alternative to heroin, has always had its detractors who argue that recovery, rather than sustaining an addiction is the only route to treatment.
Szalavitz says, “The White House seems determined to prioritize drug war and anti-medication ideology over saving lives … Most people recover from addiction. But no one recovers from death.”
No one can become complacent. There are always forces threatening the progress that’s been made, whether it be off-shore criminals or an ill-informed White House.
Together we come together to recognize the challenges and to cherish our caring community. If you are a regular attendee to the August Vigil, welcome back. If you are a newbie, you will not be disappointed.
Annual Vigil of Hope at the Bateman Road basketball court, Thursday, Aug. 27, 6:30 p.m.
Nancy Green is a social worker and co-chair of the Shelter Island Health and Wellness Committee
