Toward the end of his State of the State speech on Tuesday, after ticking off a number of progressive priorities for the coming year, Governor Andrew Cuomo turned his attention to the opioid epidemic. "I think we should invest $200 million in fighting the scourge of the opioid crisis," he said. "It is rampant across the state. It is moving like fire through dry grass."

Indeed, fatal overdoses in New York for opioids, including both prescription painkillers and heroin, have climbed more than 200 percent in less than a decade. In 2017, the last year for which data is available, 3,224 state residents died as a result of overdoses involving opioids, with about half of those deaths occurring in New York City. "In the face of such tragedy," Cuomo's office claimed in his newly-released Justice Agenda, "New York is leading the fight against opioid addiction."

That claim rings hollow for harm reduction advocates. In a blistering statement released Wednesday, VOCAL-NY described Cuomo's ideas for intervention as "watered down, under-funded and ultimately half-steps that do not go far enough." His new initiatives—like promising an aggressive expansion of Medical Assisted Treatment for users in prisons, while only offering such programs at three additional facilities—"will raise hopes and accomplish nothing," the group said.

Meanwhile, the governor's promise to invest $200 million in fighting the epidemic is specious, advocates say, if not outright misleading. Cuomo first announced that funding stream during a ceremonial bill signing in 2017; a subsequent investigation by the Democrat & Chronicle found the state had "largely just shifted funds from other addiction programs" that were already covering many of the same services.

"Cuomo is wonderful at recycling talking points about funding," Jasmine Budnella, Drug Policy Coordinator at VOCAL-NY, told Gothamist. "We've had meetings about this, where we've said 'y'all promised that there would be this $200 million that is desperately needed to fight the overdose crisis and you failed us. You lied to everybody.' I don't think that's changed."

Overall, advocates say the state’s endeavors pale in comparison to those found in places like Rhode Island or Vermont, whose hub-and-spoke model of addiction treatment is often cited as the gold standard in the United States. "There are so many things that other places are doing that are truly progressive, and truly reducing overdose rates," said Alexis Pleus, Executive Director of the advocacy group Truth Pharm. "New York is not doing those things."

Pleus, who lost her son to the opioid epidemic, lives in Broome County, which has some of the highest incarceration and overdose rates in the state. Eight people have died in Broome County Jail since 2011, many of them improper detox related deaths, according to Pleus. But unlike several other states, New York's Medical Assistance Treatment program only applies to prisons, meaning that users experiencing withdrawal symptoms are left to fend for themselves in county jails.

According to VOCAL, the most significant bit of opioid news from the governor's address concerned his support for classifying fentanyl as a schedule I controlled substance—a priority of Republicans in the State Senate that could wind up criminalizing a significant number of users, rather than helping them get treatment, advocates say. Last year, fentanyl was involved in more than half of New York City overdoses.

"Beyond the fact that criminalization is never the answer to a public health crisis, this also opens the door to drug-induced homicide laws," said Budnella. The phenomenon, in which prosecutors bring charges against fellow users in accidental overdose deaths, has become increasingly popular in D.A.'s offices across the country, despite little evidence that the approach benefits public health. According to one 2017 study, drug users cited fears of facing charges as a deterrent to calling 911 about another individual's overdose.

Equally notable, according to Budnella, is what Cuomo did not say. After signaling his support for supervised injection facilities (SIFs)—in which in which heroin users can shoot up with clean supplies—during a debate this summer, the governor made no mention of the sites in either his speech or his Justice Agenda. While Mayor Bill de Blasio announced a pilot program last year to bring four SIFs to New York City, a spokesperson for City Hall told Gothamist in November that those sites are still waiting on approval from the state health department. Activists, including artist and photographer Nan Goldin, have employed some creative methods to force the governor's hand, including erecting mock injection sites outside his Midtown office. But according to Budnella, Cuomo doesn't seem to be getting the message.

"It feels as if Governor Cuomo is giving us nothing but rhetoric, while people are dying and our communities are mourning," she said. "He's not giving us innovative solutions. He's not being a leader when compared to other states across the country who are taking this issue seriously."

The Governor's Office did not return a request for comment.