NYC Homeless Mortality Report Reveals Substance Use as Leading Killer Amid Broader Overdose Trends

A newly released joint report from New York City’s Department of Health and Mental Hygiene (DOHMH) and Department of Social Services/Homeless Services (DHS) documents that substance-related causes accounted for nearly half of deaths among people experiencing homelessness in fiscal year 2025 (July 2024–June 2025). Of 634 total deaths, 285 (45%) were linked to drugs or alcohol, with drug-related causes alone responsible for 251 deaths (40%) and alcohol misuse for 34 (5%).

This aligns with NY Post reporting on the official 2026 mortality report, which notes drug overdoses as the dominant cause despite an overall 18% drop in homeless deaths from 770 the prior year and a 28% decline in drug-related fatalities from 348.[1][1] Other leading causes included heart disease (78 deaths, 12%), accidents excluding overdoses (60, 9%), and cancer (23, 4%). The data covers deaths in shelters, on streets, subways, and other locations, with 52% of decedents unsheltered.

Context from prior analyses underscores persistence: a HELP USA review of DOHMH/DHS reports from FY2006–FY2024 shows overdose deaths among this population surging 815% to 348 by FY2024, remaining the top cause for over a decade.[2] Citywide patterns echo this, with NYC DOHMH data highlighting ongoing opioid involvement in the majority of overdoses amid a national crisis.[3] Officials caution that figures may undercount due to incomplete data on migrants in separate facilities.

The report, the 20th in a legally mandated series, highlights vulnerabilities compounded by housing instability and health disparities, even as shelter populations declined to ~83,200 by early August 2026 from pandemic-era peaks.