With fatal drug overdoses at alarming levels in New York City, particularly from opiates like heroin, Mayor Bill de Blasio on Monday vowed to reverse the tide and reduce the number of deaths by 35 percent over five years through a combination of outreach, treatment and law enforcement.

The plan, alluded to in Mr. de Blasio’s state of the city address last month, would see the city spend as much as $38 million a year on a broad array of services, including expanded methadone and buprenorphine treatment for addicts; a focus at city hospitals on dealing with addiction and overdoses; aggressive prosecution of illicit opioid distributors and heroin dealers; and the distribution of medication to reverse heroin overdoses to all 23,000 city patrol officers.

The announcement, at Lincoln Hospital in the Mott Haven neighborhood in the Bronx, comes as illicit and prescription opioids are driving a surge in fatal overdoses in New York City, and it follows efforts around the country to address an epidemic that the Drug Enforcement Administration last year said kills more people than firearms.

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