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Fatal drug overdoses in Denver and across Colorado show declines through first half of 2024

Fatal drug overdoses in both Denver and across Colorado have declined through the first half of 2024, matching national trends and offering a ray of sunshine after the fentanyl crisis fueled years of mounting death tolls.

Still, experts and health officials cautioned, the data is preliminary and only covers the first six months of this year — and Colorado’s number of overdose deaths still remain well above pre-pandemic levels.

“Any improvement is good news,” said Rob Valuck, the executive director of the Colorado Consortium for Prescription Drug Abuse Prevention. “It certainly beats (a plateau) or going up, and it’s something we desperately need. The two big messages I have are: The things we’re doing are working, and we still have a long way to go.”

Fatal overdoses in Denver dropped 11%, to 303 deaths, between January and July compared to the same period last year when the death toll was 313, according to data from the Office of the Medical Examiner. Statewide, the fatal overdose rate per 100,000 residents declined 8% and the total number of deaths fell nearly 5% during the first six months of this year compared to 2023.

Final figures for this year won’t be available until the spring. But if those trends hold for the rest of 2024, it would mark a shift of years of increases or stubbornly high plateaus.

Statewide, as fentanyl replaced heroin as the dominant opioid in the drug supply, fatal overdoses doubled from 912 in 2016 to 1,881 in 2021, and they’ve held at high levels since. Deaths in Denver flattened in 2022 only to surge by nearly a third, to 598 deaths, in 2023, according to city data.

“It is encouraging to see overdose death rates dropping. It’s not something we’ve seen for five years,” said Tristan Sanders, the director of community and behavioral health for Denver’s Department of Public Health and Environment. “It’s nice to see the data go the way we want it to for once.”

But Sanders, like others, said the data was still preliminary and that overdoses still remained too high. Sanders cautioned that the national data showing declines still indicated that deaths remained high among minority groups, whose rates have surged amid the fentanyl crisis.

Nationally, fatal overdoses fell more than 14% between June 2023 and June 2024, “a stunning and rapid reversal of drug overdose mortality numbers,” Brown University researcher Brandon Marshall said.

Colorado officials urged particular caution about comparing the state’s data to national trends. While deaths from overdoses dropped nationally through June 2024, they effectively remained flat here: 1,820 Coloradans fatally overdosed between July 2023 and June 2024, compared to 1,837 over the same time period the year before, a 1% decrease.

More promisingly, though, Colorado’s data showed more significant declines in fatal overdoses caused by fentanyl and opioids more broadly.

“While there remains a 3-4 month lag in the complete registration and processing of this data, and the numbers for 2024 may change as the data are finalized in the coming months, we are hopeful this suggests the beginning of a downward trend, particularly in overdose deaths involving opioids and fentanyl specifically,” Vanessa Bernal, spokeswoman for the Colorado Department of Public Health and Environment, said in an email.

Experts said a number of factors could help explain the declines:

The state has distributed millions of dollars worth of naloxone, an opioid overdose antidote, to pharmacies, schools, hospitals, advocacy groups and individual citizens in recent years
Efforts to expand treatment options — including by expanding Medicaid to cover substance-use care — appear to be breaking through
Tens of millions of dollars in settlement money from companies involved in the opioid crisis has begun to flow to a variety of entities across the state and will continue to do so for nearly two decades

“We’ve worked really hard over the last decade to expand access. It’s not where it needs to be, but in Colorado, we went from an 85% treatment gap to now in the mid-to-upper 50s range,” Valuck said, referring to the proportion of people who need or want substance-use treatment but are unable to get it. “It’s not great, but it’s a heck of a lot better than when it was 85%.”

Data from the Centers for Disease Control and Prevention indicate Colorado tripled its rate of naloxone distribution between 2019 and 2023, while improving its distribution of buprenorphine — a key medication used to treat opioid addiction — and curbing distribution of legitimate opioids from pharmacies.

Earlier this month, the Drug Enforcement Administration‘s top official also announced that the agency had detected a decrease in the potency of fentanyl pills for the first time since 2021.

Perhaps most fundamentally, the public — and drug users themselves — are also likely more familiar with the potency and presence of fentanyl, which is far stronger than heroin or legitimate opioid pills. It has also spread to all corners of the drug supply, contaminating methamphetamine, cocaine and other substances — endangering drug users unaware of its presence or unfamiliar with fentanyl’s unique potency.

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Health departments, schools, law enforcement agencies and the state of Colorado itself have launched education programs about fentanyl. The state also set aside money to buy and distribute strips to test drugs for the presence of fentanyl.

But the declines may also be explained by a grim effect of years of high overdose deaths.

“It could also be the adverse selection of people who were at the highest risk of experiencing a fatal overdose have already died,” said Tyler Coyle, an addiction medicine doctor who recently served as the president of the Colorado Society of Addiction Medicine. “Which sucks. And now we’re analyzing a population of people who are still using in settings where it could be hazardous, but for whatever reason they aren’t experiencing the same outcome.”

The Associated Press contributed to this report.

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