Deadly overdoses declined barely in Colorado in 2022, newly finalized state knowledge reveals, after two years of surging deaths. However public well being officers and habit consultants drew little consolation from final yr’s totals, which stay close to document highs amid fentanyl’s rising dominance of the illicit drug provide.
“(Overdoses) evened themselves out a little bit bit. We have now a brand new regular, which is horrible,” mentioned Dr. Josh Blum, an habit medication doctor at Denver Well being. “Now now we have a steady, unacceptably excessive demise charge.”
In 2022, 1,799 folks fatally overdosed in Colorado, a 4% drop from 2021’s complete of 1,881, in line with knowledge from the state Division of Public Well being and Atmosphere. The figures symbolize a bittersweet stabilization: A slight, one-year decline continues to be a reprieve after charges almost doubled lately. The variety of fentanyl-related deaths — which quadrupled between 2019 and 2021 — plateaued, and methamphetamine fatalities dipped.
But 2022’s charge continues to be increased than some other pre-pandemic yr, and fentanyl and methamphetamine proceed to gasoline and dominate the disaster. Fentanyl, a potent artificial opioid, was current in additional than half of all deadly overdoses right here final yr. Extra Coloradans died after ingesting the drug in 2022 than overdosed on all medication in 2016.
“It’s this concept that whereas we’d be capable to discover some encouragement if the numbers keep the identical or if we do see considerably of a rise — however the numbers are unacceptably excessive to start with,” mentioned Natalee Salcedo, the group well being promotion supervisor for the Adams County Well being Division. The county has {one of the} highest overdose demise tolls within the state, and Salcedo mentioned latest will increase have been most important amongst Black residents.
It’s unclear what precisely prompted the flattening of deaths, six habit and public well being officers mentioned, they usually cautioned towards drawing any conclusions of broader traits primarily based off of 1 yr. Sterling McLaren, Denver’s chief medical officer, mentioned the state could have reached a pure plateau of overdoses, versus some kind of turning level.
She and different consultants additionally famous the elevated availability of hurt discount and a few remedy companies. The state has begun to embrace hurt discount companies, supposed to assist hold drug customers alive and wholesome till they’re prepared or in a position to search remedy. However Blum and Salcedo each known as on legislators to go additional and to permit for protected drug-use websites, during which customers can devour illicit medication underneath the supervision of well being suppliers. A invoice that will’ve allowed a facility to open in Denver handed the Home earlier this yr, solely to die in a Senate committee in late April.
Legislators have extra totally embraced extra frequent hurt discount instruments: Colorado has spent thousands and thousands to distribute naloxone, which is used to reverse opioid overdoses, and lawmakers handed a invoice final yr to dole out free doses to a broader group of entities, together with colleges.
The state distributed greater than 258,000 naloxone doses between July and March, mentioned Sam Bourdon, the hurt discount grant program supervisor for the state well being division. That’s greater than double what was distributed within the yr prior. Denver additionally distributes naloxone without spending a dime to metropolis residents.
Lawmakers additionally put aside a number of hundred thousand {dollars} to purchase fentanyl check strips, they usually expanded remedy in jail settings. Thirty-one of the state’s 64 counties have additionally agreed to distribute fentanyl check strips, and the state has ordered greater than 80,000, Bourdon mentioned.
The pandemic’s finish and the broader return to normalcy can also have contributed to the state’s numbers stabilizing. Although it elevated isolation and quickly restricted conventional remedy choices, the COVID-19 disaster additionally shepherded in constructive adjustments to drug remedy elsewhere, Blum mentioned: Methadone, a key medicine used to deal with opioid dependence, has turn out to be extra accessible underneath enduring pandemic-era guidelines. Telehealth has expanded, and federal regulators in December additionally made it simpler for physicians to offer sufferers one other opioid remedy medicine.
Nationally, overdoses elevated barely in 2021, in line with knowledge from the Facilities for Illness Management and Prevention. Like in Colorado, drug deaths surged throughout America in the course of the pandemic, and 2022 represented a relative plateau after these peaks. In an announcement to the New York Instances, the Biden administration’s drug czar attributed that stabilization to expanded remedy, improved naloxone distribution and legislation enforcement efforts to restrict fentanyl trafficking.
Policymakers in Colorado have equally sought to crackdown on the drug. In the identical legislation that elevated funding for naloxone and check strips, lawmakers additionally tightened penalties for drug customers caught with the equal of roughly 10 fentanyl drugs and for sellers whose fentanyl brought on a deadly overdose.
However state knowledge present that fentanyl continues to monopolize the drug provide, a grim if unsurprising warning that overdose charges are more likely to stay excessive. Although it has respectable medical makes use of, fentanyl has turn out to be the opioid of alternative for drug producers lately, given how low cost and straightforward it’s to provide relative to heroin. It’s flooded the broader drug provide, usually contaminating different substances with out customers’ data. In 2022, as an illustration, greater than half of methamphetamine and cocaine deaths additionally concerned fentanyl.
Heroin, in the meantime, has been largely changed within the illicit market. Black tar heroin was once the dominant opioid in Colorado, and 220 folks overdosed from the drug in 2020. However that complete plummeted to 62 deaths in 2022, state knowledge reveals, as cartels have prioritized fentanyl.
The shift has been years within the making, knowledge and consultants say. Whereas heroin requires a climate-dependent cultivation course of, fentanyl might be made year-round in labs. Fentanyl can also be 50 occasions stronger than heroin and represents a much more profitable product for the cartels that dominate the illicit opioid commerce. It’s cheaper for customers, too: A fentanyl capsule can price as little as $2 to $3 apiece.
So far, Colorado hasn’t grappled with the brand new artificial substances, just like the animal tranquilizer xylazine, which might be flooding components of the East Coast. Xylazine, which isn’t an opioid, is commonly blended in with fentanyl and is especially damaging to customers who inject it. Kirk Bol of the state well being division mentioned there have been 4 deaths involving xylazine right here in 2022.
It’s unclear if 2022’s stabilization will maintain. Denver, which accounts for the most important share of the state’s overdoses, started this yr “scorching,” with extra drug deaths than the primary few months of 2022, mentioned Ethan Jamison, a forensic epidemiologist with town’s Workplace of the Medical Examiner.
He mentioned 2023 would offer perception into what Coloradans ought to count on going ahead. However fentanyl’s enduring presence suggests the excessive charges will endure, and public well being officers urged state leaders to proceed embracing hurt discount approaches.
“It’s simply going to make the subsequent couple of years (expletive),” Blum mentioned. “It’s going to be actually difficult for the subsequent few years as a result of in lots of instances, individuals who have simply been launched to opioids die earlier than they even get an opportunity to get into remedy as a result of the drug provide is so potent.”
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