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Travis County saw a historic number of fatal overdoses last year. Advocates say that was preventable.

A vial of naloxone
Miguel Gutierrez Jr.
Travis County wants to be able to distribute naloxone to counteract opioid overdoses.

More than 300 people in Travis County died from overdoses last year, according to the medical examiner. It was the highest number of overdose deaths in the county’s recorded history.

Now, county officials say they’re pushing for more harm-reduction measures to cut down on fatal overdoses and opioid addiction — including declaring a public health crisis.

Nearly 40% of drugs involved in the county's 308 overdoses contained fentanyl. In 2020, only 35 overdose deaths involved the drug. In 2021, that number was 118.

In light of the spike in deaths, the Travis County Commissioners Court on Tuesday renewed a program to provide methadone to people struggling with opioid addiction. County Judge Andy Brown also suggested Central Health, the county-funded health care provider, establish a program to distribute the drug, which helps ween people off opioids.

“Methadone is a safe way to where they will not have withdrawal, and they can go to work and things like that," he said. "There has been a call for us to provide more of these services that will lead to, hopefully, fewer overdoses in our community."

Brown said Wednesday he’s also considering declaring a public health crisis. That designation wouldn't carry the legal weight of a public health emergency declaration, but it would help the county bolster funding to programs that address substance abuse.

Brown also wants the county to directly distribute naloxone, a drug that counteracts opioid overdoses. Currently, the county partners with Integral Care, the mental health authority and largest behavioral health provider in the area, for the program. Travis County wants to take a more active role in distributing the lifesaving drug.

Texas lawmakers approved a law in 2015 that greatly expanded access to naloxone, allowing individuals and even pharmacies like Walgreens the ability to acquire the drug with greater ease, but it's unclear whether a governmental entity would be able to do so.

Brown said he's asked County Attorney Delia Garza to look into how the county could distribute the drug under state law.

Cate Graziani of the Texas Harm Reduction Alliance has been pushing for that for nearly a year. After a surge in drug-related deaths in 2020, the nonprofit released a report in August calling for an expansion of measures like naloxone distribution and expanded access to methadone.

"We warned our local officials about this last August," she said. "They really didn't take action, and now we're here."

Graziani said she's encouraged to see the county take a more active role, but acknowledged it’s not immediately clear if a naloxone-distribution program would be legal.

She said it would likely draw scrutiny from Gov. Greg Abbott, a frequent critic of the county's and city's progressive-leaning policies. Graziani said she hopes Abbott becomes more engaged and realizes substance abuse affects Texans of all stripes.

"It is affecting people across communities, races and ethnicities. This is not a kind of single-population issue. ... Communities around the state know that to be true, and I do think this is a moment where we need to stand together and let our state officials know we do not want our folks to die anymore — and our folks are also their folks," she said. "Republican voters are dying of overdose in Texas, and I hope that the governor cares about them."

State law currently prohibits distribution of strips to test whether there is a concentration of fentanyl in drugs. While Brown called on state lawmakers to allow for that, Graziani said it may be "too little too late" from a harm-reduction standpoint. This year's spike in fatal overdoses suggests most drugs in the Austin area contain some trace of fentanyl, she said.

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Andrew Weber is a general assignment reporter for KUT, focusing on criminal justice, policing, courts and homelessness in Austin and Travis County. Got a tip? You can email him at Follow him on Twitter @England_Weber.
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