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Fentanyl deaths in Travis County doubled in 2022, medical examiner says

A person holds a vial of liquid labeled "Naloxone."
Miguel Gutierrez Jr.
A person holds a naloxone kit, a life-saving drug used for people actively experiencing an overdose.

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Fentanyl-related deaths more than doubled in Travis County in 2022, according to data from a newly released county medical examiner’s report.

The Travis County Medical Examiner’s Office investigates and certifies the cause for all local deaths that are “sudden, unexpected, violent, suspicious, or unnatural.” In 2022, 417 deaths investigated by the medical examiner were attributed to accidental overdoses, a 35% year-over-year increase.

Much of that uptick was ascribed to fentanyl. The synthetic opioid is approved by the Food and Drug Administration for pain relief uses in controlled medical settings, but it is dangerous when misused. Fentanyl is 50 times more potent than heroin, and has been found in pills made to look like oxycodone and other pharmaceutical drugs. It was a factor in 245 deaths in Travis County last year, up from 118 in 2021. Over a three-year period, the difference is even starker; the examiner’s office only connected 22 deaths to fentanyl in 2019.

While increased fentanyl overdoses occurred across all demographics, the escalation was highest among Black and Hispanic residents, as well as women.

“It's clear this public health crisis isn’t impacting an isolated group of people. Overdoses affect everyone in Travis County,” Travis County Judge Andy Brown said at a news conference Thursday. “These are our families, our friends, our coworkers, and we need to continue investing in dignified solutions that work.”

Travis County and the City of Austin both declared opioid overdoses to be an official public health crisis in 2022 following a record-setting number of overdoses in 2021. County commissioners also invested $350,000 into harm reduction measures, including the life-saving drug naloxone, used for people actively experiencing overdoses.

Brown said his office would advocate to redouble this commitment through the next fiscal year’s budget by requesting a $750,000 line item for an overdose prevention fund. Additionally, the county will soon consider how to invest an initial disbursement of $1.47 million in funds from a statewide settlement with drug companies for their involvement in the opioid crisis. Brown and other Travis County leaders are also set to meet with city officials and local public health experts in the coming weeks to discuss a strategy for reducing overdoses.

Cate Graziani, co-executive director of the Harm Reduction Alliance, said local leaders should look to organizations with trusted community relationships as partners in their efforts.

“We have been sounding the alarm on overdose deaths and fentanyl for many years and calling on public health strategies to fight these deaths,” Graziani said. “And I'm angry because every overdose is preventable with information that's rooted in harm reduction that goes beyond a ‘one pill kills’ message.”

“One pill kills” is a tagline Gov. Greg Abbott has employed in his own recently launched initiative aimed at curbing fentanyl use, and it is often used in efforts to educate teens about the risk of taking unprescribed pills that may be cut with fentanyl.

Brown and others voiced support for several state-level solutions, including current proposed legislation such as House Bill 362, which would legalize the use of fentanyl testing strips, a harm-reduction measure supported by Graziani’s organization.

Travis County Sheriff Sally Hernandez said fentanyl is top of mind for local law enforcement and that several active investigations are ongoing to pursue potential dealers of the drug.

The pace of fentanyl-related overdoses over the past three years in Travis County, while alarming, is not unusual in the national landscape, according to Travis County Medical Examiner Keith Pinckard.

“This is a problem that’s been brewing for several years, in fact, across the country,” Pinckard said. “[We’re] now simply catching up with other regions.”

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Olivia Aldridge is KUT's health care reporter. Got a tip? Email her at Follow her on X @ojaldridge.
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