State’s overdose rates stabilized in 2022 but remain near record levels
Fatal overdoses declined slightly in Colorado in 2022, newly finalized state data shows, after two years of surging deaths. But public health officials and addiction experts drew little comfort from last year's totals, which remain near record highs amid fentanyl's growing dominance of the illicit drug supply.
"(Overdoses) evened themselves out a little bit. We have a new normal, which is terrible," said Dr. Josh Blum, an addiction medicine physician at Denver Health. "Now we have a stable, unacceptably high death rate."
In 2022, 1,799 people fatally overdosed in Colorado, a 4% drop from 2021's total of 1,881, according to data from the state Department of Public Health and Environment. The figures represent a bittersweet stabilization: A slight, one-year decline is still a reprieve after rates nearly doubled in recent years. The number of fentanyl-related deaths — which quadrupled between 2019 and 2021 — plateaued, and methamphetamine fatalities dipped.
Yet 2022's rate is still higher than any other prepandemic year, and fentanyl and methamphetamine continue to fuel and dominate the crisis. Fentanyl, a potent synthetic opioid, was present in more than half of all fatal overdoses here last year. More Coloradans died after ingesting the drug in 2022 than overdosed on all drugs in 2016.
"It's this idea that while we might be able to find some encouragement if the numbers stay the same or if we do see somewhat of an increase — but the numbers are unacceptably high to begin with," said Natalee Salcedo, the community health promotion manager for the Adams County Health Department. The county has one of the highest overdose death tolls in the state, and Salcedo said recent increases have been most significant among Black residents.
It's unclear what exactly prompted the flattening of deaths, six addiction and public health officials said, and they cautioned against drawing any conclusions of broader trends based off of one year. Sterling Mclaren, Denver's chief medical officer, said the state may have reached a natural plateau of overdoses, as opposed to some sort of turning point.
She and other experts also noted the increased availability of harm reduction and some treatment services. The state has begun to embrace harm reduction services, intended to help keep drug users alive and healthy until they're ready or able to seek treatment. But Blum and Salcedo both called on legislators to go further and to allow for safe drug-use sites, in which users can consume illicit drugs under the supervision of health providers. A bill that would've allowed a facility to open in Denver passed the House earlier this year, only to die in a Senate committee in late April.
Legislators have more thoroughly embraced more common harm reduction tools: Colorado has spent millions to distribute naloxone, which is used to reverse opioid overdoses, and lawmakers passed a bill last year to dole out free doses to a broader group of entities, including schools.
The state distributed more than 258,000 naloxone doses between July and March, said Sam Bourdon, the harm reduction grant program manager for the state health department. That's more than double what was distributed in the year prior. Denver also distributes naloxone for free to city residents.
Lawmakers also set aside several hundred thousand dollars to buy fentanyl test strips, and they expanded treatment in jail settings. Thirty-one of the state's 64 counties have also agreed to distribute fentanyl test strips, and the state has ordered more than 80,000, Bourdon said.
The pandemic's end and the broader return to normalcy may also have contributed to the state's numbers stabilizing. Though it increased isolation and temporarily limited traditional treatment options, the COVID-19 crisis also shepherded in positive changes to drug treatment elsewhere, Blum said: Methadone, a key medication used to treat opioid dependence, has become more available under enduring pandemicera rules. Telehealth has expanded, and federal regulators in December also made it easier for physicians to give patients another opioid treatment medication.
Nationally, overdoses increased slightly in 2021, according to data from the Centers for Disease Control and Prevention. Like in Colorado, drug deaths surged across America during the pandemic, and 2022 represented a relative plateau after those peaks.
Stay up-to-date with Colorado Politics by signing up for our weekly newsletter, The Spot.