Travis County is shifting focus to prevent overdose deaths as fentanyl ravages the area

An Austin-Travis County EMS vehicle parked outside of St. Davids North Austin Medical Center on July 7, 2020. (Allie Goulding/The Texas Tribune, Allie Goulding/The Texas Tribune)

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When Travis County Judge Andy Brown got a phone call two weeks ago about a rash of overdoses that claimed at least eight lives in Austin over a span of 27 hours, he knew the dark day he had been preparing for had arrived.

“That day was absolutely horrible and something we haven’t seen before as far as I know,” Brown said.

When the dust settled, the number of deaths had climbed to nine, and at least 79 separate overdose incidents in the span of three days. The origin of the deadly spike in overdoses and the people responsible still remain a mystery.

However, in the back of Brown’s mind, he knew that if he hadn’t spent the past couple of years pushing for overdose reversal drugs like Narcan to be available to the public, specifically in restaurants and bars, the situation might have been much worse.

“The number of overdoses was extraordinary,” Brown said. “But dozens of people who overdosed didn’t die, and that is the only good I have seen come out of this because if this happened three years ago, the death toll most likely would have been much higher.”

Travis County is in the midst of a drug epidemic, and it doesn’t appear to be slowing down anytime soon as fentanyl, a powerful synthetic opioid often mixed with other substances, is ravaging the state’s capital city.

Texas Department of State Health Services data shows that overdose deaths in Travis County are higher than in other urban Texas counties.

In 2023, Travis County recorded 440 accidental drug-related deaths, or 33 deaths per 100,000 residents. That’s higher than Dallas County, which reported 25 deaths per 100,000 residents last year, Tarrant and Bexar counties, which saw 23 deaths per 100,000, and Harris County, with 21 deaths per 100,000 people.

The rise in both the illegal use of fentanyl and now the manufacturing of counterfeit prescription drugs that contain this lab-made drug has made this a particularly deadly problem across the nation.

From August 2022 to August 2023, there were an estimated 5,566 drug-related deaths in Texas, and 45% of them involved fentanyl, according to the Centers for Disease Control and Prevention. Texas Health and Human Services reported last year that, on average, five Texans die every day from fentanyl poisoning.

The state’s drug overdose deaths increased by more than 75% in the past five years. The number of deaths involving fentanyl has steadily climbed since 2014, from 3.7% of 2,111 drug-related deaths to 44% of 4,931 drug-related deaths in 2022, according to a report from the Texas Department of State Health Services.

The drug overdose death rate in Texas was at 17 deaths per 100,000 residents, according to the Centers for Disease Control and Prevention report in 2021, the last year with available data. This number is significantly lower when compared to similar states like California, at 27 per 100,000, and Florida, at 38 per 100,000.

The Centers for Disease Control and Prevention is predicting record numbers of drug poisonings across the nation for 2023, with their latest estimate for the 12-month period ending June 2023 at 112,323 lives lost. Nearly 70% of these drug poisonings are from fentanyl.

Earlier this year, Texas launched “One Pill Kills,” a multimedia campaign designed to warn Texans about the dangers of fentanyl. Lawmakers last year also passed House Bill 6, increasing the penalties related to the sale and production of fentanyl by classifying overdoses from the drug as “poisonings,” triggering murder charges for those convicted of giving someone a fatal dose of fentanyl.

Lt. Patrick Eastlick, for the Austin Police Department’s organized crime unit, said their department began conducting undercover operations and targeted enforcement to combat fentanyl dealing in downtown, North Austin, and portions of South Austin.

Eastlick said these operations uncovered that fentanyl is being mixed into crack cocaine, methamphetamine, and even marijuana by drug dealers to increase the volume of their product and their profit. He said when the synthetic opioid, which is 100 times more potent than morphine, isn’t mixed correctly, it can trigger overdoses.

“It’s concerning to us to see fentanyl not only being mixed with marijuana but all these substances that are being mixed with it,” Eastlick said. “And it’s a concern that all people should have when consuming narcotics.”

In its annual report, the Travis County Medical Examiner’s Office said this overdose spike was a growing trend. In 2022, 417 Travis County residents died from drug-related overdoses, or 31 deaths per 100,000 people. It marked the first time that overdoses were the leading cause of accidental death in the county since 2011.

That year, 27% of the accidental deaths were people in their 30s, and 21% were in their 20s.

“This problem affects all parts of Travis County. It affects the unhoused and the suburbs,” said Travis County District Attorney spokesperson Ismael Martinez.

In 2021, the district attorney’s office created a community-based strategy to raise awareness and provide funding and access to life-saving drugs like Narcan to bars and restaurants where overdoses happen regularly. The effort was eventually taken over by the county, and the City of Austin started to pitch in.

Brown said in his State of the County address in April that the state has failed to expand substance use treatment, leaving counties to tackle the problem. He said Travis County allocated $860,000 last year to provide Narcan kits, methadone — a medication that reduces opioid craving and withdrawal — and peer support services. The money comes from the Texas Opioid Abatement Fund Council, formed in 2021 to ensure that money recovered from the statewide opioid settlement agreements is used to tackle the opioid crisis.

“We listened to the community when they came to us a couple of years ago and asked us to do more. And since then, we’ve given out almost 15,000 doses of Narcan around the county,” Brown said. “The city has done the same and more. While the number of overdoses is increasing, so are the number of overdoses that are reversed by Narcan.”

Brown said Travis County officials are focusing on preventing overdose deaths rather than trying to stop the flow of drugs.

“I really want to put our county’s efforts towards continuing to improve education about how every overdose death is preventable if you use Narcan or have Narcan available,” Brown said.

Brown also believes the best way to stem the opioid epidemic in Travis County is to address the lack of mental health resources in the area.

“Our community has a lot of unmet mental health needs, and unmet mental health needs and substance use disorder go hand in hand,” Brown said.

Disclosure: Emergent, the maker of Narcan, has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a complete list of them here.

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