Fentanyl-related deaths have more than doubled from 2021-22 in Travis County, the latest medical examiner’s report shows.

The report—which analyzes fatalities in Travis County—found drug deaths increased among every group in 2022, particularly in Hispanic and Black communities and in women.

“Travis County is facing double the number of funerals, double the number of empty seats at the dinner table and double the number of families with more questions than answers,” Travis County Judge Andy Brown said at an April 26 news conference. “This is and this continues to be a significant threat to the public's health and safety. We're fighting an enemy who strikes at all and does not discriminate.”

Local and state action

Since Travis County declared drug deaths a public health crisis last year, officials have increased Narcan access by installing Narcan vending machines throughout the city and distributing the overdose reversal drug to local bars. The county also expanded education surrounding fentanyl and invested $350,000 in harm reduction efforts.

Looking ahead, Brown said the court is working on approving $750,000 in the fiscal year 2024 budget to create an overdose prevention fund, which will include recommendations from the Texas Harm Reduction Alliance—an organization that provides resources and education to people who use drugs.

There have been several moves to increase drug overdose awareness statewide, including Gov. Greg Abbott’s “One Pill Kills” campaign and a recent decision to distribute Narcan to law enforcement in every county in Texas.

Several bills to increase harm reduction tools are also moving through the legislative process, including House Bill 362, which would propose an exception to Texas paraphernalia law and legalize fentanyl test strips.

Manufacturing and possessing fentanyl test strips are prohibited by the law. Manufacturing test strips is punishable with up to $4,000 in fines or a year of jail time, and possession entails fines up to $500.

The bill was passed overwhelmingly by the House in early April and is waiting to be taken up by the Senate.

What they’re saying

Travis County Medical Examiner Keith Pinckard said the drug crisis is not unique to Austin as the prevalence of fentanyl has increased throughout the country.

Members of the THRA and Community for Recovery said increasing harm reduction tools, such as Narcan, fentanyl test strips and peer support services, is key to lowering the number of drug deaths in the county, as about 500 deaths were prevented—just through the THRA—by having Narcan accessible in 2022.

“I'm devastated and angry about the numbers that we're discussing today,” THRA co-Executive Director Cate Graziani said. “We have been sounding the alarm on overdose deaths and fentanyl for many years and calling on public health strategies to fight these deaths. 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.”

2022 medical examiner report findings
  • 417 people accidentally overdosed in Travis County in 2022, up from 308 in 2021.
  • Accidental drug deaths related to methamphetamine, cocaine and fentanyl all increased each year since 2019.
  • Fentanyl-related overdoses are surging the most in the county, from 118 in 2021 to 245 in 2022.
Demographic breakdown
  • The number of women who died of an accidental fentanyl related overdose increased 191% from 24 in 2021 to 70 in 2022.
  • People ages 31-40 had the highest number of fatal overdoses in 2022.
  • The number of Black people who died of an accidental fentanyl-related overdose increased by 460% from five in 2021 to 28 in 2022.
  • The number of Hispanic people who died of an accidental fentanyl related overdose increased by 247% from 19 in 2021 to 66 in 2022.