The why
Overdoses remain the leading cause of accidental deaths in Travis County—ahead of both falls and motor vehicle accidents—prompting commissioners to renew a 2022 public health crisis declaration in November.
Described as a “festering need” by Commissioner Ann Howard, the county has launched programs aimed at vulnerable populations, increasing access to treatment for those at risk of overdose—a crisis that reached its peak in 2023.
In 2024, there were 1,102 emergency medical service calls and dispatches for overdoses and 878 emergency room visits for overdoses, according to the Austin Public Health opioid overdose dashboard.
What's being done
Travis County launched a jail-based substance use intake program in December after receiving a $1.6 million federal grant.
The program integrates medication-assisted treatment with harm reduction strategies and peer recovery support within the county jail system, continuing to assist individuals as they transition back into the community.
As part of its broader efforts to expand substance use treatment, the county purchased a building in North Austin that will serve as a residential and treatment facility for women and their children.
The facility will provide a space for women to receive care while still caring for their children or working toward reunification. The initiative is expected to improve access to treatment and enhance maternal and child health outcomes, Laura Peveto, division director at Travis County Health and Human Services, told commissioners.
There are currently no similar treatment centers in the area, with the nearest options for mothers seeking treatment located in Houston or Dallas.
Presently in the permitting process, the county-owned facility is set to open in Fall 2025 and will be operated by Houston-based Santa Maria Hostel Inc., with capacity for up to 100 individuals. Staff also noted that the site has room for future expansion.
In addition to treatment programs, the county and its partner agencies have distributed 20,180 doses of naloxone—the life-saving medication that reverses opioid overdoses—since October 2023. The county receives naloxone through the state-supported Be Well, Texas program, working with numerous nonprofit organizations for distribution, including:
- Black Men’s Health Clinic
- Communities for Recovery
- NICE Project
- The Other Ones Foundation & The Other Ones Foundation Esperanza
- SAFE Alliance
- Safe Haven
- SIMS Foundation
- Sunrise Homeless Navigation Center & Sunrise Community Church
- Texas Harm Reduction Alliance
- Trinity Center Austin
- Urban Alchemy
- Vivent Health
- Working Group 512
Additionally, three sharps collection kiosks have been installed at community facilities, with a fourth pending. These kiosks are routinely monitored, with health professionals tracking usage data.
Disposal kiosks are located at:
- Texas Harm Reduction Alliance – 1803 E. Cesar Chavez St., Austin
- Vivent Health – 104 E. Highland Mall Blvd., Austin
- Austin Resource Center for the Homeless & Urban Alchemy – 500 E. Seventh St., Austin
- Sobering Center (pending) – 1213 Sabine St., Austin
In recent years Travis County has received various settlement funds from both opioid manufacturers and distributors. To date, the county anticipates $4.7 million in total opioid abatement settlement payouts to occur over an 18-year period to be used toward local harm reduction services. The county expects to see its third settlement disbursements sometime in spring 2025.
During the fiscal year 2024-25 budget session, county officials also allocated $325,000 from the opioid abatement budget for peer recovery and methadone programs. An additional 400,000 was designated for overdose prevention efforts in November.
According to Peveto, the county is actively working to negotiate new harm reduction services contracts with three organizations that have specialized expertise. Staff is looking to target populations that include transition-age youth, drug users with high risk of overdose, and individuals receiving treatment for STI, STD and HIV.
“The things that we have accomplished are awareness, understanding, acknowledgement,” Peveto told commissioners in November. “... but we're still having people die on a regular basis from an overdose. So we're not there yet, and we certainly need to continue to be aggressive in how we address this.”
The county works closely with the city of Austin and Central Health as both entities have also received millions in settlement funds.
Central Health, the county’s taxpayer-funded hospital district, budgeted roughly $5 million towards substance abuse services.
The outlook
A report from the county coroner in December showed the first decline in accidental opioid deaths in more than three years.
Travis County Judge Andy Brown highlighted the county's commitment to addressing the opioid crisis through a “public health approach,” emphasizing its life-saving impact.
“For the first time in two years, we are seeing the number of people dying from drug overdoses go down,” Brown said. “The progress we’ve made in reducing overdose deaths this year is a direct result of the community’s dedicated efforts to work together and tackle this crisis head-on.”
The next report from the Travis County Medical Examiner is anticipated for April 2025, while the county’s health and human services department is expected to come back to commissioners in August with another update.
