Drug overdose deaths hit Denver harder in 2023 than they ever have in 100 years of record keeping, preliminary numbers from last year show.

The overdose crisis has, in particular, hammered the city’s homeless population. Homeless people made up 38% of the overdose deaths last year, according to the data. 

In 2023, 522 people died from drug overdoses, the most since tracking began in 1923, according to Denver’s Office of the Medical Examiner.

Officials are alarmed by the increasing numbers — up at least 15% from 2022. About 40% of that record number of fatal overdoses involved fentanyl, said Ethan Jamison, epidemiologist for Denver’s medical examiner.

Because there are still 136 such death cases waiting for final toxicology testing, the 2023 number will end up being even higher.

“We just keep seeing the numbers going up,” said Dr. Sterling McLaren, Denver’s assistant medical examiner and chief medical officer.

McLaren said the biggest problem with drug overdose deaths is the fact that people are combining potent drugs to get a more exhilarating high.

“It’s not just fentanyl. Most of our overdose deaths involve more than one drug, and that’s often fentanyl combined with methamphetamine,” McLaren said. 

McLaren said she would like to get to the bottom of why more people are fatally overdosing, specifically “what drives people to use substances and to continue to use substances.”

“It all goes back to behavioral health issues,” she said. 

She said she first started seeing overdoses on an upward spiral in 2020, during the COVID-19 pandemic.

Why?

“That’s the million dollar question,” she said, theorizing that “it was a stressful time for a lot of people.” 

Most fatal overdoses were men and over half of those who died were White, according to the data. A quarter of the overdose deaths were Hispanic, and 15% were Black. About 2% were American Indian and 1% were Asian.

More than a third of those who lost their lives to overdoses in Denver last year were homeless. Most of the deaths, 320 of the 522 total, occurred in a residence, according to statistics released by the Denver Department of Public Health and Environment.

“This is a problem that affects everybody. The housed, the unhoused, people who have jobs and people who don’t have jobs,” McLaren said.

Housing advocates earlier told The Denver Gazette that the crisis has been pernicious.

“We’re in the worst overdose crisis we’ve ever been in,” said Lisa Raville, executive director at Harm Reduction Action Center. 

A few weeks ago, Tristan Sanders, director of community and behavioral health at the city’s health department, blamed fentanyl for the deaths.

“It really just reflects fentanyl being in Denver, which is not a new thing, but has been something we’ve been looking at for a long time,” Sander said.

Fentanyl, used legitimately as a medical anesthetic, is a synthetic opioid that has become a dominant player in the illicit market and is increasingly being mixed into other substances. It’s cheaper and produces a stronger, more fleeting “high,” according to experts. But its potency in small quantities makes it unlike any other substance that preceded it in the drug supply.

Though final numbers for overdose deaths statewide won’t be available until this summer, the Colorado Department of Health and Environment recorded 1,454 total drug overdose deaths among Colorado residents from 2023, thus far.

There were 1,799 total in 2022, according to agency statistician Kirk Bol. 

In response the overdose crisis, state policymakers in 2022 approved legislation to heighten the felony charges for possession of 1 to 4 grams of any substance containing fentanyl; adopt programs to help people stay alive and treat their addictions, including mandating medication-assisted treatment in jails an education program; and, push for the widespread availability of opioid antagonists, such as Naloxone, and testing strips that drug users could use to see if the street drugs they’re taking contain fentanyl.

Beyond possession, lawmakers also increased the penalties for distributing any amount of a substance containing fentanyl, carfentanil or benzimidazole opiate. The 2020 legislation automatically made it a high-level drug felony for anyone convicted of dealing substance containing those drugs that led to death. The law similarly hit someone with a that same conviction level if that person brought the substance into Colorado or had certain equipment, like a pill press.

Some advocates argue that further criminalization won’t improve the situation, while others, notably law enforcement leaders and their allies say policymakers should treat fentanyl like “the deadly” substance it is.

As of August 2023, just 17 people had been charged for dealing fentanyl that killed someone, according to The Denver Gazette’s news partner 9News.

Soon, the city’s health department will be testing Denver’s wastewater for fentanyl and other substances to better understand who is using drugs and where to help with prevention.

Department spokesperson Emily Williams said that the wastewater effort “is in its early planning stages.”