The Good News 

2024 was a year of optimistic news in the fight against opioid use and deaths from overdose. According to reporting by NPR in September, U.S. drug overdose data showed a sudden and significant decline in deaths of around 15% over the previous twelve months, which U.S. public health officials hoped would mean as many as 20,000 fewer fatalities each year if the trend continues. Further, 2024 saw progress in the multi-state lawsuits against opioid pharmaceutical manufacturers, with the potential to produce billions in settlement money. 

Closer to home, Colorado, which hopes to receive around $800 million in settlement funds over the next few decades, reported similar declines in fentanyl-related deaths during the first half of 2024, with officials expressing cautious optimism that years of work combatting the crisis was finally starting to turn the tide. While it’s too soon to know for sure, subject matter experts believe this reversal is due to greater awareness around the dangers of the drug, how to more safely use and the presence of less immediately lethal drugs, or mixtures of drugs, on the street.  

Perhaps most crucial to the recent trend reversal is the increased presence of Naloxone. Naloxone, also known as Narcan, is commonly used as a nasal spray and can quickly reverse opioid and fentanyl overdose. The Biden administration worked in partnership with local public health agencies and non-profits to make this tool more widely available. As of now, Naloxone can be purchased over the counter at many pharmacies and is being distributed for free in many high-risk communities.  

As a community behavioral health center with myriad programs treating substance use disorders, WellPower staff are acutely tuned in to crisis. Our evaluation and research team, in collaboration with clinicians treating substance use disorders, recently pulled data around fentanyl to see if the same trends are being reflected in our own community. What we found made us rethink the narrative that was prevalent in 2024 news. 

A Reason for Caution 

While compliance with privacy laws prohibits WellPower from collecting specific data on people who use fentanyl, we do keep track of the presence of fentanyl in the lives and awareness of people we serve by charting how often the topic arises during services.  

By looking at the number of times the word “fentanyl” is marked in clinical notes, evaluation staff noted that, despite the decline in fentanyl-related overdoses and deaths nationwide and in Colorado, mentions of fentanyl during services has continued to rise. 

As the above chart shows, while the steepest increases took place between 2021 and 2023, fentanyl is still very present in the lives of many people served at WellPower, and that prevalence is increasing. Seeing this, we wanted to explore why our trends don’t necessarily mirror the recent narrative. 

The Frontline Perspective 

For an on-the-ground point of view, we spoke with program manager Ellie Carpio, LPC, LAC, NCC, who leads WellPower’s Medication Assisted Treatment (MAT) program as well as our new Intensive Outpatient (IOP) program. When presented with WellPower’s data, Ellie wasn’t surprised that the numbers don’t exactly seem to be matching up. “I think what we are doing is working to an extent, and the harm reduction approach, which addresses the harm done by substance use by increasing education and access to things like Naloxone, has been positive. However, 10 years ago I rarely saw someone present with fentanyl as their primary substance, and today I hear more and more that fentanyl is the drug of choice for many people coming to WellPower for substance use disorder.”  

When asked why the rates of fentanyl usage continue to be cause for concern, Carpio had a quick answer. “It’s everywhere. It’s easy, fast and cheap to produce. And while it is the primary substance many people seek out, it’s also being put into drugs not typically associated with opiates, like meth and cocaine. Many of our folks come in with a stimulant use disorder, only to realize that they’re dealing with opioid withdrawals. In contrast to withdrawal from a substance like meth, opioid withdrawal is intensely painful and uncomfortable and often catches stimulant users off guard.” 

Also worth noting, data shared by the Opioid Response Network indicates that, as of 2023, more than 70% of overdose deaths involved an opioid. Often, the individuals who overdose aren’t even aware that fentanyl is in the substance they are using. 

On the Horizon 

So where do we go from here? It’s no surprise that Carpio wanted to reinforce how crucial it is to continue the fight and maintain resources for battling the opioid crisis. “One worrisome sign is report of a general decline in substance use, particularly for the adolescent and young adult demographic. But if you look closer at this data, while the number of users may be going down, the risk associated with that use is increasing because of how present fentanyl still is. Our focus for harm reduction and education needs to be on young people, and right now there are way too few resources.” 

Medication Assisted Treatment (MAT) is a proven method for managing withdrawal from substance use so that individuals can focus on recovery. “When someone isn’t spending all their time relieving the painful symptoms of withdrawal, they are more free to pursue their recovery goals and get back to the life they are meant to live,” shared Ellie.  

Currently, resources for MAT clinics that treat adults are slim, and nearly non-existent for young adults. Despite the growing threat opioid use poses to youth, there are only two community-based MAT clinics for the 15-25-year-old demographic in the state of Colorado. 

Staying in the Fight 

Unfortunately, the limited resources that exist even now are under threat. While we are still awaiting official action from the federal government, recent reports suggest that the Substance Abuse and Mental Health Services Administration (SAMHSA) is facing a 50% budget reduction on top of a 10% cut that took place in February of 2025. Also under threat is the federal grant money that provides training and access to the lifesaving drug Naloxone. 

So what can we do to ensure we see positive gains rather than sliding back into the height of this crisis? Stay aware that we aren’t yet out of the woods, and advocate with your elected officials to keep resources available. While the narrative may have changed, we are still very much in this fight, and our public policy, funding and awareness must reflect that. 

If you or someone you know is struggling with substance use, call WellPower’s Access Line to learn more about our services: (303) 504-7700.