Fentanyl Overdose Deaths Fall: Tucson

What sources there told me about why.

Drug- overdose deaths fell in many parts of the United States in 2024, after several years of record increases.

I reached out to sources in Tucson, Arizona to hear their ideas about why.

Tucson is a weathervane for the country when it comes to illegal drugs. It’s two hours north of Mexico and part of a heavy drug trafficking route into the United States.

Pima County, where Tucson is located, has seen that same significant drop in overdose deaths, dating to early last year.

The Pima County Medical Examiner reported had 603 overdose deaths in 2023 for the five Arizona counties it serves. More than half were due to fentanyl. In 2024, once cases are completed, that number will likely be closer to 450, due largely to a drop in fentanyl deaths.

The reporting I’ve done indicates that in Tucson the supply of fentanyl has dropped.

Fentanyl has been the drug scourge in Tucson since about 2017, coming in those counterfeit pills made to look like legitimate pharmaceuticals, such as Percocets, or Xanax bars, and especially what’s known as “blues” – oxycodone generic 30mg pills.

By 2019, Tucson was awash in those pills, made in underground labs in western Mexico.

Legitimate pharmaceutical pills once sold on Tucson streets for $20 to $30 apiece. Fentanyl pills began coming up from Mexico were stronger and cheaper, falling eventually to $1 apiece. Here’s what one woman told me:

To traffickers, fentanyl is a wonder drug because it lasts only a short time. Addicts must constantly use fentanyl to keep withdrawals at bay. They become steadfast customers. The supplies of fentanyl coming up from Mexico through these years allowed them to do that. It took their tolerances up to previously unimaginable levels.

By 2021, according to Tucson drug counselors I spoke with, those who didn’t die were soon smoking from 50 to 80 pills a day. Alex, a long-time addict, remembers those days:

The numbers illustrated the magnitude of the fentanyl supply and its ability to create, exacerbate, and prolong addiction. But given the massive fentanyl supplies coming through Tucson, high tolerance to the drug was only a temporary defense.

One counselor emailed me in 2023 to say: “We have a saying here: There are no long-term fentanyl users. The life expectancy for someone caught in this trap is not long. Even with high tolerance the risk of overdose is real.”

Pima County fentanyl-overdose deaths climbed from 100 in 2019 to 342 in 2023.

Then around the summer of 2024, or perhaps a few months before that, according to the long-time Tucson users I spoke with, the supplies of fentanyl began to drop.

Street prices for pills that actually contained fentanyl rose to between $3 and $5 apiece.

Many street pills, meanwhile, now either have none of the drug, or far less than those surviving on Tucson streets are used to, said one woman I re-interviewed after speaking to her in 2023.

Higher prices, weaker pills are different ways of saying that fentanyl supply has diminished, just as those who have survived on the street have reached high tolerances to the drug.

The number of overdoses has dropped. So, tellingly, has the need to use Narcan, the overdose reversal drug, she told me:

There has been no surge, however, in people rushing to treatment centers for help with their fentanyl withdrawals, now that supplies have fallen.

Fentanyl is still on Tucson streets, though apparently in lesser quantities.

What did happen, said one counselor I spoke with, was a surge in use of methamphetamine, which is available in relentless, unprecedented supply. With that came the psychosis that the meth out of Mexico has been creating nationwide for more than a decade. Meth-related overdoses have surpassed fentanyl overdoses, according to the Pima County Medical Examiner.

Said one counselor:

She believes one reason for that is that many addicts may be using meth to control their withdrawals from fentanyl, which would be unheard of in other eras.

A significant drop in fentanyl overdose deaths is such welcome news, no matter what the reason.

But it’s worth mentioning that in Pima County, overdose deaths in 2024, once they are all officially counted, will still rank higher than any year before 2020, according to the county’s medical examiner’s office.

Why did the supply of fentanyl drop in 2024 and what else is involved in the decline in OD death? Topics for later posts.