After seeing a reprieve, of sorts, from fentanyl overdose last year with the number of deaths in Colorado reaching a plateau — a first in three years — the opioid appears to be making a deadly come back in 2023.

Preliminary numbers in Denver show a roughly 16% increase in the number of fentanyl overdose deaths this year, according to the Denver Department of Public Health & Environment.

The number of fentanyl-related overdose deaths in Colorado appeared to have leveled off last year with 920 deaths compared to 912 in 2021.

While the number of fentanyl deaths showed a modest 1% increase across the state, it masked what was taking place in Denver, which saw an 11% decline in overdoses.

In 2017, Denver had just 17 fentanyl overdose deaths.

That number shot up to 144 overdoses in 2019 and again in 2021 to 220 deaths.

Last year, Denver had 196 fentanyl deaths.

If the 16% pace holds for the remainder of this year, Denver could see more than 225 fentanyl overdose deaths.

That would shatter all previous records in Denver.

Fentanyl is a powerful synthetic that is 50 times more potent than heroin. Consequently, a fentanyl overdose can happen much quicker and be more difficult to halt than one caused by other opioids.

The drug can come in the form of pills or capsules, rock and pure powders.

Denver Police have seen a rise in powdered fentanyl in recent months, said Doug Schepman, a department spokesperson.

And that’s a troubling development.

The risk of overdose increases without the measured dose of a pill, police and public health officials warn.

“You don’t necessarily know how much your body is going to be able to handle when you’re using powder than when you’re using a pill,” said Emily Williams, a spokesperson with the Denver Department of Public Health & Environment.

Schepman agreed.

Even very small amounts can, and have been, deadly.

Four in every 10 counterfeit pills with fentanyl have a potentially lethal dose, according to lab tests by the U.S. Drug Enforcement Administration. Two milligrams of fentanyl — or amount small enough to fit on a pencil tip — is considered a lethal dose.

“It could make it easier for someone to take a lethal amount,” Schepman said of fentanyl powder.

It’s unclear whether the rise in powdered fentanyl accounts for the increase seen in overdose deaths.

From June last year through May of this year, preliminary numbers show Denver has had 289 fentanyl overdose deaths. This is compared to 250 fentanyl overdose deaths over the same time period in the previous 12 months, health department data show.

The numbers are preliminary because it can take up to 10 weeks for lab results, Williams said.

With fentanyl overdoses on the rise in Denver, public health officials are offering free test strips and naloxone, which is used to reverse opioid overdoses.

Public health officials also advise against mixing drugs or using alone.

In November, the U.S. Drug Enforcement Administration (DEA) warned of a sharp trafficking increase of fentanyl mixed with xylazine. Also known as “Tranq,” xylazine is a powerful sedative approved for veterinary use.

While the DEA Laboratory System reports about 23% of fentanyl power in 2022 contained xylazine; its use in Denver is not widespread.

Only two overdose fatalities in Denver last year involved xylazine, according to the Denver health officials.

No xylazine-related deaths have been reported this year in Denver.

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