Overdose deaths in Orange County dropped 30 percent in 2024, new data shows

In step with a national decline in accidental drug overdose deaths over last year, the local Medical Examiner’s Office in Florida is reporting a 30 percent overall decline in fatal overdose deaths from 2023 to 2024 and a 37 percent decline in overdose deaths involving opioids, specifically.

Last year, an estimated 341 people in Orange County died of accidental drug overdose, down from 490 in 2023 and the county’s peak of 538 overdose deaths in 2021. Overdose deaths related to opioid painkillers, specifically, dropped nearly 50 percent, from 453 deaths in 2021 to 229 in 2024.

Dr. Thomas Hall, manager for the Orange County Office for a Drug-Free Community, attributes the decline to a “community collaboration” involving first responders, hospital healthcare providers, community-based substance use disorder treatment providers, scholars and nonprofit public health agencies.

The Office for a Drug-Free Community was first established roughly 25 years ago, back in 1999. Hall told Orlando Weekly it’s “unique” in that it’s publicly funded by the county, meaning it’s not reliant on private donors, nor limited by fluctuations in available grant money or the generosity of private entities.

Its initial purpose was to address the proliferation of heroin, while today they’re up against something much more powerful, and deadly if misused.

Illegally manufactured forms of fentanyl, a synthetic opioid about 50 times more potent than heroin, has been a driving cause of overdose deaths in Central Florida and across the United States. Just a small amount, equivalent to few grains of salt, can be deadly for someone who doesn’t have a tolerance for the drug.

Because of its potency and comparatively low cost, fentanyl is often laced into other drugs bought illegally — such as cocaine, meth, heroin or counterfeit pills — often unbeknownst to the person buying or using the substance.

But public health campaigns, distributing naloxone (an opioid antagonist that can reverse an opioid overdose) and increasing access to addiction treatment in Orange County appears to be making a difference.  Over in Palm Beach County, opioid overdose similarly plunged an estimated 46 percent last year.

Opioid overdose deaths have dropped nearly 50 percent in Orange County since 2021.

“There’s a lot of people working on this,” Hall told Orlando Weekly in an interview. As someone who’s worked in the field of mental health and substance use for 30 years, Hall said he’s seen a notable difference in how people these days are talking about fentanyl, thanks in part to public awareness campaigns like “One Pill Can Kill.”

There’s greater “anxiety” about finding fentanyl in pills sold on the street, he said, and a better understanding of where it can show up. Not everyone who dies from an overdose necessarily suffers from an addiction. For instance, a person may think they’re buying Xanax pills from a dealer — a drug commonly prescribed to treat anxiety disorders — but instead are buying a drug off the street that also contains fentanyl.

Data from the Ninth District’s Medical Examiner’s Office obtained by Orlando Weekly shows alprazolam (the generic name for Xanax) was involved in at least nine drug-related deaths in 2024, in combination with at least one opioid.

According to the U.S. Drug Enforcement Administration (DEA), five out of every 10 counterfeit pills tested by the agency last year contained a potentially deadly dose of fentanyl. That’s down from seven out of every 10 pills in 2023.

Most overdose deaths locally have occurred among people aged 35 to 55. But the proliferation of fentanyl in the illicit drug supply has also been a concern when it comes to teenagers who illegally buy or are otherwise exposed to drugs.

According to data from the local Medical Examiner’s Office, at least 12 drug-related deaths last year occurred among people age 20 or younger. Most of those deaths involved opioids, predominantly fentanyl. The youngest victim exposed to a deadly dose of fentanyl was just 4 years old.

But the landscape for broadening access to preventative and treatment strategies has, nonetheless, improved. Pandemic-related disruptions to addiction treatment, social support systems, and access to life-saving medicine like naloxone (also known as Narcan), fueled a devastating rise in fatal drug overdoses from 2020 through 2023.

Many people during the COVID-19 pandemic’s lockdown period were also using drugs alone, where they wouldn’t have someone to call 911 if they stopped breathing, went cold and clammy, or lost consciousness.

The availability of fentanyl has also notably decreased since the peak of the overdose crisis, according to Hall, who coordinates efforts to combat the crisis with both health and law enforcement agencies.

While certain parts of the country have seen the emergence of illicitly-sold “designer drugs” like nitazines (a newer form of synthetic opioids) and xylazine (a non-opioid tranquilizer with horrific side effects), Hall said those drugs haven’t shown up as prominently yet in Orange County.

Xylazine wasn’t identified in any autopsy reports last year, locally, while nitazines were identified in six.

A combination of treatment and preventive strategies

Orange County in recent years has leveraged funds provided by the state, and through national legal settlements with opioid manufacturers, to fund projects on both the treatment and overdose prevention side. The county expects to receive more than $50 million from the legal settlements alone over the next 15 years.

Under the direction of Hall, who serves as an administrator of the settlement funds, the county has contracted with nonprofits like Largest Heart and Project Opioid to give out free Narcan and fentanyl test strips — small strips of paper that can detect fentanyl in drugs.

According to Hall, more than 25,000 Narcan kits and 8,286 fentanyl test kits were distributed both online and at events throughout Orange County from October to December alone. Community partners, in partnership with the county, also held 146 training sessions, demonstrating how to use Narcan and fentanyl test strips.

On the treatment side, the county recently opened a medication-assisted treatment program at the Orange County Medical Clinic just west of downtown Orlando, in Parramore. The program, offering MAT for opioid addiction at no charge, prioritizes people with opioid use disorder who are underinsured or uninsured, and who have been involved in the criminal justice system.

People who are released from a jail or prison are at a significantly higher risk of fatal overdose compared to the general public. Setting an example for other communities in Florida, the Orange County jail became the first in the state to offer medication-assisted treatment — the “gold standard” treatment for opioid addiction — in 2022. The program has since treated nearly 600 people since.

More than 25,000 Narcan kits and 8,286 fentanyl test kits were distributed throughout Orange County from October to December of last year alone

“Of the people who died from an overdose in 2023 and were released from jail within the prior 365 days, none of them were involved with our MAT Treatment program,” said Dr. Raul Pino, director of Orange County Health Services, in a statement.

The county also works with hospital systems like Orlando Health to provide medication for opioid use disorder (generally buprenorphine, also known as Suboxone) as an option for people who cycle in and out of hospital ERs for overdose or addiction-related conditions.

Medication-assisted treatment can help reduce drug cravings and withdrawal symptoms, and may improve a person’s likelihood of survival and recovery outcomes.

Hall confirmed that, flush with opioid settlement funds, they’re looking to expand these hospital programs, which served hundreds of people from October to December alone. He’s also trying to find more physicians’ offices in the community that are willing to help provide MAT to people with addiction once they leave a carceral setting or an inpatient hospital program.

Factors such as stigma can be a big barrier, he admitted, even among doctors. But with public education and awareness campaigns, the goal is that it will become easier to bring people onboard. Although the county saw a decline in overdose deaths last year, Hall said he wants readers to know, “Nobody’s asleep at the wheel.”

For his part, he said the decline only pushes him to work harder — because they’re seeing that what they’re doing in Orange County is working.

Nationally, drug overdose deaths have plunged roughly 26 percent since the summer of 2023, according to preliminary data from the Centers for Disease Control and Prevention (CDC), a federal agency that (like other federal health agencies) is bracing for potential cuts as a result of directives from the Trump administration.

“It is unprecedented to see predicted overdose deaths drop by more than 27,000 over a single year,” said Allison Arwady, director of the CDC’s National Center for Injury Prevention and Control, in a statement last month.

According to NPR, drug overdose deaths have been declining rapidly since the summer of 2023. Overdose death rates tripled from 2003 to 2019, according to the CDC, and increased an additional 58 percent through 2022.

The recent decline has been attributed to factors such as weaker forms of fentanyl circulating, broader access to Narcan, and the tragic reality that many of those most vulnerable to fatal overdose have already died, NPR reports.

Dozens of members of Congress have expressed concern that floated layoffs at agencies like the Substance Abuse and Mental Health Administration, under the Trump administration, could undermine efforts to combat the overdose crisis.

According to CBS News, SAMHSA’s workforce — tasked in part with regulating opioid addiction treatment providers — hit a record low by the end of the first Trump administration. During the Biden administration, staffing increased substantially, the New York Times reported.

This post has been updated to clarify that the new overdose data comes from the Ninth District Medical Examiner’s Office, not the Orange County Medical Examiner’s Office.

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This article appears in Apr 2-8, 2025.