Why are Synthetic Opioids Overdose Deaths Rising Faster in Colorado?
Introduction
As discussed in CSI’s June 2025 fentanyl study, fentanyl and other synthetic opioids are the most common drugs involved in overdose deaths.1 These drugs, even in small doses, can be deadly. Over 150 people die every day from overdoses related to synthetic opioids like fentanyl in the U.S.[i] On a positive note, across the country synthetic opioid overdose deaths have begun to stabilize or fall—and have been doing so since June 2023 (see left axis of figure 1).[1]
The downward trend, though, is not consistent across the country—indeed, more recently Colorado has been moving in the opposite direction of the country.
From 2018 through November 2023, synthetic opioid overdose deaths (SOOD) were generally trending up in the state, as they were in the country, reaching a peak in November 2023 at 1,213. After peaking, like the rest of the country, SOODs in Colorado began dropping. This trend lasted until November 2024. Since then, Colorado has been on a different trajectory than the nation. SOODs have been growing, up from 803 in November 2024 to 957 in August 2025. If Colorado had followed the national trend from November 2024 through August 2025 in SOOD, deaths would have been 610 in August 2025, a 57% difference from what occurred. If one sums the monthly differences from November 2024 through August 2025, the number of excess deaths in Colorado comes to 1,620.
What is behind the 1,620 excess deaths? Is there something Colorado could do differently to save lives? This paper explores those questions.
Key Findings
- Since December 2024, synthetic opioid overdose deaths (SOOD) in Colorado have grown at the third fastest rate in the country at +17%. Meanwhile, the national rate has decreased by -21% during this same period.
- The only two states with faster growing overdose deaths rates are two neighboring states, Arizona (+26%) and New Mexico (+21%).
- Colorado was one of only five states to see an increase in synthetic opioid overdose deaths since December 2024. The other four were Arizona, New Mexico, Montana, and South Dakota.
- Colorado has seen 1,620 excess deaths from synthetic opioids. If Colorado had followed the national trend of declining synthetic opioids deaths, Colorado would have had 1,620 fewer deaths.
- Forensic economists are often called on to value lost life. Although there are many ways to value life, if one assumes each life has a statistical value of $13.4 million, the value of life lost for the 1,620 excess deaths is approximately $18.3 billion. While this number does not encompass the entire value of human life, it does indicate that lives lost due to fentanyl and other opioids reduce the economic potential of the state.
- Since October 2022, the U.S. Customs and Border Protection has seized about 28.7 billion milligrams of fentanyl.
- Two milligrams of fentanyl can be lethal depending on body size, tolerance, and prior use. Assuming roughly 15% purity, this implies that since October 2022 the federal government has seized enough fentanyl to potentially kill 2.2 billion people, or about 25% of the global population.
The Backdrop: Synthetic Opioid Overdose Death (SOOD) Rate in Colorado
As backdrop, figure 2 shows the recent trends in synthetic opioid overdose death (SOOD) rate across states with reported information.[ii] Colorado shows up on top—and not in a good way—with the third fastest-growing drug overdose death rate (+17%) among states since December 2024. The only two states experiencing more rapid increases in SOODs are Arizona (+26%) and New Mexico (21%). On the other end of the spectrum, SOODs have fallen most in Vermont, Virginia, New York, and Wisconsin, all of which have seen declines of more than 30%). Meanwhile, the average U.S. rate trended downward during this time
(-21%).
Why are drug overdose deaths getting worse in Colorado and going down in other states? Are there economic trends that would explain the death trends? Are there policies other states pursued that are making a material difference at the state level?
Among surrounding states, a similar picture emerges with Colorado, Arizona, and New Mexico as outliers.
The Statistical Value of Life: How Much is it Costing Colorado?
Before looking at reasons for the excess deaths from SOOD, this section places a value on the issue—essentially, the dollar value of life lost. As one might expect, the value of each life lost varies widely depending upon circumstances, demographics, and many other variables.[iii] One common measure is the Value of Statistical Life (VSL), which is an economic measure used to quantify the benefit of reducing the risk of death. It helps policymakers, courts, and others measure the cost-effectiveness of regulations and interventions. Using this measure, the VSY of every life in 2026 is approximately $13.4 million. Multiplying $13.4 million by the number of excess deaths from November 2024 to August 2025 gives the value of lost life due to SOOD is about $18.3 billion.
Measures Taken to Improve the Situation
Policymakers at the state and federal level have taken steps to limit the consumption of fentanyl and other synthetic opioids by either increasing criminal penalties for possession and distribution or expanding prevention and harm-reduction efforts. Some states and cities have opted for the former while others have opted for the latter. Additionally, the federal government has expanded penalties for consumption and possession of fentanyl and other synthetic opioids.
Fentanyl Seizures at the Southwest Border
In addition to discouraging consumption, distribution, and possession of fentanyl and other synthetic opioids, the federal government has continued its efforts to prevent fentanyl and other synthetic opioids from entering the country.
According to U.S. Customs and Border Patrol (CBP), fentanyl seizures at the southwest border totaled 63,286 pounds from October 2022 through January 2026—or about 28.7 billion milligrams. The milligram measurement is important because it can potentially only take approximately two milligrams of pure fentanyl for individuals to have had a lethal dose.
[iv] Per the U.S. Drug Enforcement Agency (DEA), a reasonable estimate of purity for fentanyl seized is 15%.
[v] This estimate means that the 28.7 billion milligrams is enough to have been a lethal dose for about 2.2 billion people, or about 25% of all people living on earth today.
Treatment-Related Options for Opioid Users
In 2019, the Colorado legislature passed bill HB19-1263, Offense Level for Controlled Substance Possession. This bill made the possession of four grams or less of most drugs, including fentanyl, a misdemeanor rather than a felony. Moreover, this bill provided grants to counties that provided treatment services and programs to people who came into contact with the criminal justice system. The bill mentioned the following:
It is the intention of the general assembly to classify most drug possession on and after March 1, 2020, as a misdemeanor offense with different sentencing options and limited incarceration penalties. The purpose of this sentencing scheme is to provide offenders who are assessed to be in need of treatment or other intervention with probation supervision in conjunction with effective medical and behavioral intervention and treatment.
Although the bill sought to place individuals who violated drug offenses into treatment, figure 5 shows that overdose deaths continued to rise during this period. At the same time, treatment admissions increased substantially, suggesting that expanded treatment access did not correspond with reductions in overdose deaths.
Why Colorado’s Overdose Trend Diverges from the Nation
Is there evidence that a specific policy offers better results, at least when measured by lower synthetic opioid deaths? That is an open question for continued research. What is clear is that the resulting drug overdose deaths cannot be currently tied to one specific policy or situation. Instead, a variety of factors affect a state’s experience with drug overdose deaths, including penalties associated with fentanyl possession and distribution, a given state’s proximity to the southwest border, and the state’s broader patterns of drug supply and trafficking.
In Colorado, penalties for the possession of fentanyl are not as strict as those in some other states. For example, laws in neighboring or nearby states, such as Texas, define fentanyl as a Schedule I drug, which includes expanded penalties for fentanyl possession and/or distribution. Texas has seen its synthetic opioid overdose deaths drop by -27% since December 2024 despite being a large magnet for in-migration.
In addition to the aforementioned, Colorado still retains a “knowing” requirement in its fentanyl possession statute. SB25-044 of the 2025 Second Regular Session proposed eliminating the “knowing” clause, but it did not pass. Below is the proposed language from the lost bill.[vi]
Effective July 1, 2025, the bill makes the possession of a qualifying controlled substance a level 4 drug felony. The bill repeals the following provisions of law related to the penalties for possessing a qualifying controlled substance:
A provision that reduces the penalty if the fact finder in the case finds that the possessor made a reasonable mistake of fact and did not know that the material, compound, mixture, or preparation contained fentanyl, carfentanil, benzimidazole opiate, or an analog thereof; and
A provision that requires a court to vacate the drug felony conviction and enter a conviction for a level 1 drug misdemeanor upon the defendant's successful completion of a community-based sentence to probation or to a community corrections program.
Colorado’s patterns in lessening criminal sentencing for drug offenses, implementing treatment-based courses of action for those who violate the drug crimes, and overall drug supply and trafficking history in the state, make it an environment where drug overdose numbers continue to increase.
Bottom Line
As synthetic opioid deaths continue to rise relative to most states, Colorado’s legislative response remains comparatively limited. Despite taking steps in 2022 in the direction of increased penalties and expansion of harm-reduction and treatment measures with the passage of bill HB22-1326, the state has not enacted additional legislation that would strengthen criminal penalties for fentanyl possession and distribution that seemed to have worked in other states like Texas, which is a gateway to fentanyl distribution.
[1] The downward trend in synthetic opioid overdose deaths stems from data released by the U.S. Department of Health and Human Services.
[ii] U.S. Department of Health & Human Services, National Center for Health Statistics. VSRR Provisional Drug Overdose Death Counts. Data.gov. Accessed March 3, 2026. https://catalog.data.gov/dataset/vsrr-provisional-drug-overdose-death-counts
[iii] Hammitt, James K. “Consistent Valuation of a Reduction in Mortality Risk Using Values per Life, Life Year, and Quality-Adjusted Life Year.” Health Economics 32, no. 9 (September 2023): 1964–1981. https://doi.org/10.1002/hec.4697