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Travis County Medical Examiner reports 2024 drop in accidental drug and fentanyl deaths
Summary
The County Medical Examiner reported a 22% decrease in accidental drug deaths between 2023 and 2024 and a 36% drop in fentanyl‑involved deaths, while emphasizing continued concern about multi‑drug toxicity and youth exposure.
The Travis County Medical Examiner’s Office presented its 2024 annual report to the Commissioners Court on April 29, reporting an overall decline in accidental drug deaths and in fentanyl‑involved fatalities compared with 2023.
Chief Medical Examiner Keith Pinkard told the court the office investigated 1,779 jurisdictional cases brought to the office in 2024. He said accidental deaths remain the largest non‑natural class and that drug toxicity was the leading cause of accidental deaths; accidental drug deaths fell to 380 in 2024 from 486 in 2023, a 22% decrease.
Pinkard said fentanyl‑involved deaths rose from 22 in 2019 to a peak of 279 in 2023, but fell to 179 in 2024, a 36% decrease. He said fentanyl is often present with other drugs: in 2024, 89% of fentanyl‑involved deaths involved multiple substances, and 45% of fentanyl deaths also included methamphetamine. Pinkard cautioned that the in‑house toxicology lab’s full results can take weeks to months, and the office lists each compound on death records for public‑health surveillance.
The office highlighted child and infant deaths: among fatalities under 1 year, 36% were suffocation in unsafe sleep environments. The medical examiner also noted that homicides and firearm deaths trended down slightly from recent highs.
Commissioners and staff discussed the role of naloxone and harm‑reduction activities: Harm Reduction Alliance reported about 300 naloxone reversals in 2024, and Travis County EMS also reported significant reversal activity. The ME urged continued community distribution, public education and cross‑agency coordination. The court received the briefing; no action was taken.
Pinkard said the Medical Examiner’s lab is accredited and the office maintains interlocal autopsy contracts with 49 neighboring counties for fee‑for‑service work that supplements local casework and public health reporting.
