Colorado’s law that made possession of small amounts of fentanyl a felony had almost no effect on overdose deaths, but may have discouraged people from sticking with treatment for opioid addiction, an initial study of the legislation’s impact found.
House Bill 1326, which passed in 2022, lowered the threshold for felony charges to one gram from four grams of any drugs containing fentanyl. It also made selling a dose of fentanyl that killed someone a class-one felony, carrying a penalty of up to 32 years in prison — but prosecutors only filed nine cases in the first 10 months after the law changed.
Lawmakers included a provision requiring the state’s Behavioral Health Administration to commission a study about whether the change helped reduce overall overdose deaths or increase the number of people receiving medication to treat opioid addiction. Fentanyl was a factor in close to three out of every five Colorado overdoses in 2023.
The overall death rate from all overdoses remained essentially unchanged in the first 16 months after the law changed, according to a report completed late last year by researchers at the University of Colorado School of Medicine and Kaiser Permanente Colorado.
Overdose deaths among Black Coloradans were higher than expected in four of the examined months, but other states that hadn’t changed their laws also saw more Black residents die during that time.
Dr. Joshua Barocas, the lead researcher, said Colorado’s overdose deaths moved in line with nationwide trends and projections from before the law changed.
“It didn’t reverse the trends,” he said.
U.S. Rep. Brittany Pettersen, a Democrat who was one of the bill’s sponsors when she served in the state Senate, said supporters didn’t expect to see a major decline in overdose deaths after the bill passed.
Law enforcement wanted another tool to pursue drug dealers, but the requirement that jails offer addiction-treatment medication and new funding for harm reduction were far more important, she said.
“We were working with police and impacted community members to walk that line and find a balance,” she said.
Some parts of the law hadn’t taken full effect during the period the researchers examined, including a requirement that jails offer the three major medications for opioid addiction treatment: buprenorphine, methadone and naltrexone.
Buprenorphine and methadone are milder opioids, which prevent people who are addicted from enduring painful withdrawal symptoms. Naltrexone blocks the pleasant effects of opioids, so people won’t want to misuse them.
The Behavioral Health Administration said in a statement that it would continue to monitor the effects of all changes in the law.
“It may be too early to fully assess the impacts of HB22-1326,” the agency’s statement said.
The data ended before overdose deaths started to drop last year. Nationwide, overdose deaths have fallen 26% from their peak in June 2023, meaning about 30,000 people survived last year who would have died if overdoses continued at their prior pace, according to NPR.
Colorado hasn’t yet finalized its 2024 death data, but overdoses were on track to drop year-over-year.
The state’s overdose deaths slowly trended up over the last two decades, then spiked during the pandemic, which followed shortly after fentanyl arrived in the state’s drug supply. At the peak in 2021, 1,881 people died of overdoses, 912 of which involved fentanyl. While the total number of overdoses stabilized in 2022 and 2023, the share attributed to fentanyl grew.
No one knows if the nationwide decrease is because fewer people are using illicit drugs, the supply has become slightly safer, those who use drugs are taking more precautions, or some combination of the three. Some researchers theorize that the number of people vulnerable to overdose is down because so many died over the last few years.
People with opioid addiction were about equally likely to start either buprenorphine or methadone for treatment after the law changed as they were before, according to the report. They may have been less likely to stick with methadone treatment, though the authors cautioned that reporting standards for methadone clinics changed at that time, which could have influenced the results.
Barocas said he believes the drop is real, and worries that people were afraid to stand in line for methadone, knowing they would face higher penalties if caught with fentanyl. The percentage of methadone patients in treatment for six months dropped by half in the year after the law changed, with fewer than one in five sticking with treatment by the end.
“That’s my fear, that this acted as a deterrent to medication,” he said.
Then-House Speaker Alec Garnett, a Democrat and one of the bill’s sponsors, said at the time that he had to accept tougher penalties to gather enough votes to pass the treatment and harm reduction provisions. He declined to speak about the bill’s impacts through representatives for his current employer, UCHealth.
The third sponsor, then-Sen. John Cooke, a Republican, didn’t respond to phone messages.
The researchers will continue to look deeper into the data, to see how the law change affected different groups of people who use drugs, Barocas said. Interviews with law enforcement and people working in the addiction space suggest they don’t hold out much hope that any benefits will show up later, which is consistent with decades of research on punitive drug policies, he said.
“Colorado is no different than anywhere else that has been studied,” he said.
Sign up for our weekly newsletter to get health news sent straight to your inbox.
