County renews opioid overdose crisis declaration, funds more harm reduction

On Tuesday, the Travis County Commissioners Court voted unanimously to extend its opioid overdose crisis declaration to October 2026 and to authorize $100,000 worth of naloxone, a lifesaving overdose reversal drug, as well as $100,000 – and possibly another $300,000 soon – toward new harm reduction services. However, they also learned that the opioid settlement funds that have made such investments possible are soon to run out, forcing the county to make some tough decisions in the coming years. 

These services are sorely needed – Travis County has the highest rate of overdose of any county in Texas – but they seem to be working. The nation has actually seen a precipitous decline in overdose deaths for the first time since 2020.

“The money that you are providing is doing good,” said Phil Owens, peer recovery program manager with Communities for Recovery. Owens added that in the overdose spike in May this year, when over the span of three days, 79 people overdosed downtown, “there were only nine fatalities, which means people who are using drugs are saving lives. First responders are saving lives. Bystanders are saving lives. What you’re doing is valuable.”

Because of related efforts by Austin Public Health and Central Health, staff recommended a reduced investment in naloxone, from $175,000 in Fiscal Years 2023 and 2024 to $100,000. The other $100,000 will go toward community organizations like Texas Harm Reduction Alliance to help increase its capacity for street outreach, especially in North Austin. THRA has a drop-in clinic on East Cesar Chavez but has indicated that it has been seeing an increased need in North Austin especially. The funds will also go toward increasing capacity for peer support services. 

Harm reduction advocates said putting naloxone in the hands of providers that are directly reaching out to the populations most at risk of overdose – people who are homeless – is more effective than supplying it to first responders.

“We need more access for people who are using and their loved ones, and less access towards institutional players,” said Cate Graziani, co-director of Vocal TX. “It’s important for them to have naloxone, but it’s more important for people who are closest to overdose to have it, and I think that is where a gap exists, especially free 24-hour access.”

Em Gray, director of the N.I.C.E. Project, which supplies vending machines around town stocked with free naloxone, said, “The vending machine program doesn’t interact with people the way that the street outreach does – that is what really helps get people the supplies that they need. Those kinds of relationships that we build are really what changes lives and makes harm reduction thrive.”  

The investments the county re-upped this week are made possible by a national opioid settlement that has paid out a total of $1.7 million to the county so far. The first settlement funds were received in August 2023 and have been used to reimburse prior expenses related to the crisis, as well as short-term contracts to provide peer recovery support and methadone services – as well as 17,468 doses of naloxone distributed to first responders and throughout the community. The 2025 investment will be the third disbursement of settlement funds, which can vary year to year. 

Indeed, county staff warned commissioners that the funds will decrease by 2026, meaning the county can’t keep up its investment of $525,000 a year without supplementing with the General Fund, which would affect the FY 27 budget. However, Commissioner Ann Howard spoke in opposition to attempting to stretch the funds for longer, saying, “It’s hard for me to pass a declaration of emergency and then know that we’re spending a couple hundred thousand that we got from an abatement program – like, if we need to be doing more, we should be doing more. I wouldn’t keep it for later.” Howard’s push resulted in an amendment to the resolution that asks staff to come back to the court with ideas for using an extra $300,000 of settlement money in the coming months – though it was unclear when they should come back or if that funding can be spent before they do.

The county’s investments in harm reduction services total $525,000 for FY 25, but with Howard’s amendment of the additional $300,000, will soon total around $825,000. This makes future spending uncertain – staff had already projected that if the court spends the usual $525,000 in FY 25 and 26, in FY 27 the opioid settlement funds available drop to $380,277. Now that the county is spending even more upfront, it’s unclear when all the funding will run out from the settlement. 

The county is not the only entity providing resources to the community, however. Most importantly, Central Health has already received a whopping $4 million to the county’s $1.7 million in settlement funds. That’s almost the total the county can expect to receive over 18 years. Central Health is spending that money on naloxone vending machines and expanding methadone treatment through its Medical Access Program (MAP), but the county could not provide specific details of its spending at the meeting. Commissioner Brigid Shea added an amendment to the resolution to prod Central Health to do more, and quickly, to use those funds.

“There is no way the opioid abatement funds on their own, as they’re being allocated, can cover or meet the need of investment that our community has,” Laura Peveto with county Health and Human Services warned commissioners. “If that is the intent of the court, that we invest based on the dollars that we have through the opioid abatement settlement, we’re going to have to start tapering down once we hit FY 27. If that’s not the intent or the vision, then the funds are available.” 

Photo made available through a Creative Commons license.

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