Fatal fentanyl overdoses may have peaked in Washington state, according to preliminary data. But it’s not all good news.

At the end of 2023, the quarterly death toll nationwide fell 9% after rising almost quarterly since 2019. While synthetic opioid deaths are still rising in some parts of the state, the rate in King County has fallen since July 2023, when an average of four people died from fentanyl overdoses almost daily.

Caleb Banta-Green, a research professor at the University of Washington School of Medicine, said the change appears to be driven primarily by the fact that so many fentanyl users in the Seattle area have already died.

“There are only so many people who use a drug, and when the mortality rate is that high, at some point – in a really terrible way – it starts to disappear on its own like a forest fire,” Banta-Green said. “So it’s literally running out of fuel. The terrible thing in this case is that the fuel is people.”

Banta-Green said a bleak trajectory is also evident on the East Coast, where fentanyl made early inroads.

“I hope that we continue to see a decline, but I hope that the future decline is not because people are dying, but because they have access to the really wonderful life-saving interventions that we are making great strides to implement more broadly want to spread.” available,” he said.

These include replacement medications such as buprenorphine and methadone, which help reduce opioid intake and reduce the risk of fatal overdose.