Drug overdose deaths and overdose-related emergency room visits surged in Santa Fe, Rio Arriba and Taos counties during the first three months of 2025 compared to the same period a year earlier.
Most of the fatalities were linked to fentanyl use, according to the New Mexico Department of Health, which released new data Thursday showing the concerning rise throughout Northern New Mexico.
The sharp increase is a regional anomaly: Data shows fatal overdoses statewide in the first quarter of 2025 were lower than in the same three months of 2024 by more than 100 deaths.
Health officials attribute at least some of the growth in overdose deaths and emergency room visits to more potent fentanyl pills and powders in the region -- although the reason for the higher concentrations in the three-county area is tough to pin down.
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Therese Johnson, 55, tries to get a syringe filled with fentanyl into the veins on her arm in the shrubs along St. Francis Drive in Santa Fe on June 9, 2025.
"We're finding that there's an increased amount of fentanyl in these pills. I have no idea why; we just know that this is happening," said David Daniels, the Harm Reduction Section manager at the New Mexico Department of Health.
Santa Fe Mayor Alan Webber said in a statement Thursday the data "should serve as an alarm bell in the night for everyone in our community."
He called for a summit to bring together state, federal and local resources to determine a "coordinated strategy" to reverse the trend.
"Without such a plan, I fear that the problem will continue to grow and claim more lives and cause irreparable damage," Webber said.
Gov. Michelle Lujan Grisham in August declared a state of emergency in Española and surrounding Rio Arriba County, citing in part a rise in drug addiction. Welcomed by elected officials in the area, the proclamation authorized about $750,000 in state funding for local law enforcement agencies to manage crime.
In a letter sent Monday, Republican legislative leaders also called on the governor to consider incorporating proposals to "reduce out-of-control drug and violent crime" during the upcoming special legislative session, which is set to begin Oct. 1.
Over 80 deaths in 12 months
New Mexico had the seventh highest rate of drug overdose deaths in the nation in 2023, according to data from the U.S. Centers for Disease Control and Prevention.
The state's drug deaths peaked in 2022. The most recent provisional data from a 12-month period ending in mid-2025 shows a drop of some 200 deaths.
Rio Arriba County long has had the highest overdose death rates in the state and among the highest rates in the nation. But rates in Santa Fe and Taos counties also outpaced national averages from 2019 to 2023.
Taos County saw the most significant increases in the first quarter of 2025, with a 340% growth in overdose deaths and 206% growth in overdose-related emergency room visits. The county topped 30 deaths in a 12-month period ending in June 2025.
Overdose-related emergency room visits in Santa Fe County increased by 131% and deaths by 104% in the first three months of 2025, compared to the same time in 2024. By June 2025, a 12-month count of overdose deaths totaled more than 80 deaths -- far more than those than Rio Arriba, Taos or Doña Ana County.
Santa Fe County emergency rooms saw more than 70 overdose-related visits in the first quarter of 2025, more than double the number of ER visits in those same three counties.
Overdose deaths increased by 48% in Rio Arriba County, while overdose-related ER visits were up 81% in early 2025. A 12-month tally of overdose deaths totaled just under 60 deaths by mid-2025.
Added demand on resources
Arturo Delgado, a spokesperson for Christus St. Vincent Regional Medical Center, said Santa Fe's largest hospital hasn't seen an overall increase in overdose deaths in the past year.
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A woman opens a foil packet containing fentanyl pills while her acquaintance smokes another of the pills last summer on Central Avenue in Albuquerque.
But emergency medical personnel from the Santa Fe city and county fire departments regularly respond to reports of substance-related emergencies. Both agencies also follow up after an incident to provide overdose-reversing naloxone -- better known as the brand name Narcan -- to prevent a future fatality.
The Santa Fe County Fire Department has seen an increase in those calls this year, Chief Jacob Black said in a statement. The pattern, he said, "indicates a concerning upward trend" and places "added demands on our personnel and resources."
The city fire department responds to overdoses on a daily basis, Assistant Chief Scott Ouderkirk said. Although the agency is adequately staffed right now, he'd like to increase personnel and trucks to be more available in more locations.
Daniels pointed to an increase in potency as one of the reasons for the growth in deaths and ER visits.
In some ways, he said, a fentanyl pill is like a glass of orange juice.
If you combine a can of concentrated orange juice with the right amount of water, you get a nice drink, Daniels said. But if you mix the concentrate with just a quarter of the recommended amount of water, you end up with a much stronger beverage -- and maybe a blood sugar spike.
"That's what we're seeing when it comes to these fentanyl pills now," Daniels said. "There is more opiate, more fentanyl in these illicit pills than it had in the past."
A few years ago, a typical pill would contain 1% or less fentanyl, Daniels said. Now, the same kind of pill could contain 15% or 20% of the opioid.
More people overdosing alone?
The increases in overdose deaths and ER visits come amid waves of enforcement initiatives aimed at homelessness, drug use and crime in the region.
The city of Santa Fe recently has ramped up efforts to clear out unsanctioned homeless encampments, and police have arrested residents for setting up camps.
Española police cleared residents out of a controversial city-sanctioned camp in August 2024. A year later, city officials voted to deny a special-use permit for the city's only homeless shelter.
Joe Dudziak, who for years has run a nonprofit street outreach program for the homeless in Santa Fe, said he suspects the recent crackdown on encampments, like the increase in pill potency, is a contributing factor in the rise in overdoses and deaths.
While many people living on the streets carry the "miracle drug" naloxone, he said, somebody else has to be present to administer it during an overdose.
People are more likely to overdose alone when they are forced out of a camp.
"If you're in an encampment, there's a lot of people around, and so people notice when somebody goes down," Dudziak said.
Plans to combat upward trend
Preparations are underway to try to curb the rise in overdose deaths, Daniels said.
His team's guiding philosophy is to "accept that substance use is a part of our world" while minimizing its harmful effects through strategies like needle exchanges and wide distribution of naloxone.
No-cost naloxone is available at public health offices throughout the state or via an online request portal.
Health Department data indicates naloxone distribution has increased across the state, including in Santa Fe and Rio Arriba counties, since 2024.
In Taos County, naloxone distribution has remained relatively flat.
Naloxone reversals -- which result in a patient outcome of "OK" -- have been trending upward in Rio Arriba County since the start of 2024. The same was true in Santa Fe County until a dip in reversals during the second quarter of 2025, according to Health Department data. Though, officials note the true numbers of distributions and reversals likely are undercounted.
Presbyterian Española Hospital shares concerns about rising numbers of overdoses in the region and the increasing potency of fentanyl, Administrator Brenda Romero said in a statement. The hospital plans to expand its medication-assisted treatment offerings with a new clinic space, expected to reach at least 1,900 patients in its first year.
Daniels said the state Health Department is ramping up its harm reduction work -- like naloxone distribution and drug testing -- to get the regional increase in overdose deaths and ER visits under control.
"Any increase, especially like this, is a cause for concern," he said.