In the US, the number of drug overdose deaths has been increasing dramatically over the last two decades. The number of drug overdose deaths in 2023 was nearly 10 times that in 1999. Since 2009, drug overdoses has been the leading cause of injury deaths, surpassing the number of deaths by both motor vehicle crashes and firearms. It’s widely recognized that opioids were driving the national drug overdose epidemic with consistent increases in opioid overdose deaths, and particularly sharp increases in the last couple of years. For the first time since 2018, opioid overdose deaths in the US decreased by 3% from 2022 to 2023, nevertheless, deaths involving opioids still remain high.
In Los Angeles County (LAC), increases in drug overdose deaths in LAC were observed starting in 2015, and were also particularly steep in the last couple of years. Compared to 2023, opioid overdose deaths decreased by 2% from 2022, but were still 22% more than in 2020 (Figure 1).
(Note: Based on death certificate data. For local opioid- and fentanyl-related death data from the Coroner’s Office, please see Figures 4-6).
In the US, the rise in opioid overdose deaths can be outlined in three distinct waves (Figures 2-3):
California followed a similar pattern as the overall US with a slight lag. In LAC, the number of synthetic opioid deaths sharply increased from 2015 through 2023, driving the increase in opioid deaths (Figures 2-3).
According to LAC Coroner’s data, opioid deaths were relatively stable from 2010-2015, then began increasing in 2016. In 2023, opioid overdose deaths plateaued with only a 1% increase from the previous year at 2,085 deaths.
The number of fentanyl overdose deaths in LAC has been increasing every year since routine testing of fentanyl began in May 2016. In 2022, fentanyl overdose deaths increased to 1,910, surpassing meth overdose deaths (n=1,882), and continued to rise the following year by 3%. From 2016-2023, fentanyl overdose deaths have jumped by 1,707%.
Heroin deaths decreased 64% from 390 in 2020 to 142 in 2023 (Figure 4).
In 2010-2023, opioids were involved in over half of all accidental alcohol and drug (AOD) overdose deaths in LAC (ranging annually from 46% to 67%).
In 2010, 54% and 28% of AOD deaths involved Rx opioids (excluding fentanyl) and heroin, respectively. Over time, the involvement of heroin and Rx opioids in overdose deaths decreased, and they were each identified in less than 10% of AOD deaths in 2021 and thereafter.
In contrast, fentanyl-involved overdose deaths greatly increased, from accounting for only 3% (rate=0.2 per 100,000 population) in 2010, to nearly two-thirds (64%; rate=20.0) of all AOD deaths in 2023 (Figure 5).
In 2016-2023, opioid overdose deaths occurred most frequently among adults aged 26-34 years in LAC for all opioid types, except Rx opioids which was most common among adults aged 55-64 years (Figure 6).
Since 2016, adults aged 26-34 years have consistently had the highest number of deaths involving opioids. In 2023, adults aged 35-44 years surpasssed adults aged 26-34 years (Figure 7).
In 2016-2023, males accounted for the majority (79%) of all opioid overdose deaths in LAC (Figure 8). The annual number of opioid overdose deaths among males increased 294% from 426 to 1,677, largely due to the increasing number of deaths involving fentanyl, while that for females increased by 186% from 142 to 406 (Figure 9).
From 2016-2023, Whites accounted for about half of overdose deaths involving any opioid (45%), Rx opioids (58%), heroin (56%), and fentanyl (41%) in LAC (Figure 10). Throughout 2010-2022, there were consistently more opioid overdose deaths among Whites compared to Latinxs and Blacks, but in 2023, opioid overdose deaths decreased among Whites and were surpassed by Latinxs (Figure 11).
According to LAC Coroner’s data, opioid overdose deaths were highest in the Metro region (SPA 4), and lowest in the Antelope Valley (SPA 1) region. Fentanyl overdose deaths were also highest in the Metro region and lowest in the Antelope Valley region, while heroin and Rx opioid (excluding fentanyl) overdose deaths were highest in the San Fernando region (SPA 2), and lowest in Antelope Valley region (Figure 12).
Instructions: Hover over map to display drug name, and click on map to enlarge image.
Figure 12. Opioid, fentanyl, prescription opioid, and heroin overdose deaths, by SPA, LAC, 2019-2023
Source: LAC Coroner
Notes:
1 Dot = 1 death
Blue dots = Prescription Opioid (excluding fentanyl) Overdoses
Green dots = Fentanyl Overdoses
Red dots = Heroin Overdoses
According to the Statewide Unintentional Drug Overdose Reporting System (SUDORS), in LAC, over half (54%) of accidental opioid overdose deaths during 2019-2023 took place in a private residence, such as a home or apartment. Outdoor settings (i.e., street, sidewalk, alley, highway, or freeway) were the next most frequently reported location (14%), followed by hotel/motels (7%) (Figure 13).
Figures 1-3. Centers for Disease Control and Prevention, National Center for Health Statistics. National Vital Statistics System, Mortality 1999-2020 and 2018-2023 on CDC WONDER Online Database, released in 2024. Data are from the Multiple Cause of Death Files, 1999-2020 and 2018-2023, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10-expanded.html on Feb 6, 2025.
Figures 4-12. Los Angeles County Medical Examiner/Coroner’s Office. Coroner and Toxicology data. Data as of July 2024.
Figures 13. Statewide Unintentional Drug Overdose Reporting System. Data as of October 10, 2024.