In the US, the number of drug overdose deaths has been increasing dramatically over the last two decades, peaking in 2022. The number of drug overdose deaths in 2022 was nearly 6 times that in 2000. 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. From 2023 to 2024, drug overdose deaths sharply decreased, and continued to decrease from 2024 to 2025 to below pre-COVID-19 pandemic levels.
In Los Angeles County (LAC), increases in drug overdose deaths in LAC were observed later starting in 2015, and also peaked in 2022. Similar to national trends, From 2023 to 2024, there was a sharp drop in overdose deaths, particularly opioid overdose deaths, and a continued drop from 2024 to 2025 though still above pre-COVID-19 levels (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 overdose deaths sharply increased from 2015 through 2023, driving the increase in opioid overdose deaths. From 2023 to 2025, drops in synthetic opioid overdose deaths are driving the overall opioid overdose deaths down (Figures 2-3).
(Note: Routine testing for fentanyl among overdose deaths started in 2016).
According to LAC Medical Examiner’s data, accidental opioid overdose deaths increased every year in the past decade until 2023, then dropped by 34% in 2024 and continued to decline by 8% the following year.
Fentanyl has been a major driver of accidental overdose deaths, involved in 94% of all opioid overdose deaths during the peak of the opioid epidemic in 2023. Since 2023, fentanyl overdose deaths dropped by 43%.
The proportion of accidental drug overdose deaths involving prescription (Rx) opioids excluding fentanyl decreased from 35% in 2016 to 5% in 2025. Heroin-involved accidental drug overdose deaths decreased from 27% in 2017 to 5% in 2025 (Figure 4).
Note: Routine testing of fentanyl among overdose deaths began in May 2016.
In 2016-2025, opioids were often involved in accidental alcohol and drug (AOD) overdose deaths in LAC (ranging annually from 51% to 68%).
In 2016, 35% and 24% 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 after.
In contrast, fentanyl-involved overdose deaths greatly increased, accounting for only 10% (age adjusted rate=1.0 per 100,000 population) of AOD overdose deaths in 2016, to nearly two-thirds (64%; age adjusted rate=19.2 per 100,000 population) in 2023 (Figure 5). Despite decreases, fentanyl continued to be involved in 49% (age adjusted rate=10.8 per 100,000 population) of AOD overdose deaths in 2025.
In 2016-2025, opioid overdose deaths occurred most frequently among adults aged 40-64 years in LAC for all opioid types (Figure 6).
Since 2016, adults aged 40-64 years consistently had the highest number of deaths involving opioids for all opioid types, except fentanyl, which initially had more deaths among those aged 26-39 from 2016 to 2021 (Figure 7). However, when accounting for different population sizes, those aged 26-39 had the highest rates of opioid overdose deaths from 2017 to 2025. The highest rates for heroin and Rx opioid overdose deaths were in those aged 40-64 (Figure 8).
In 2016-2025, males accounted for the majority (79%) of all opioid overdose deaths in LAC (Figure 9). The annual number and rate of opioid overdose deaths among males increased from 2016 to 2023, largely driven by fentanyl. From 2023 to 2025, opioid overdose deaths fell 41% for males and 33% for females (Figures 10-11).
From 2016-2025, Whites were the largest race/ethnicity group for all opioid overdose deaths, accounting for 44% of any opioid, 40% of fentanyl, 55% of heroin, and Rx 57% of Rx opioid overdose deaths (Figure 12).
Throughout 2016-2022, there were consistently more opioid overdose deaths among Whites compared to Hispanic/Latinos and Blacks, but in 2023, opioid overdose deaths decreased among Whites and were surpassed by Hispanic/Latinos (Figure 13).
The rate of all opioid overdose deaths was highest among Blacks starting from 2020, primarily due to fentanyl. Whites consistently had the highest rate of heroin overdose deaths from 2016 to 2025 (Figure 14).
According to LAC Medical Examiner’s report 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 the West (SPA 5) and Antelope Valley regions (Figure 15).
Instructions: Hover over map to display drug name, and click on map to enlarge image.
Figure 15. Opioid, fentanyl, prescription opioid, and heroin overdose deaths, by SPA, LAC, 2020-2024
Source: LAC Medical Examiner
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), from 2019 to June 2025, in LAC, over half (52%) of accidental opioid overdose deaths during took place in a home or apartment, often their own residence. The next most frequently reported location of accidental opioid overdose death was on the street, sidewalk, alley, highway, or freeway (14%). Other locations accounted for relatively small proportions (Figure 16).
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 4-15. Los Angeles County Department of Medical Examiner. Medical Examiner investigation reports. Data as of May 2026.
Figures 16. Statewide Unintentional Drug Overdose Reporting System. Data as of April 6, 2026.
