Hospitalizations

Opioid Hospitalizations in Los Angeles County

According to HCAI data (formerly OSHPD), there were a total of 265,486 hospitalizations in LAC from 2005-2022 that listed opioids as a diagnosis (abuse, dependence, use, or poisoning) or external-cause-of-injury. Opioid-related hospitalizations increased by 79% from 11,209 in 2005 to 20,116 in 2016, then decreased by 22% to 15,623 in 2022 (Figure 1).

About 15% of opioid-related hospitalizations listed opioids as the principal diagnosis or principal external-cause-of-injury between 2005-2022. Primary opioid hospitalizations increased by 87% from 1,415 in 2013 to 2,641 in 2022 (Figure 2).

Among opioid poisoning hospitalizations that specified opioid type, prescription (Rx) opioids (including natural/semi-synthetic opioids, methadone, and synthetic opioids) were the most frequently reported opioid type in 2016-2022 (Figures 3, 4).

Synthetic opioid poisoning hospitalizations has been trending up since 2016. Heroin poisoning hospitalizations increased from 2006, peaking in 2018, then decreased every year from 2018-2022 (Figures 1, 2).

Opioid Hospitalizations by SPA

In 2022, the South Bay region (SPA 8) had the highest rate per 100,000 of all opioid-related hospitalizations, although the West region (SPA 5) had the highest rate of all primary opioid hospitalizations.

The Antelope Valley region (SPA 1) and the Metro region (SPA 4) had the highest rates of opioid poisoning hospitalizations, mostly driven by prescription opioids including natural/semi-synthetic and synthetic opioids such as fentanyl. 

Heroin hospitalization rates were highest in the South region (SPA 6) (Figure 5).

Figure 5. Opioid hospitalizations per 100,000 population by SPA, opioid type, and diagnosis type, LAC, 2022

Source: HCAI

Instructions:

Make a selection at the top of the maps to compare hospitalization rates by SPA, opioid type, and diagnosis type.

Demographics

Overall, opioid hospitalizations generally increased with age. Adults 65+ (27%) was the largest age group, and adults 55+ accounted for nearly half of all opioid-related hospitalizations in 2016-2022. 

Each older age group consistently had more natural/semi-synthetic opioid poisoning hospitalizations throughout 2016-2022 (Figures 6-7).

From 2016-2022, hospitalizations for poisoning by synthetic opioids such as fentanyl increased dramatically for adults aged 26-34 years, young adults aged 18-25 years, and adults aged 35-44 years. 

Hospitalizations for poisoning fell for all age groups from 2018-2022, especially among those young adults aged 18-25 years, adults 26-34 years, and adults aged 55-64 years (Figures 8-9).

From 2016-2022, males accounted for more opioid-related hospitalizations than females. The gender disparity was wider for primary opioid hospitalizations. 

The gender disparity differed by opioid poisoning types. While hospitalizations for poisoning by heroin in males were triple (3.1 times) that of females and double (1.9 times) for synthetic opioids such as fentanyl, hospitalizations for poisoning by natural/semi-synthetic opioid poisoning was nearly the same among males and females from 2016-2022 (Figures 10-11).

Hospitalizations for both synthetic and natural/semi-synthetic opioid poisoning had been higher among females up until 2017 and 2018 respectively, then rapid increases began among males. In 2022, males had nearly quadruple (4.0 times) the number of hospitalizations for primary synthetic opioid poisoning, and nearly double (1.8 times) the number of hospitalizations for primary natural/semi-synthetic opioid poisoning. Males consistently accounted for about three quarters of heroin poisoning hospitalizations from 2016-2022 (Figure 12-13).

Whites accounted for the largest proportion of all opioid hospitalizations every year since 2005. From 2016-2022, the number of primary opioid hospitalizations decreased among Whites (by 39%), while increasing for Latinxs (by 90%), Blacks (by 25%), and Asian or Pacific Islanders (API, by 22%) (Figures 14-15).  

Latinxs are emerging as the predominant race/ethnicity, nearly catching up to Whites for all opioid-related poisoning hospitalizations, and surpassing Whites for primary opioid poisoning hospitalizations. This is due to a faster increase in hospitalizations for poisoning by synthetic opioids such as fentanyl, and a slower decrease in hospitalizations for poisoning by heroin from 2016-2022 compared to Whites (Figures 16-17).

Neonatal Abstinence Syndrome

Neonatal abstinence syndrome (NAS), or drug withdrawal symptoms in newborns, can occur if the mother uses opioids during pregnancy.

Newborns hospitalized with NAS increased 172% from 82 in 2008 to 223 in 2017, then fluctuated between 158 and 194 hospitalizations through 2022 (Figure 18).

Economic Burden of Opioids

From 2012-2022, patients hospitalized for all opioid-related conditions stayed in the hospital for an average of 6.4 days, and accounted for 1,193,521 total hospital days.

The mean hospital charge for each opioid-related hospitalization in LAC was $96,574, increasing from $57,323 in 2012 to $122,960 in 2022. 

The annual opioid-related hospital spending increased from $780 million in 2012 to $1.9 billion in 2022, and resulted in a total of $18 billion in total spending from 2012-2022 (Figure 19).

Mean length of stay: 6.4 days

Total hospital days: 1,193,521

Mean hospital charge: $96,574

Total hospital spending: $18 billion

Notes: Hospitalizations for less than 1 day were counted as having a length of stay of 1 day. All costs were adjusted for inflation to 2022 US dollars.

References

Figures 1-19. Department of Health Care Access and Information (HCAI, formally OSHPD). Nonpublic Inpatient Discharge and Emergency Department data, 2005-2022. California Department of Public Health.
Note: Based on diagnoses and external-cause of injury listing any ICD code for opioid abuse, dependence, use, or poisoning for all intents and encounters. Counts based on case admission date. For specific opioid types, encounters for sequelae and remission were excluded.