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  • Fentanyl made up 59% of all overdose deaths
    A close up of two circular pills, one is white with an M stamped on it, the other is slightly yellow with an M stamped on it.
    The authentic 30mg Oxycodone is on the left. The fake 30mg Oxycodone laced with fentanyl is on the right.

    Topline:

    A record 3,220 people died of drug overdoses in Los Angeles County in 2022. That’s about eight to nine people per day, fueled primarily by fentanyl and methamphetamine, according to a report from the L.A. County Department of Public Health.

    Why are overdoses increasing? Fentanyl is being found mixed in other drugs, including methamphetamine and counterfeit pills. Just a tiny amount of fentanyl can cause death.

    How much have they gone up? From 2016 to 2022, fentanyl overdose deaths in Los Angeles County increased 1,652%.

    Who is dying? People over the age of 26 are driving the bulk of overdoses, and men make up the vast majority of overdose deaths. You can find out more about the report here.

    Fentanyl, a dangerously potent synthetic opioid, has surpassed methamphetamine for the first time to become the most common drug in fatal overdoses in Los Angeles County, authorities said.

    Listen 0:56
    LA County Overdose Deaths In 2022 Climb To More Than 3,200

    The powerful drug accounted for 59% of all alcohol and drug overdose deaths and 92% of all opioid overdose deaths last year, according to a report from the L.A. County Department of Public Health.

    “Eight to nine people per day in Los Angeles County are overdosing fatally,” said Dr. Gary Tsai, director of the department’s Bureau of Substance Abuse Prevention and Control.

    A record 3,220 people died of drug overdoses in Los Angeles County in 2022. That’s a nearly 7% increase from 2021, when 3,010 people died of drug overdoses in the county, authorities said.

    The report relied on data derived from medical examiner and toxicology reports. If a drug was listed as one of the causes of death, it was classified in the report as a contributor to an accidental overdose. Suicides were excluded.

    A dangerous combination

    Experts say fentanyl is increasingly found mixed in other drugs, including methamphetamine, in what has been called the “fourth wave” of the opioid crisis by researchers.

    “The key differentiator between substance use now and substance use 10 years ago is fentanyl, because fentanyl is something where — whether you've used for a long time or whether this is the first time you're touching a substance — it can immediately be life threatening,” said Tsai, who treats people with addictions and has seen the devastating effects of both drugs first hand.

    Authors of the report note the data did not allow them to determine whether people who died of overdoses involving fentanyl took the drug on purpose in combination with another drug or if they took it accidentally because it was added to another drug without their knowledge.

    Counterfeit pills containing fentanyl are fueling the crisis because even a tiny amount can cause death. The Drug Enforcement Administration reported that laboratory testing indicated seven out of every 10 pills seized by the DEA last year contained a lethal dose of fentanyl.

    The federal agency has so far seized a record 86 million fentanyl pills in 2023, exceeding last year’s total of 58 million pills. Some commonly faked prescription drugs include, OxyContin, Percocet, Vicodin, Xanax and Adderall. The DEA said counterfeit pills are being sold online and over social media.

    Who is dying?

    People over the age of 26 are driving the bulk of overdoses in L.A. County, according to the report. For the first time, people between 40 and 64 years of age made up the highest number of fentanyl overdose deaths, with 870. People aged 26 to 39 were the second highest with 736 deaths.

    More people in both age groups died from fentanyl overdoses in 2022 than the previous year.

    Men made up the vast majority of overdose deaths in the county last year at 1,561. Women accounted for 347.

    Tsai said where and how people use drugs may be factors.

    “A significant risk factor for fatal overdoses is using alone," Tsai said. “I think this is a trend that we've seen for decades and decades in terms of there being more men in our substance use treatment system than women.”

    People experiencing homelessness are a high risk group for overdose deaths. A record 2,201 people experiencing homelessness died in Los Angeles County in 2021, a 70% increase compared to 2019, according to a report released earlier this year from the Department of Public Health.

    Drug overdoses, fueled by fentanyl and methamphetamine, were the leading cause of death.

    “There's a tragedy happening in L.A., and it's happening on a daily basis,” said Will Nicholas, director of the county’s Center for Health Impact Evaluation. “On average, over the last couple years, two people every day are dying of overdose on the street [in L.A. County]. It’s a shocking number and it is preventable.”

    In a striking observation, the report authors cited anecdotal reports from women users who favor methamphetamine “because its sleep-depriving effects help protect them from the sexual assaults prevalent in life on the street.” That may explain why methamphetamine contributed to a higher percentage of female versus male overdose deaths.

    A white and gray box has red and black text and black and white drawings depicting the steps for administering a nasal spray to a person who is unconscious. The three main steps read "1. Identify opioid overdose and check for response. 2. Give Narcan Nasal Spray. 3. Call for emergency medical help, evaluate, and support."
    Instructions in a Narcan box for the prevention of opioid overdose.
    (
    Noé Montes
    /
    for LAist
    )

    Do you have naloxone?

    Tsai calls naloxone, a medication that reverses the effects of an opioid overdose, “the difference between life and death.”

    Naloxone, sometimes referred to by the brand name Narcan, is now available over the counter, though it can come with a $45 price tag at some pharmacies. There are multiple places where naloxone is distributed for free, including public libraries and some consulates in L.A. County.

    Tsai said the county has made “good progress” on getting more naloxone in the public’s hands, but he wants to ensure there is as much of the medication in the community as possible.

    “In glove compartments of cars, in medicine cabinets in our homes, everyone should have it, because of how common overdoses are now,” he said.

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