Fatal overdoses in LA County — including fentanyl deaths — declined last year, health officials say

Drug overdose deaths throughout Los Angeles County declined 22% last year compared to the previous year, according to a report released Wednesday by the Department of Public Health.

It’s the most significant drop in county history, led by an unprecedented decrease in fentanyl-related deaths.

The number of accidental overdose deaths or poisonings involving fentanyl decreased by 37% in 2024, the first reduction since county officials began routinely testing for the drug, according to the report. Methamphetamine-related overdose deaths decreased by 20% last year, compared to 2023.

Fentanyl overdose deaths had previously surged from 109 deaths in 2016 to more than 2,000 in 2023, a crisis-inducing increase of 1,700%.

That crisis has disproportionately hit L.A. County’s more than 75,000 unhoused residents for whom overdose remains the leading cause of death. Fentanyl overdoses claimed the lives of more than 1,500 unhoused Angelenos at their peak in 2022, according to county Public Health data.

Officials say the sharp decrease in 2024 shows that recent county investments in overdose response, harm reduction methods and treatment are saving lives.

“This progress reflects the dedication of countless staff and community partners who work every day to connect people with life-saving resources and care,” county Public Health Director Barbara Ferrer said in a statement. “While we are encouraged by this trend, we know the work is far from over.”

The findings in the local report mirror a decline of more than 25% in drug overdose deaths nationally in 2024, according to provisional data from the CDC.

The CDC said there were multiple factors behind that drop, including widespread distribution of naloxone — a medication that can reverse the effects of an opioid overdose — along with increased access to treatment for substance use disorder and shifts in the illegal drug supply.

The L.A. County analysis is based on data from the Medical Examiner and is part of a yearly data report by the health department’s Substance Abuse Prevention & Control division.

By the numbers

Both the number and rate of drug overdose deaths had increased steadily beginning in 2015 and reaching a peak of 3,220 deaths in 2022. That was a rate of nearly 33 deaths per 100,000 population.

In 2023, overall drug overdose deaths declined by nearly 3%, the first reduction in a decade. But 2024’s decline was much bigger at 22%.

Drug-related overdose and poisoning deaths dropped from 3,137 deaths in 2023 to 2,438 deaths in 2024, the lowest number recorded since 2019. Last year’s rate was nearly 25 per 100,000.

Fentanyl crisis slows down

Fentanyl is a synthetic opioid 50 times more potent than heroin. While effective for treating pain when taken as prescribed, the known or unknown use of illicitly manufactured versions of the drug can lead to addiction or overdose, health officials say.

Fentanyl has been a major driver of accidental overdose deaths in L.A. County in recent years, unseating methamphetamine in 2022 as the most common drug listed as a cause of death in county records.

Last year, fentanyl was involved in 52% of all accidental overdose deaths in the County, down from 64% in 2023.

Despite the sharp decline in fentanyl overdose deaths, there were still 1,263 in L.A. County last year, representing a significant public health threat. According to health officials, many of those deaths resulted from unintentional poisonings in which people consumed pills or drugs in other forms without knowing they contained fentanyl.

Health officials say overdose and poisoning deaths cut across socioeconomic lines, but the risks were greater in poorer parts of L.A. County last year. The rate of overdose deaths from fentanyl was four times higher in neighborhoods where more than 30% of families live below the federal poverty line compared to more affluent areas with less than 10% of families living below the poverty line, according to the county report.

The new data also show fentanyl overdose death rates disproportionately affected Black Angelenos in 2024. Black residents make up about 8% of the county’s population, but accounted for 19% of fentanyl deaths last year.

Meanwhile, men in L.A. County die from fentanyl overdoses at much higher rates than women, according to the report. For every woman who dies from a fentanyl overdose, about four men die from the same cause.

Adults between ages 26 and 39 years had the highest rate of fentanyl overdose death.

The report found fentanyl overdose deaths decreased across each of the five L.A. County supervisorial districts last year.

What’s working?

County health officials said the report shows that local investments in prevention, treatment and harm reduction are saving lives.

Harm reduction is a public health approach that aims to reduce the negative consequences that accompany drug use, recognizing that some people are unwilling or unable to stop using substances.

In L.A. County, harm reduction providers distribute naloxone, drug-checking strips, clean syringes and more for free to people who use drugs, including unhoused Angelenos struggling with addiction. Those providers also connect participants with other supportive services.

Last year, the county increased investments in substance-use prevention by 260%, drug treatment by 275% and harm reduction services by 500%, according to the Public Health Department.

L.A. County has dramatically expanded its distribution of naloxone in recent years, making it more available in libraries, jails and other spaces. In 2020, county service providers handed out 48,000 doses of naloxone, known by the brand name Narcan. Last year, they distributed nearly 480,000 doses, according to an earlier county report.

The county launched an education campaign encouraging county employees and residents to carry naloxone.

Since 2019, the county’s health departments have collaborated to prevent at least 35,000 drug overdoses, according to their estimates. In addition to a million naloxone doses, those systems have delivered 3 million sterile syringes and 100,000 fentanyl test strips.

The county does street outreach and has opened a dozen new health hubs in high-need areas, including a new Skid Row Care Campus opened last month in the Skid Row-area of downtown L.A. The campus will include a dedicated harm reduction health hub focused on drug users, as well as a health center and 250 interim housing beds.

In the new report, county officials suggest more harm reduction measures are needed in order to save more lives, including “safer consumption sites” — designated spaces where people can use drugs under the supervision of trained personnel.

Los Angeles County does not fund or operate any safe consumption sites, according to officials. The approach is controversial. In 2022, Gov. Gavin Newsom vetoed a bill that would have allowed L.A. and other cities to run supervised drug injection sites.

Last month, L.A. County health departments launched a new website, ByLAforLA.org, highlighting their collective approach to the overdose crisis.