US overdose deaths are dropping. Is California following?

Overdose deaths around the nation appear to have dropped as much as 13%, according to recent data from the Centers for Disease Control and Prevention.

In California, the numbers reveal a slower drop. From May 2023 to May 2024, state overdose deaths seem to have decreased by around 9%.

However, the projection is based on preliminary data that’s far from finalized.

Local experts say it’s too early to tell what the drop means for the state and more specifically for Los Angeles.

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As California’s most populated county, L.A. has had the highest number of deaths compared to other areas in the state for years — an issue that’s disproportionately affected marginalized communities.

The national stats

Joseph Friedman, a physician and a substance use researcher at the University of California San Diego, said the national news is encouraging.

“Obviously, we don’t want to jump to conclusions and kind of determine that prematurely, but it really does appear to be a real thing,” he said.

Friedman, who tracks rapid shifts in the overdose crisis, said there may be several reasons for the reduction in deaths.

Some researchers say the fentanyl supply is getting less deadly. Another impetus could be the strategy known as harm reduction, which is a drug prevention approach that aims to meet people with addiction where they’re at. In recent years, local governments have done more to provide free overdose reversal agents like naloxone.

Still another cause may be simply that the crisis is so severe that many people who use fentanyl and other opioids are dying off.

Why it’s not clear in California

It’s hard to know right now if the apparent decline in overdose deaths in California will continue to show up in the numbers.

That’s because county health departments can be slow to report overdose deaths to the CDC. A coroner or medical examiner might change the reported cause of death for a particular person after more information becomes available. And because the counts from local municipalities are relatively small, it can be challenging to use those numbers to identify trends.

State counts can give a clearer picture of the drug crisis. But Friedman said the CDC’s early data could reflect an undercount, or that deaths could have picked up in the months after May. It will likely be months into 2025 until we know a fuller picture.

“We’re the state with the single highest number of overdoses,” he said. “Really, the single most important place to kind of tackle the overdose crisis, I would argue, is California. We’re the overdose capital of the world.”

There were other declines in previous years, Friedman added, but then deaths went up exponentially.

California’s racial inequalities in overdoses

What we do know is that change is not occurring equally for everyone.

The latest data from 2023 shows the overdose death rate among Black and Native Americans in California is about twice as high as those among white people.

In total numbers, Black people accounted for about 13% of the fatal overdoses in California last year, while making up about 5% of the state’s population, according to public health and census data.

In L.A. County, that’s starker at roughly 19% of deaths compared to making up 8% of the local population. That gap also widens in the county for fentanyl-related deaths.

The death rate among Hispanics is lower than other groups, but Friedman said it’s rising quickly among young Hispanics, which is concerning.

“This is consistent with the national picture where even though historically Hispanic communities have been really insulated from the worst of the opioid crisis,” he said, “that’s really starting to change.”

L.A. County is a prime case study

Ricky Bluthenthal, a sociologist at USC’s Keck School of Medicine, has been doing community-based research with people who use drugs in L.A. since 2000.

He and other experts generally agree the overdose crisis gets portrayed as a white problem. At one point in Bluthenthal’s career, he was one of a handful of African Americans leading a syringe program in the country. These programs help dispose of and provide access to sterile supplies for safer substance use.

Harm reduction strategies like this have also often targeted white populations better than communities of color.

“The early places where harm reduction was adopted was driven more by the politics of the local communities than the need,” he said. “So even in L.A., the first syringe program wasn’t in Skid Row. It was in West Hollywood.”

A dose of naloxone.

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Irfan Khan

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Los Angeles Times via Getty Images

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Disparities cross more than race, too. In Bluthenthal’s first study in L.A. from years ago, a third to half of the people in it were unhoused. But in his recent studies, people experiencing homelessness now make up closer to 80%.

Drug overdose has been the leading cause of death among people experiencing homelessness, at a risk factor 38 times more than the general county population. In 2020 and 2021, overdose accounted for about two deaths per day.

Bluthenthal said there’s been robust efforts to reduce the impacts of drugs, like syringe service programs and naloxone distribution. But it gets complicated when people live on the street.

“People have their stuff thrown away and that stuff includes medications for HIV, for Hepatitis C, naloxone for overdose reversal treatment,” he said. “All of these things diminish people’s capacity to take care of themselves. And those behaviors fall more heavily on people of color.”