LA County increased access to an opioid antidote 500% in 3 years. Is that why overdose deaths leveled off?

People in Los Angeles County now have access to naloxone — the medication that can reduce the effects of an opioid overdose — in more places than ever before, including schools, churches, libraries and jails.

And that may be a key reason why the number of drug overdose deaths in the county plateaued last year, after more than eight years of alarming year-over-year increases, county officials said.

It’s part of the Department of Public Health’s local harm-reduction strategy — an approach that’s gaining traction across the country. It aims to decrease the negative consequences of recreational drug use by reducing stigma and equipping people with life-saving tools and information.

In short, it’s an attempt to meet people where they are.

This week, the county announced a 4% decrease last year in the number of fatalities from drug overdoses or poisoning compared to the previous year. Those numbers were: 3,092 deaths in 2023; down from 3,220 in 2022, according to data from the Medical Examiner’s Office.

The county Department of Public Health called it a “step in the right direction after meteoric rises amid the worst overdose crisis in both local and national history.”

“Harm reduction engages those who are at the highest risk of overdose,” said Dr. Gary Tsai, the department’s director of the Substance Abuse Prevention and Control Division. “We do think that’s one of the areas that most contributed to the plateau.”

He said there has been increased attention on the overdose deaths of young people in recent years, spurring organization leaders that had not been interested in carrying naloxone to change their minds.

More Narcan throughout L.A. County

Over the past three years, the county increased funding for harm reduction strategies by 500%, the report noted. Tsai said that the county could be seeing the benefits of that now, and admitted it’s an area the department “could have invested more heavily in the past.”

The department partnered with libraries, faith-based groups, schools, universities, housing developments and homeless shelters to provide the naloxone.

The Overdose Education and Naloxone Distribution program has videos available in English and Spanish for training, and offers in-person training for its partners.

The California Department of Health Care Services’ Naloxone Distribution Project has been particularly helpful, Tsai said. Organizations that meet the qualifications can apply to get free naloxone and fentanyl test trips.

Because of the combined efforts of the state, county and local nonprofits, many people are more mindful of the deadly effects of opioids, like fentanyl, as well as how to prevent overdose, Tsai said.

“They know what Narcan even is, which is huge,” he added.

But researchers warn against claiming victory too soon.

Joseph Friedman, a substance-use researcher at UCLA and UC San Diego, said the data might reflect that “people are getting smarter about fentanyl,” but it’s too soon to tell if the decline in deaths will continue.

“Hopefully, we’re really going to plateau for a while and then ideally go downward,” he said.

Fentanyl is still a problem

Data show that fentanyl, a synthetic opioid that's 50 times more potent than heroin and 100 times more potent than morphine, is the most common drug type listed as the cause of death in accidental overdose cases in L.A. County, according to the report. Methamphetamine is also common.

Adults between the ages of 26 and 64 continue to represent the highest overdose and poisoning deaths in the county, but death rates from fentanyl dropped for young adults ages 18 to 25 for the second year in a row, according to the report.

Other key findings for 2023 include:

• The rate of fentanyl-related deaths per 100,000 population increased for Black residents (53.3) to more than twice the rate of fentanyl-related deaths of white Angelenos (25.8).
• For the first time, the number of Latinos residents who died from fentanyl overdose (753) in 2023 was higher than the number of white residents (697) who died as a result of fentanyl.
• The rate of fentanyl deaths per 100,000 in the least affluent areas of L.A. County, was more than triple that of the most affluent areas. (59.6 vs. 16.5).

The county Department of Public Health is increasing efforts to push harm reduction and prevention strategies specifically for Black and Latino residents who have been disproportionately affected by the drug overdose crisis, Tsai said. Efforts include looking for further opportunities to offer naloxone in the settings where they are more likely to have “meaningful connections,” he said, like church or other faith-based institutions, community centers and treatment providers.

Tsai said the department is also trying to target media campaigns in heavily Black and Latino areas of L.A. County, and has expanded its work with social media influencers who can speak directly to these communities.

Fewer deaths last year compared to the year before is encouraging, Tsai said, but there’s still much more to be done. The overall numbers are still far above the numbers in 2019, when fentanyl-related deaths began surging.

“We have a lot more work to do,” Tsaid said.

You can get free naloxone doses at libraries

The L.A. County Library has officially extended its weekly naloxone clinics until the fall. More than 4,500 doses of the opioid overdose treatment have been distributed to over 1,800 people since the first five locations launched last October.

Skye Patrick, director of the L.A. County Library System, said in a statement that extending the clinics demonstrates the library's commitment to tackling the opioid crisis.

“We believe in empowering our communities through access to vital resources,” she said in a statement.

How to spot an overdose

LAist reporter Makenna Sievertson contributed to this article.