Overdose deaths in the United States are declining. Is California following us?

Overdose deaths nationwide seems to have fallen by as much as 13%.in accordance with latest data from the Centers for Disease Control and Prevention.

In California, the numbers show a slower decline. From May 2023 to May 2024, state overdose deaths appear to have decreased by about 9%.

However, the forecast is based on preliminary data that is still far from complete.

Local experts say it’s too early to tell what the decline means for the state and Los Angeles in particular.

As California’s most populous county, Los Angeles has highest number of deaths compared to other areas of the state for many years – a problem that disproportionately affected marginalized communities.

National statistics

Joseph Friedman, a physician and 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 determine this prematurely, but it does look like reality,” he said.

Friedman, who tracks rapid changes in the overdose crisis, said there could be several reasons for the decline in deaths.

Some researchers say fentanyl supplies are becoming less lethal. Another incentive could be a strategy known as harm reductionwhich is an approach to drug addiction prevention that aims to meet people with addiction where they are. In recent years, local governments have done more to provide free overdose reversal medications such as naloxone.

Another reason could be that the crisis is so severe that many people using fentanyl and other opioids are dying.

Why is it unclear in California?

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

That’s because county health departments may be slow to report overdose deaths to the CDC. A coroner or medical examiner may change the reported cause of death for a particular person after additional information becomes available. And because data for local municipalities is relatively small, using these numbers to identify trends can be difficult.

State tallies may provide a clearer picture of the drug crisis. But Friedman said the CDC’s early data may reflect an undercount or that deaths may have risen in the months after May. It will likely be months until 2025 before we know a more complete picture.

“We are the state with the most overdoses,” he said. “In fact, I would argue that the single most important place to solve the overdose crisis is California. We are the overdose capital of the world.”

Friedman added that there had been other declines in previous years, but then the death rate rose exponentially.

California’s racial disparity in overdoses

What we know is that change doesn’t happen the same way for everyone.

The latest data for 2023 shows the overdose death rate among Black and Native American people in California is about twice that of white people.

Blacks accounted for about 13% of fatal overdoses in California last year and make up about 5% of the state’s population, according to the total. public health And census data.

In Los Angeles County, the rate is even starker: about 19% of deaths, compared with 8% of the local population. This gap also widens in district fentanyl-related deaths.

The death rate among Latinos is lower than other groups, but Friedman said it is rising rapidly among young Latinos, which is a concern.

“This is consistent with the national picture where, although historically Latino communities have been really isolated from the worst effects of the opioid crisis,” he said, “that is really starting to change.”

Los Angeles County is a prime example.

Ricky Bluthenthal, a sociologist at the Keck School of Medicine at the University of Southern California, has been conducting research among people who use drugs in Los Angeles since 2000.

He and other experts generally agree that the overdose crisis is being portrayed as a white problem. At one point in Bluthenthal’s career, he was one of the few African Americans to head syringe program in the country. These programs help eliminate and provide access to sterile materials for safer substance use.

Such harm reduction strategies often target white populations more than nonwhite populations.

“The first places to adopt harm reduction measures were driven more by community politics than by necessity,” he said. “So even in Los Angeles, the first needle exchange program was not in Skid Row. It was in West Hollywood.”

The differences are not just about race. In Bluthenthal’s first study, conducted several years ago in Los Angeles, between a third and half of the participants were homeless. But according to his recent research, the homeless rate is now around 80%.

Drug overdose is the leading cause of death among homeless people, with a risk factor 38 times higher than that of the county’s general population. In 2020 and 2021, overdoses accounted for approximately two deaths a day.

Bluthenthal said there are active efforts to reduce drug exposure, such as syringe service programs and distribution of naloxone. But things get more complicated when people live on the streets.

“People are throwing away their stuff, including HIV medications, hepatitis C medications, naloxone to treat overdoses,” he said. “All of these things reduce people’s ability to take care of themselves. And this behavior falls disproportionately on people of color.”