Majority of Los Angeles Overdose Deaths Caused by Fentanyl

Fentanyl caused a majority of fatal overdoses in Los Angeles County for the first time last year, with nearly 60% of the area’s overdose deaths attributed to the increasingly popular opioid. Fentanyl replaced methamphetamine as the county’s most common drug cited as the cause of accidental drug or alcohol overdose deaths, according to a new report from the L.A. County Department of Public Health.

“It’s absolutely heartbreaking,” Amanda Cowan, executive director of Community Health Project Los Angeles, told the Los Angeles Times, adding, “These communities are just being decimated.”

In 2022, Los Angeles County reported 3,220 accidental overdoses. Of those, more than 1,900 deaths were caused at least in part by fentanyl, according to county data. Under the county’s reporting protocols, more than one drug may be listed as the cause of an overdose death.

L.A.’s spike in overdose deaths caused by fentanyl comes at a time of record overall overdose deaths nationwide. In 2021, 107,573 people died of an overdose in the United States, according to data from the Centers for Disease Control and Prevention. The number dropped slightly last year, falling to 105,452 in 2022, a decrease of 2%

“We’re still amid the worst overdose crisis in history, and that’s obviously an emergency situation,” said Dr. Gary Tsai, director of Los Angeles County’s Substance Abuse Prevention and Control program. “We’re doing a lot of work to improve our system, but there’s obviously still a lot of work that we have to do.”

In its report, the County of Los Angeles Department of Public Health noted that fentanyl has permeated the supply of illicit street drugs, endangering the lives of casual drug users and those with substance misuse disorders alike. Illicitly manufactured fentanyl (IMF) “is cheap and easy to make quickly and in large quantities. It has been found in nearly all forms of illegal street drugs and counterfeit pills, as drug traffickers intentionally add fentanyl to their drugs to reduce costs, to enhance the effect of an existing drug, and/or to make their drugs more addictive,” the health department wrote in the report. 

“Fentanyl can also be a contaminant when handling multiple drugs with the same equipment or in unclean environments,” the report continues. “Thus, drugs containing IMF have variable and high potency, and can be more dangerous than often perceived, especially for youth who may experiment with drugs or pills.”

The county data showed a sharp disparity in the number of fentanyl overdose deaths. The largest number of fatal fentanyl overdoses were among white people and in more affluent areas of the county. But when adjusted for population, Black people and those living in high-poverty areas died of a fatal fentanyl overdose at significantly higher rates. 

“In the case of race/ethnicity, Black people account for 8% of the [county] population, and disproportionately accounted for 21% of fentanyl overdose deaths in 2022,” the report said.

Ricky Bluthenthal, a professor of population and public health sciences at the University of Southern California’s Keck School of Medicine, said that the racial disparities in fentanyl overdose deaths are concerning, noting they have gotten worse in recent years. But he added that the problem is a national one that illustrates the need to target resources such as the lifesaving drug naloxone, a nasal spray that can reverse an opioid overdose.

“It speaks to a national challenge that we have in the United States, related to making sure that both medication for opiate use disorder and naloxone is readily available for people who live in predominantly African American and Latino neighborhoods,” Bluthenthal said.

Through his research, Bluthenthal has determined that L.A.’s supply of heroin has mostly been replaced by fentanyl, which is about 50 times more potent. 

“We are facing this really dramatic change in the illicit drug supply; looking at the figure over time, it sort of makes you want to cry,” Bluthenthal said.

The more than 1,900 overdose deaths caused by fentanyl represent a jump of nearly 1,700% in the number of fatal overdoses caused by the drug in just six years.

“This transition is wreaking havoc on people,” he added.

Tsai said that the report included some positive data points. Overdose deaths among children fell for the first time in two years. Additionally, the rate of increase in the number of fentanyl deaths dropped significantly, possibly indicating that the number of deaths may be beginning to level off. But health officials warn the community must remain vigilant to the dangers of the illicit drug supply.

“On the fentanyl front, we might be slowing down, just looking at the numbers, but there’s still so many things that can happen between now and when we get the 2023 data,” said Tsai. “All it takes is another more potent substance to come into the drug supply for that number to then shoot up.”

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