Overdose Deaths

Drug Overdose Deaths

The number of drug overdose deaths has more than tripled since 1999 in the U.S. Drug overdose is now the leading cause of injury deaths, surpassing the number of deaths by both motor vehicle crashes and firearms starting from about 2009. It’s widely recognized that Rx drugs, particularly prescription opioids, are driving the national drug overdose epidemic with consistent increases in Rx opioid and heroin overdose deaths. 

Increases in drug overdose deaths in LAC were observed starting in 2015 (Figure 1). While nationwide drug overdoses decreased from 2017 to 2018, drug overdoses continued to increase from 2017 to 2018 in LAC. (Note: For local opioid- and fentanyl-related death data from the Coroner's Office, please see Figures 4-6).

Figure 1. Number of drug overdose, motor vehicle, and firearms deaths, US and LAC, 1999-2018
Source: CDC Wonder

(Note: Opioids include natural/semi-synthetic opioids, synthetic opioids (excluding methadone), heroin, methadone, opium, and other/unspecified narcotics.)

3 Waves of the Opioid Epidemic

In the US, the rise in opioid overdose deaths can be outlined in three distinct waves (Figures 2-3):
1. Increased prescribing of opioids in the 1990s, with overdose deaths involving Rx opioids (natural and semi-synthetic opioids and methadone) increasing since at least 1999.
2. Rapid increases in overdose deaths involving heroin beginning in 2010.
3. Increases beginning in 2013 in overdose deaths involving synthetic opioids, particularly illicitly-manufactured fentanyl (IMF) which can be found in combination with heroin, counterfeit pills, and cocaine.

California followed a similar pattern as the overall US. In LAC,  the number of synthetic opioid deaths  sharply increased  from 2015-2018, driving the increase in opioid deaths (Figures 2-3).

Figure 2. Number of opioid overdose deaths per 100,000 population by opioid type, 1999-2018
Source: CDC Wonder

United States

California

Los Angeles County

Figure 3. Rate of opioid overdose deaths per 100,000 population by opioid type, 1999-2018
Source: CDC Wonder

United States

California

Los Angeles County

(Note: Deaths for synthetic opioids exclude methadone.)

LAC Coroner's Data

According to LAC Coroner's data, there were about 500 opioid-related deaths in recent years, with 587 in 2018 (Figure 4). 

Rates of opioid overdose death were highest in the Antelope Valley (SPA 1) and Metro (SPA 4) regions, and lowest in the San Gabriel (SPA 3) region (Figure 5). 

Figure 4. Opioid (including heroin) overdose deaths, LAC, 2011-2018
Source: LAC Coroner

Figure 5. Opioid (including heroin) overdose death rate per 100,000 by SPA, LAC, 2018
Source: LAC Coroner

In 2018, there were 260 fentanyl-related deaths (Figure 6). 

Figure 6. Fentanyl overdose deaths, LAC, 2014-2018
Source: LAC Coroner

(Note: The Medical Examiner/Coroner's Office began routine testing of fentanyl in May 2016).

References

Figures 1-3. Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2018 on CDC WONDER Online Database, released February, 2020. Data are from the Multiple Cause of Death Files, 1999-2018, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10.html on Feb 21, 2020 4:36:05 PM.

Figures 4-6
. Los Angeles County Department of Medical Examine-Coroner. Los Angeles County Coroner Data.