Overdose Deaths

Drug Overdose Deaths

The number of drug overdose deaths has more than tripled since 1999 in the US. 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 Rx 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, and were particularly steep in the last couple of years (Figure 1). (Note: For local opioid- and fentanyl-related death data from the Coroner's Office, please see Figures 4-6)

In the US, opioid overdose deaths increased 47% and 38% in 2020 (n=68,630) compared to the deaths in 2018 (n=46,802) and 2019 (n=49,860), while in LAC, opioid overdose deaths increased each year from 2015 to 2020. Compared to 2020, opioid overdose deaths increased by 162% from 2018 (n=512) and by 88% from 2019 (n=715) in LAC. (Figure 1

Figure 1. Number of drug overdose, opioid overdose, motor vehicle, and firearms deaths, US and LAC, 1999-2020
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 with a slight lag. In LAC, the number of synthetic opioid deaths sharply increased from 2015-2020, driving the increase in opioid deaths (Figures 2-3).

Figure 2. Number of opioid overdose deaths by opioid type, 1999-2020
Source: CDC Wonder

United States

California

Los Angeles County

Figure 3. Rate of opioid overdose deaths per 100,000 population by opioid type, 1999-2020
Source: CDC Wonder

United States

California

Los Angeles County

(Note: Deaths for synthetic opioids exclude methadone. The number of synthetic opioid deaths were <5 for 2001 and 2007 in LAC, and were replaced with a 0 in the chart. Rate estimates were not shown for LAC before 2014 due to small numbers.)

LAC Coroner's Data

According to LAC Coroner’s data, Rx opioid deaths were relatively stable from 2010-2015, then began increasing in 2016. By 2021, there were 1,719 opioid-related deaths, a 10.9% increase from the previous year (Figure 4).

Figure 4. Opioid (including heroin) overdose deaths, LAC, 2010-2021
Source: LAC Coroner

Figure 5. Opioid overdose death by SPA, LAC, 2015-2020
Source: LAC Coroner


According to LAC Coroner's data, opioid overdose deaths were highest in Metro (SPA 4) region, and lowest in the San Gabriel (SPA 3) and Antelope Valley (SPA 1) regions (Figure 5).

Notes: 

1 Dot = 1 death

Blue dots = Prescription Opioid overdoses

Green dots = Fentanyl Overdoses

Red dots = Heroin Overdoses

The number of fentanyl overdose deaths in LAC has been increasing every year since routine testing of fentanyl began in May 2016. 

In 2021, fentanyl-related overdose deaths increased to 1,504, a 1,280% jump from 2016, and a 31% increase from the previous year (Figure 6).

 In 2021, deaths for all opioid overdose deaths increased to 1,719, compared to 1,526 deaths for methamphetamine overdose deaths.    

Figure 6. Fentanyl, methamphetamine, and all opioids overdose deaths, LAC, 2010-2021
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 1999-2020 on CDC WONDER Online Database, released 2021. Data are from the Multiple Cause of Death Files, 1999-2020, 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 Mar 16, 2022.

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