The number of overdose deaths in the United States is decreasing. Will California follow suit?

Overdose deaths occur across the country Looks like it's down 13%according to recent data From the Centers for Disease Control and Prevention.

In California, numbers show that the decline is slow. From May 2023 to May 2024, the state's overdose deaths appear to have decreased by about 9%.

However, this prediction is based on preliminary data that is far from final.

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

LA is the most populous county in California. highest number of deaths For years, compared to other parts of the state, disproportionately affected marginalized communities.

country statistics

Joseph Friedman, a physician and drug use researcher at the University of California, San Diego, said the national news is encouraging.

“Obviously we're not going to jump to conclusions and we're not going to judge prematurely, but it seems like a really real thing,” he said.

Friedman, who has been tracking the rapid evolution of the overdose crisis, said there could be several reasons for the decline in deaths.

Some researchers say the supply of fentanyl makes it less lethal. Another driver may be a strategy known as . harm reductionThis is a drug prevention approach that aims to meet people with addiction where they are. In recent years, local governments have stepped up efforts to provide free drugs to reverse overdoses, such as naloxone.

Yet another reason may simply be that the crisis is so severe that many people who use fentanyl and other opioids are dying.

Why is it not clear in California?

It's difficult to know right now whether the numbers will continue to show a clear decline in overdose deaths in California.

This could cause delays in county health departments reporting overdose deaths to the CDC. A medical examiner or medical examiner may change a particular person's reported cause of death after more information becomes available. Also, the numbers collected from local governments are relatively small, so it can be difficult to identify trends using those numbers.

State counts provide a clearer picture of the drug crisis. But Friedman said the CDC's early data may reflect an undercount or that the number of deaths may have increased in the months since May. It could be several months until 2025 before we see a fuller picture.

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

Friedman added that while there were other declines in the previous year, the number of deaths has increased exponentially since then.

California's racial disparities in overdose

What we do know is that change is not happening equally to everyone.

The most recent data from 2023 shows that Black and Native American people in California are nearly twice as likely to die from an overdose as white people.

Statistics show that black people accounted for about 13% of overdose deaths in California last year and made up about 5% of the state's population. public health and census data.

In Los Angeles County, the proportion is even worse, at about 19% of deaths, compared to 8% of the local population. The difference is even wider county In cases of fentanyl-related deaths.

Although the death rate for Hispanics is lower than other groups, Friedman said the rate is rising rapidly among young Hispanics, which is concerning.

“This is consistent with the situation in this country, where historically the Hispanic community has been really insulated from the worst of the opioid crisis, and that's really starting to change,” he said.

Los Angeles County is a key case study

Ricky Brusenthal, a sociologist at the Keck School of Medicine at the University of Southern California, has conducted community-based research on people who use drugs in LA since 2000.

He and other experts generally agree that the overdose crisis is being portrayed as a white problem. At one point in Brusenthal's career, he was one of the few African Americans to lead the organization. syringe program In the country. These programs help dispose of and provide access to sterile supplies for safer use of materials.

Such harm reduction strategies often better target white populations than communities of color.

“In the early regions where harm reduction was introduced, it was driven more by local community politics than by necessity,” he says. “So even in Los Angeles, the first syringe program wasn't in Skid Row. It was in West Hollywood.”

Naloxone dose.

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Los Angeles Times (via Getty Images)

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Disparities are not just racial. In Brusenthal's original study in Los Angeles many years ago, one-third to half of the residents were homeless. However, his recent research shows that nearly 80% of people are currently experiencing homelessness.

Drug overdose is the leading cause of death among people experiencing homelessness, with risk factors 38 times higher than in the county's general population. Overdoses in 2020 and 2021 will be approx. 2 deaths in 1 day.

Brusenthal said strong efforts have been made to reduce the impact of drugs, including syringe service programs and naloxone distribution. But things get even more complicated when people are living on the streets.

“People are having their belongings thrown away, including drugs to treat HIV and hepatitis C, and naloxone to reverse an overdose,” he said. “All of these things reduce people's ability to manage themselves, and these behaviors impact people of color even more visibly.”