California continues to lead the nation in drug overdose deaths by a lot each year. It’s a heartbreaking statistic. The CDC reported that California recorded just over 9,000 tragic deaths in 2024. Texas was the next closest state with almost 5,000 overdose deaths.
Opioids are blamed for a large percentage of those tragic cases. According to the California Department of Public Health (CDPH), California recorded 5,462 Opioid overdose deaths in 2024. Fentanyl (a synthetic opioid) accounted for 4,770 of those deaths.
We decided to break those opioid deaths down by California counties to give a better view of where the most overdoses occur and where Substance Use Disorder (SUD) patients may be most in danger.
The Top Ten California Counties for Deadly Opioid Overdoses?
The CDPH tracks overdose deaths across the state and in each county every year. Below, we have 2024 numbers. 2025 figures are still preliminary, and 2026 numbers will be tabulated once the year ends.
Los Angeles County contributes the most tragedies according to California statistics. The county documented 1,058 opioid deaths in 2024. That was down from 2023’s 1,603 incidents.
Here’s a graphic representation of the ten California counties with the most opioid deaths in 2024.
A few key breakouts:
- Orange County came out 3rd on the list with 411 opioid deaths in 2024. That was down from 2023’s 576 deaths across the county in places like Costa Mesa and Huntington Beach.
- Riverside County was 5th on this unfortunate list with 375 deaths in 2024. That followed 580 fatal opioid overdoses the year before. Those deaths were recorded in places known for many drug rehab facilities and luxury rehabs, like those in Palm Springs.
- Sacramento County was 7th on the list with 234 fatalities in 2024. The year before, there were 331opioid deaths recorded.
Full List of Opioid Deaths in Each California County
L.A. County is always the answer to the question “which California County records the most opioid overdose deaths each year?”
But there are some counties with smaller populations but with similar levels of fatal overdoses.
This is an alphabetical list of all 58 counties in California and their sad and fatal opioid overdose cases in 2024:
We will be updating these statistics as soon as 2025 figures are finalized and when 2026 numbers are eventually released.