Key Findings
- Over 34,000 Californians died from fentanyl from 2019 through 2025 according to data from the California Department of Public Health. 2025 data is preliminary.
- 33,537 of the deaths are tied to a specific county, while 468 of them have no county listed.
- Los Angeles County had over 4,000 more fentanyl deaths than the county with the second most deaths (San Diego County).
WHAT IS FENTANYL?
According to the California Department of Public Health, fentanyl is a synthetic opioid that's up to 50 times stronger than heroin, while also 100 times stronger than morphine. CDPH says it can be sold alone or it can be added to other drugs like heroin, methamphetamine, cocaine, pills, etc. CDPH says adding fentanyl to those drugs can make them cheaper and more powerful.
In 2022, CDPH says 59% of drug-related overdose deaths in California included fentanyl.
The Most Deaths From 2019-2025 by County
- Los Angeles: 7,640
- San Diego: 3,163
- Orange: 2,877
- Riverside: 2,444
- San Francisco: 2,436
- San Bernardino: 1,873
- Kern: 1,265
- Alameda: 1,193
- Sacramento: 1,133
- Ventura: 869
Los Angeles County alone accounts for around 23% of fentanyl deaths where a county is listed. The top 10 counties account for roughly 74% of fentanyl deaths. Riverside County is only slightly ahead of San Francisco County, leading by only eight deaths. Ventura County is the only county in the top 10 with less than 1,000 deaths.
Most Fentanyl Deaths in 2025 by County (Preliminary)
- Los Angeles: 878
- San Francisco: 339
- San Diego: 336
- Orange: 269
- Riverside: 263
- San Bernardino: 228
- Sacramento: 201
- Alameda: 185
- Kern: 133
- Ventura: 115
County With Highest Fentanyl Death Rate by Year
Rates are age-adjusted per 100,000 residents. Only counties that CDPH rates as stable are included. 2025 data is preliminary.
- 2019: San Francisco (19.1)
- 2020: San Francisco (38.1)
- 2021: Mendocino (49.1)
- 2022: Humboldt (56.8)
- 2023: San Francisco (50.9)
- 2024: Tuolumne (44.1)
- 2025: Lake (40.9)
Highest Fentanyl Death Rate in 2025 (Preliminary)
Only counties that CDPH rates as stable are included.
- Lake (40.9)
- Humboldt (40.0)
- Del Norte (39.9)
- San Francisco (33.7)
- Siskiyou (28.6)
- Butte (24.8)
- Shasta (24.2)
- Lassen (22.5)
- Sutter (20.6)
- Santa Cruz (17.1)
San Francisco made the top 10 for death rate every year from 2019 to 2025, and ranked No. 1 in 2019, 2020 and 2023. Humboldt made the top 10 for death rate every year from 2021 to 2025. 33 of 58 counties had their highest death count in 2023. This includes seven where 2023 tied with another year.
STATE TRENDS
There was a statewide drop in deaths in 2024. Los Angeles County fell from 1,497 in 2023 to 958 in 2024. That's a drop of 539 deaths, the largest drop in the state. Meanwhile, several other counties showed a relatively large drop that year too. Riverside County showed a drop of 209. San Diego County was down by 205 deaths. Orange and San Bernardino Counties also showed drops as well, with Orange falling by 161 and San Bernardino falling by 145.
However, seven California counties went against the 2024 statewide drop. The largest increases came from Monterey County and Tuolumne County. Monterey increased from 48 deaths to 61 deaths. Tuolumne County rose from 11 to 18.
Multiple counties showed increases from 2024 to 2025 according to preliminary data. The biggest of those increases were Humboldt, Ventura, and Lake. Humboldt rose by 14 deaths while Ventura rose by 9. Lake rose by 7.
HOW WE BUILT THIS MAP
We created this map using data from the California Department of Public Health's California Overdose Surveillance Dashboard. We filtered our search by specifically fentanyl-related overdose deaths by county for all ages from 2019 through 2025. Rates are age-adjusted per 100,000 residents.
2025 data is preliminary and could possibly change in the future.
468 of the deaths on CDPH's site don't have a county listed. Those deaths are not included on this map, but also shouldn't be ignored when thinking of the larger impact of fentanyl in California.
Additionally, only stable rates are ranked. CDPH flagged certain counties across different years as having rates that are unstable. As a result, we decided to deem those counties unrankable. For example, Alpine County's rate in 2024 was 454.75, but that rate is based on five deaths. CDPH flagged that rate as unstable.
Counties that are on one list may not be on another list. Tuolumne County is an example of this. Tuolumne ranked No. 1 in 2024 for its death rate, but it's flagged as unstable in 2025 preliminary data with five deaths. For that reason, Tuolumne isn't on the 2025 list.
Safety Tips
CDPH says they're continuing to increase fentanyl awareness to reduce stigma and protect Californians.
Their safety tips include:
- Carry naloxone with you to reverse opioid overdoses
- Know what's in your drugs by utilizing tools like fentanyl test strips, which test drugs for fentanyl presence
- Use sterile syringes if you're injecting drugs
- Use excessive caution if you decide to mix drugs
- Never use drugs alone
- Know how to recognize and respond to an overdose
- Find treatment and support
- Store medications and drugs in a lock box out of reach of children
If you or a loved one need help, you can call the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline by dialing 1-800-662-HELP (4357).
TAKING ACTION AFTER A DRUG-RELATED TRAGEDY
When loved ones are allowed to harm themselves or overdose while under the care of a rehab facility, they should not be blamed.
Find out how a lawyer can help.
Sources for this article include the California Department of Public Health (CDPH) and the Substance Abuse and Mental Health Services Administration (SAMHSA).