San Diego County sees progress in overdose prevention, but challenges remain

By Seraphina Eberhardt

Photo:  District Attorney Summer Stephan, standing with other county officials, speaks at a press conference recognizing International Overdose Awareness Day.  Photo courtesy of Marla Kincade, Substance Abuse and Overdose Taskforce

October 19, 2025 (San Diego) -- San Diego County is seeing progress in the efforts to reduce substance use and overdose, according to the 2025 Annual Report Card released by the Substance Use and Overdose Prevention Taskforce (SUOPT). The report shows that overdose deaths dropped for the second year in a row, falling from 1,203 deaths in 2023 to 945 in 2024, a decrease of 21%.

While this trend is positive, experts stress that overdose deaths are still double what they were in 2015. Serious gaps also remain among different communities, racial and ethnic groups, and people experiencing homelessness.

Overdose Mortality

Fentanyl is still the main cause of overdose deaths, but its role fell from 63% in 2023 to 52% in 2024. Methamphetamine was also a major factor, present in 63% of overdose deaths last year.

For the first time in years, no children or teens under 18 died from an overdose in 2024. In a statement provided by her office, San Diego County District Attorney Summer Stephan called this milestone an important sign of hope. "I am encouraged by the data that shows a reduction in overdose deaths from fentanyl and methamphetamine,” Stephan said. “The fact that we had zero overdose deaths of children and teens under 18 is a statistic that gives us hope and lets us know we are on the right track to save lives.”

Photo, right:  "Drugs" by Brandon Giesbrecht is licensed under CC BY 2.0.

DA Stephan emphasized that the effort to reduce overdose numbers continues, “While I am grateful for this trend, we cannot take our focus off this problem until there are no more overdose deaths.” Stephan said. “We will continue to be laser focused on fighting to save lives from overdoses by prosecuting drug dealers and cartels that produce increasingly toxic drugs every year, and by expanding treatment for those suffering from addiction and increasing education and awareness in our schools and community.”

The report also points to regional differences. The Mountain Empire area, Lemon Grove, Palomar-Julian, Pauma, and Central San Diego all had overdose death rates much higher than the county average.

Demographic differences are clear as well. Black/African American residents had the highest death rate at 68.6 per 100,000, compared to the county average of 27.8. Men were three times more likely than women to die from an overdose. People experiencing homelessness remain at extreme risk, making up nearly 30% of overdose deaths. For this group, methamphetamine was more common than fentanyl.

Emergency Department Trends

Photo, left:  Sarah Stierch (CC BY 4.0)

Emergency department (ED) visits related to overdose peaked in 2021 and have gone down since then. Still, some troubling signs remain. Between 2019 and 2021, opioid-related ED visits for youth under 18 rose 81% before beginning to decline.

Racial differences also show up in ED data. From 2019 to 2023, overdose-related visits rose 167% for Black residents, compared to 67% for Latinos and 46% for whites.

Prescribing Patterns

The report also tracked prescribing trends. Opioid prescribing has steadily gone down, from 20.6 pills per resident in 2020 to 18.9 in 2024. Benzodiazepine prescriptions during the same 2020–2024 time period remained stable. Stimulant prescriptions spiked in 2023 due to reporting changes but leveled off in 2024.

Public Safety Data

Law enforcement data shows changes in drug supply and prosecution. Federal charges for methamphetamine dropped by more than 60% from 2020 to 2024. Prosecutions for fentanyl rose quickly through 2022, then went down in 2023 and 2024.

Among youth arrestees in 2024, more reported buying or stealing pills rather than being given them, showing changing access and rising demand.

Collaborative Solutions

SUOPT, coordinated by the Center for Community Research, brings together healthcare providers, schools, law enforcement, government agencies, nonprofits, and residents. It operates through quarterly meetings and subcommittees focused on topics like healthcare, safe disposal, overdose prevention, substance misuse education, and harm reduction. This emphasizes that collective efforts are essential to tackle the complex impact that methamphetamine and opioids, especially fentanyl, are having on our communities.

Marla Kingkade, facilitator of SUOPT, pointed out that the report card shows the power of working together. “The SUOPT Report Card highlights key data and trends from across our community with the shared goal of preventing overdoses,” Kingkade said. “This collaboration demonstrates how, together, we can provide prevention, resources, and hope for a healthier San Diego County.”

Looking Ahead

The reduction in overdose deaths shows that prevention, education, and treatment efforts are having an effect. However, the high numbers and differences across race, geography, and housing status mean the crisis is not over.

The 2025 report shows both progress and the urgent work still ahead for San Diego County.

Resources for San Diegans

The Institute for Public Strategies (IPS) is working to keep our community safe by providing free, lifesaving tools. We offer Naloxone, a medicine that can quickly reverse an opioid overdose, as well as fentanyl and xylazine test strips, which help people check for dangerous substances before use. By making these resources available at no cost, IPS empowers individuals to act, prevent overdoses, and protect the health of our neighborhoods.

In addition, IPS provides informational presentations and hands-on training to help people recognize the signs of an overdose and respond effectively.

If you, your organization, or your loved ones would like free Naloxone or fentanyl and xylazine test strips or training on how to save a life, please reach out. Contact Paola Rochin Bochm at prochinbochm@publicstrategies.org or 619-476-9100 x141.

The County of San Diego makes Naloxone widely available at many locations and through public vending machines across San Diego County. You can visit the County’s Naloxone information page here.

You can also call 2-1-1 to find out where Naloxone is available near you.

If you are unable to access these distribution points, the BHS Harm Reduction Team may offer delivery options, subject to availability. Please email harmreduction.hhsa@sdcounty.ca.gov.

If you or someone you know is dealing with substance use, emotional distress, or needs someone to talk to, call or text 988 to connect with the San Diego Access & Crisis Line. It’s available 24/7 with free, confidential support in over 150 languages. You can also contact the Access & Crisis Line at (888) 724-7240.

IPS works alongside communities to build power, challenge systems of inequity, protect health, and improve quality of life. IPS has a vision for safe, secure, vibrant, and healthy communities where everyone can thrive. To learn more about IPS East County, follow us on our social media platforms: IPS East County Facebook, IPS East County X, and East County Youth Coalition Instagram. Our website is at IPSEast.org.

Seraphina Eberhardt (right) is the Director of Prevention Programs for San Diego County at the Institute for Public Strategies.