Nationally, in California and in Los Angeles we have seen a much-needed decline in fatal overdoses over the past year. While this downward trend deserves to be acknowledged as lifesaving progress in the battle against the escalation of illicit Fentanyl use, and is a bittersweet relief to those who have tragically lost loved ones in the past, it has been underreported that the needle of non-fatal overdoses hasn’t really budged, and it matters – a lot.
Additionally, with the vital increase in the availability of lifesaving medications like naloxone to reverse the effects of an overdose, many overdoses go unreported and are now self-administered. While this has contributed to the reduction in fatal overdoses, it reduces the effectiveness of being able to count non-fatal overdoses which could mean there has actually been an increase in the last year according to the National Institute of Health and the CDC states that in 2025 suspected non-fatal overdoses that came to emergency rooms has slightly increased.
So, why does the flat or slight increased rates of non-fatal overdoses matter if fatal overdoses are declining:
- Traumatic brain injury and other types of brain injury are becoming more prevalent for those that survive drug overdoses and it is harder to initially detect in emergency department visits, according to research cited in Psychology Today.
- Non-fatal overdoses aren’t harmless – they are predictive in that research shows that survival increases the risk of a future fatal event in the next week.
- Surviving opioid related overdoses is the beginning of a path to long-term recovery, but without consistent behavior change and recovery support over a period of years, sustainable recovery is tenuous and return to illicit drug use and additional risk of overdose is likely according to Public Health Nursing research published in 2024.
- According to recent research by the CDC and NIH overdoses are becoming more severe more often due to the mixing of other drugs like Xylazine and Medetomidine with Fentanyl where Naloxone is less effective or not effective in reviving people from overdose and causes other issues like open sores and comatose like states where people are just slumped over for hours.
Repurposing tragedy into transformation with the following approaches could go a long way towards better providing solutions:
- Expand post‑overdose pathways. Embed peer navigators and access to medications patients can be prescribed to use at release from every ER, jail, shelter, and ambulance crew.
- Better policies to track non-fatal overdose events at the point of contact with first responders and emergency departments that trigger meaningful interventions.
- Better policies surrounding opioid addiction medications to ensure consistent drug testing, counseling and recovery support is coordinated so people don’t fall through the cracks, leading to illicit drug use recurrence. Noncompliance rates over a 6 month to a year+ with these medications can be up to 80%+ from a lack of wrap around services connected to their prescription, which leads to cessation of medication treatment and return to illicit drug use and potential overdose.
- Better recovery supports including public funding and access that include recovery housing, employment, education with integrated models that integrated models that see individuals as whole people. This should also include purpose driven-community engagement – peer mentorship, advocacy training, and creative wellness outlets like physical training, meditation and yoga.
In conclusion yes, let’s applaud the strides we are making in reducing fatal illicit drug overdoses and continue to improve upon them. But let’s also sharpen our focus on non-fatal overdoses and the underlying causes and conditions of them including the current data gaps that keep them blurred from scrutiny. Without prioritizing these “near misses”, we risk blunting the great work we are all doing to help not only save lives but help people awaken to a sustainable recovery from chronic and acute substance addiction. True recovery isn’t just about survival, it’s about healing, rebuilding, connection and community.