San Diego County Reports Nearly 50% Drop in Black Overdose Deaths

Drug overdose deaths among Black San Diegans fell from 159 in 2023 to 85 in 2025, a decline of nearly 50 percent, San Diego County District Attorney Summer Stephan told a county task force meeting on Sept. 30.

Overall overdose deaths in the county dropped from 1,203 to 840 over the same period, and deaths among people under 18 fell from 13 to 2, Stephan said. She delivered the figures at the second meeting of the Amazing Grace Subcommittee and the San Diego County Substance Use and Overdose Prevention Taskforce, a multidisciplinary group convened at the Christian Fellowship Congregational Church and chaired by Carla Crudup.

"This is a substantial reduction," Stephan said of the numbers, crediting public health agencies, law enforcement, schools and community organizations with working together to connect people to treatment and protect those at risk of an overdose.

Methamphetamine is the unfinished part of the picture

Stephan said the county's success against fentanyl — the synthetic opioid that drove overdose deaths past 100,000 nationally in the early 2020s — has not been matched against stimulants. "But what hasn't come down in the same way is methamphetamine," she said, adding that meth-related deaths have risen among older adults because prolonged use takes a cumulative toll on the body and can lead to heart failure.

The county's capacity to treat the full range of substance use and mental health needs remains limited, she said. A $29 million county substance use treatment and recuperative care center is scheduled to open this fall.

Dr. Sayone Thihalolipavan, the county's public health officer, said San Diego has expanded narcotic treatment programs and withdrawal management beds and plans to keep broadening them, describing the progress as the product of collective community work rather than any single intervention.

Addiction framed as illness, not a character flaw

Much of the meeting was devoted to the language and assumptions surrounding addiction. Dr. Suzanne Affalo, a local family medicine physician, said that for generations addiction has been treated as a moral failing, a lack of willpower or a flaw in character, and that society does not extend to people with substance use disorder the same care it gives patients with diabetes or other chronic conditions.

She described how repeated substance use desensitizes the brain's reward system, so that more of a drug is needed to feel normal, and how the prefrontal cortex — the region governing judgment and impulse control — becomes less effective. "It requires a comprehensive kind of approach to dealing with people with substance abuse disorder, a whole person approach," Affalo said, listing behavioral therapies, counseling, peer support and medication among evidence-based options.

Reggie Washington of the local organization Project Aware walked the group through naloxone, the opioid reversal medication also sold as Narcan, and the protections California's Good Samaritan law offers bystanders who call for help. He stressed a limit that matters for a county where stimulants remain lethal: naloxone reverses opioid overdoses but does nothing for methamphetamine or cocaine overdoses. He also warned that counterfeit pills can look genuine and that fentanyl is often mixed into other drugs, so people should not assume they know what a pill contains.

Washington urged the group to reach young people where they are and to talk about drugs without judgment. "When they say they want a bar, they're not talking about a candy bar," he said, making the case that accurate, non-punitive information reaches people that warnings do not.