Meth is back on top: more California overdose deaths now involve meth than fentanyl

Key findings

Meth is back on top. In the 12 months ending December 2025, 5,267 overdose deaths in California involved meth and similar stimulants, versus 4,649 involving fentanyl and other synthetic opioids, per CDC provisional counts. Meth led when CDC's California drug data begin (mid-2019), fentanyl pulled ahead in the 12 months ending August 2021, and meth took the lead back in the 12 months ending October 2024 (5,829 vs. 5,667). Both are falling, fentanyl faster: down 42.0% from its peak versus 25.1% for meth. California's own health department counts agree: meth-involved deaths outnumbered fentanyl-involved deaths every month from June 2024 through May 2026. Nationally, fentanyl still leads.

In a crisis, call or text 988 (Suicide & Crisis Lifeline). In an emergency or a suspected overdose, call 911.

Looking for adult addiction treatment for yourself or someone you care about? Call Addiction Resource Center (ARC) at 530-625-7910.

Last updated: November 13, 2026 (America/Los_Angeles).
Data current as of: CDC NCHS provisional counts through the 12 months ending June 2026 (data available November 1, 2026) and CDPH preliminary monthly counts through May 2026 (report produced 08/21/2026); accessed November 13, 2026.
Written by Addiction Resource Center. Reviewed by Tiffany Komba, LMFT (California LMFT #136055).

These figures are public surveillance data. They are not ARC treatment outcomes.

Which drug is involved in more California overdose deaths: meth or fentanyl?

Meth. In the 12 months ending December 2025, 5,267 of California's 9,049 overdose deaths involved psychostimulants (mostly methamphetamine), or 58.2%. Synthetic opioids (mostly fentanyl) showed up in 4,649, or 51.4% (ARC calculations from CDC counts).

Those shares add up to more than 100% for a reason: a lot of deaths involve both. At least 867 deaths (9.6%) must have involved both drug groups — that's simple arithmetic on CDC's totals, and the real overlap is likely bigger.

One honest caveat: if you lump all opioids together (fentanyl, heroin, prescription painkillers and more), opioids were still in slightly more deaths (5,349) than meth in that period. The flip is meth versus fentanyl specifically.

License: Charts and derived CSVs by Addiction Resource Center (sayarc.com), CC BY 4.0. Source data: CDC National Center for Health Statistics (NCHS) and California Department of Public Health (CDPH). Underlying source data belong to those agencies, not ARC.

In a crisis, call or text 988 (Suicide & Crisis Lifeline). In an emergency or a suspected overdose, call 911.

When did meth overtake fentanyl again?

In the 12 months ending October 2024. That's the first rolling 12-month period since fentanyl's run where CDC counted more meth-involved deaths (5,829) than synthetic-opioid deaths (5,667) in California. A month earlier, fentanyl was still ahead by a hair (5,923 vs. 5,917). Meth has stayed in front in every period since.

It's actually a rematch. When CDC's California drug-specific data start (12 months ending June 2019), meth was far ahead: 2,791 deaths versus 1,175. Fentanyl surged, passed meth in the 12 months ending August 2021 (5,796 vs. 5,791), and peaked at 8,019 in the 12 months ending October 2023. Meth peaked at 7,033 (12 months ending August 2023).

So why the flip? Mostly because fentanyl deaths dropped faster. From their peaks to 2025, fentanyl-involved deaths fell 42.0% and meth-involved deaths fell 25.1%. These data can't tell us why each fell.

Does California's own data agree?

Yes, on the direction. The California Department of Public Health (CDPH) publishes preliminary monthly overdose death counts by drug. In those reports, meth-involved deaths outnumbered fentanyl-involved deaths in every month from June 2024 through May 2026 — 24 months in a row.

Add up CDPH's monthly counts and you get almost the same crossover as CDC: meth passed fentanyl in the 12 months ending September 2024 (5,905 vs. 5,861), and passed CDPH's synthetic-opioid count in the 12 months ending October 2024, the same period as CDC. For all of 2025, CDPH's monthly reports add up to 5,228 meth-involved and 4,555 fentanyl-involved deaths (ARC sums of preliminary counts).

License: Charts and derived CSVs by Addiction Resource Center (sayarc.com), CC BY 4.0. Source data: CDC National Center for Health Statistics (NCHS) and California Department of Public Health (CDPH). Underlying source data belong to those agencies, not ARC.

In a crisis, call or text 988 (Suicide & Crisis Lifeline). In an emergency or a suspected overdose, call 911.

Is this happening across the U.S.?

Not yet. Nationally, fentanyl is still the bigger killer by this measure: in the 12 months ending December 2025, 38,462 U.S. overdose deaths involved synthetic opioids (54.4%) versus 26,260 involving psychostimulants (37.2%). In this CDC file, the U.S. meth count has never passed the fentanyl count in any 12-month period since 2015.

License: Charts and derived CSVs by Addiction Resource Center (sayarc.com), CC BY 4.0. Source data: CDC National Center for Health Statistics (NCHS) and California Department of Public Health (CDPH). Underlying source data belong to those agencies, not ARC.

In a crisis, call or text 988 (Suicide & Crisis Lifeline). In an emergency or a suspected overdose, call 911.

What does this mean for families and referring clinicians?

These are statewide counts, so they can't tell you about any one person. But they're a reminder that overdose risk isn't only about opioids. Stimulants like meth are now in more than half of California's overdose deaths, often alongside fentanyl. If someone you care about uses meth, fentanyl, or both, a clear next step can help.

• Families: how to help a family member with addiction.
• Learn more: methamphetamine use treatment.
• Therapists and medical providers: refer a patient to ARC.
• Adults who need care that fits around work: ARC's intensive outpatient program (IOP) and telehealth IOP.

In a crisis, call or text 988 (Suicide & Crisis Lifeline). In an emergency or a suspected overdose, call 911.

California meth vs. fentanyl overdose deaths, selected periods

Download the data: California and U.S. meth vs. fentanyl overdose deaths, 12-month counts, CDC VSRR (CSV) (california_meth_vs_fentanyl_overdose_deaths_12_month_cdc_vsrr.csv) and California monthly overdose deaths by drug, CDPH preliminary counts (CSV) (california_meth_vs_fentanyl_overdose_deaths_monthly_cdph.csv).

License: Charts and derived CSVs by Addiction Resource Center (sayarc.com), CC BY 4.0. Source data: CDC National Center for Health Statistics (NCHS) and California Department of Public Health (CDPH). Underlying source data belong to those agencies, not ARC.

In a crisis, call or text 988 (Suicide & Crisis Lifeline). In an emergency or a suspected overdose, call 911.

Frequently asked questions

Google may not show FAQ rich results for health content; these answers are written so people and answer engines can quote a short, sourced reply.

Are more people in California dying from meth or fentanyl overdoses?
Meth, for now. In the 12 months ending December 2025, 5,267 California overdose deaths involved psychostimulants such as methamphetamine and 4,649 involved synthetic opioids such as fentanyl, according to CDC provisional counts. Many deaths involve both drugs, so the two numbers overlap.

When did meth overtake fentanyl in California overdose deaths?
In CDC's provisional data, meth-involved deaths passed synthetic-opioid deaths again in the 12 months ending October 2024 (5,829 vs. 5,667) and have stayed ahead since. Fentanyl had led since the 12 months ending August 2021. CDPH's monthly counts show meth ahead every month from June 2024 through May 2026.

Is meth overtaking fentanyl nationwide too?
No. Across the United States, synthetic opioids such as fentanyl were involved in 38,462 overdose deaths in the 12 months ending December 2025, compared with 26,260 involving psychostimulants, per CDC provisional counts. In this CDC file, U.S. meth-involved deaths have not passed fentanyl-involved deaths in any period since 2015.

Technical notes

These details sit here so the takeaways above stay easy to read. Every figure comes from the CDC or CDPH files below, unless labeled as an ARC calculation.

Citations: Ahmad FB, Cisewski JA, Rossen LM, Sutton P. Provisional drug overdose death counts. National Center for Health Statistics. 2026. VSRR Provisional Drug Overdose Death Counts (data.cdc.gov dataset xkb8-kh2a), California and United States, 12 month-ending periods; data available for analysis November 1, 2026 (dataset updated November 10, 2026). Accessed November 13, 2026. https://data.cdc.gov/d/xkb8-kh2a — California Department of Public Health, Substance and Addiction Prevention Branch. Preliminary Monthly Fatal Drug-Related Overdose Counts (monthly PDF reports produced March 2024 through August 21, 2026; data from the California Comprehensive Death File, dynamic). Accessed November 13, 2026. https://www.cdph.ca.gov/Programs/CCDPHP/sapb/Pages/Data.aspx

• What "meth" and "fentanyl" mean here: "Meth" is CDC's psychostimulants with abuse potential category (ICD-10 multiple-cause code T43.6), which CDC says includes methamphetamine (and also drugs such as MDMA and prescription amphetamines). "Fentanyl" in the CDC data is synthetic opioids other than methadone (T40.4), which CDC says includes fentanyl and tramadol. CDPH's fentanyl column is a separate count that finds fentanyl and its analogs by searching death-certificate text; CDPH's T40.4 column is shown in the cross-check table.
• Deaths can count twice: Drug categories are not mutually exclusive. A death involving both meth and fentanyl is counted in both. The "at least 867" figure is an ARC lower bound: meth deaths + fentanyl deaths − all overdose deaths (5,267 + 4,649 − 9,049). It is not a published CDC count of co-involved deaths.
• CDC data are provisional and counted by place of death: CDC VSRR counts deaths that occurred in California, including non-residents, and they are provisional. Final data (CDC WONDER, CDPH's dashboard) count California residents, so numbers will differ. Counts are rolling 12-month totals: "12 months ending October 2024" covers November 2023 through October 2024. The page uses CDC's reported counts. CDC also publishes predicted counts adjusted for reporting delays; on predicted counts, the crossover happens one month earlier (12 months ending September 2024: 6,051 vs. 6,034).
• Recent months will change: CDC flags California periods from the 12 months ending January 2026 onward as "Underreported due to incomplete data," so the page uses the 12 months ending December 2025 for its headline numbers. The latest period (12 months ending June 2026: meth 4,743, fentanyl 4,019) is shown on the chart with a dotted line. CDC notes that declines in provisional data can reflect incomplete reporting as well as real decreases. In the 12 months ending December 2025, 96.7% of California overdose death records named at least one drug.
• Why the trend starts in 2019: CDC's file has no California drug-specific counts before the 12 months ending June 2019; earlier values are withheld with the note "Data not shown due to low data quality" (too few records named a specific drug). U.S. counts go back to the 12 months ending January 2015.
• Comparing California with the U.S.: CDC advises against comparing drug-specific death rates across jurisdictions because drug reporting varies. The page only compares which drug leads within each place, using shares of each place's own total (ARC calculations). The U.S. total excludes Puerto Rico.
• CDPH monthly counts: From CDPH's Preliminary Monthly Fatal Drug-Related Overdose Counts reports (26 reports; months January 2023 to May 2026). Each month's count is taken from the newest report that lists it, so earlier months come from older (but more complete for that month) extracts. CDPH counts deaths that occurred in California by month of death and says counts are preliminary and may not include all deaths. The 12-month totals and the 2025 totals on this page are ARC sums of those monthly counts. The most recent months (such as May 2026: meth 209, fentanyl 173) are the least complete. CDPH also showed meth ahead in one earlier month, February 2024.
• CDPH dashboard (residence-based) check is pending: CDPH's California Overdose Surveillance Dashboard (https://skylab.cdph.ca.gov/ODdash/) has a final, residence-based psychostimulant indicator, but its downloads are only available through the interactive dashboard. ARC has not yet pulled that series for this page.
• This table is modified: The HTML tables and CSVs are ARC's reformatting of CDC and CDPH data. They are not official government data tables.
• License: ARC-derived charts and CSVs are licensed CC BY 4.0. The license covers ARC's charts, table layout, and derived CSVs only; CDC and CDPH data belong to those agencies and are cited via isBasedOn.
• Refresh cadence: CDC updates VSRR provisional counts monthly; CDPH has posted its preliminary monthly report about once a month. Recheck both monthly and update this page at least quarterly, or sooner if the lead changes.
• Sources: CDC dataset https://data.cdc.gov/d/xkb8-kh2a; CDC technical notes https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm; CDPH reports page https://www.cdph.ca.gov/Programs/CCDPHP/sapb/Pages/Data.aspx; latest CDPH report https://www.cdph.ca.gov/Programs/CCDPHP/sapb/CDPH%20Document%20Library/Prelim_Monthly_Death_Data_2026_07.pdf.

These numbers are not ARC treatment outcomes.

If you need help

ARC provides comprehensive addiction treatment for adults 18 and older. Our intensive outpatient program (IOP) is in Yuba City, in person or by telehealth. Detox and residential care with medication-assisted treatment (MAT) are available through our partner, Ona Treatment Center (detox information). Call 530-625-7910 or see admissions. Clinicians can refer a patient.

In a crisis, call or text 988 (Suicide & Crisis Lifeline). In an emergency or a suspected overdose, call 911. More ARC data explainers: California overdose data, including California fentanyl deaths by county, 2024, California overdose deaths vs. ED visits, and California's addiction treatment gap.

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  <a href="https://sayarc.com/learning-center/california-meth-vs-fentanyl-overdose-deaths/">
    <img src="https://sayarc.com/images/dataviz/california-meth-vs-fentanyl-overdose-deaths-trend.webp" width="1200" height="940" alt="Line chart: California overdose deaths involving meth vs. fentanyl, rolling 12-month counts, 2019-2026. Source: CDC NCHS VSRR, via Addiction Resource Center.">
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    Chart and CSV by <a href="https://sayarc.com/learning-center/california-meth-vs-fentanyl-overdose-deaths/">Addiction Resource Center</a> (sayarc.com), <a href="https://creativecommons.org/licenses/by/4.0/">CC BY 4.0</a>.
    Source data: CDC National Center for Health Statistics (NCHS). Underlying source data belong to CDC, not ARC.
    Data citation: CDC NCHS, VSRR Provisional Drug Overdose Death Counts (data.cdc.gov xkb8-kh2a), accessed November 13, 2026.
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