Substance Use in California 2025: What the Latest CHCF Almanac Reveals

Oct 2

Written By

The California Health Care Foundation (CHCF) recently published an update to its Substance Use in California Almanac, authored by Aurrera Health Group. The Almanac offers a snapshot of substance use in the state, highlighting new data, treatment trends, and policy shifts. The report shows that California has expanded in its treatment infrastructure, but unmet needs remain as the crisis continues to evolve.

Key findings include:

Higher prevalence estimates. California’s Substance Use Disorder (SUD) prevalence is now estimated at 17%, nearly double the figures from the 2022 issue of the Substance Use Almanac, based on updated DSM-5 measures.
Decreased prescription opioid use but increased impact from fentanyl. Prescription opioid use has dropped 51% since 2010, but fentanyl-related overdose deaths quadrupled between 2019 and 2023.
Unequal burden. In 2023, American Indian/Alaska Native Californians had the highest overdose death rate, followed by Black Californians. Northern rural counties face the highest regional rates of overdose deaths.
Treatment and harm reduction gains. Over 3 million naloxone kits have been distributed since 2018 through the Naloxone Distribution Project, reversing more than 200,000 overdoses. Buprenorphine use and emergency department treatment programs have expanded.
Infrastructure growth. From 2017 to 2023, the number of residential treatment facilities grew by 30%, and inpatient facilities by 400%—but access gaps remain.

The 2025 Almanac underscores both progress and urgency; California is making strides in prevention, treatment, and harm reduction, yet the crisis continues to evolve.

Aurrera Health Group works closely with state and local partners to translate data into action – expanding evidence-based treatment, strengthening harm reduction, and aligning funding with community needs. Want to discuss your project? Contact Kelly Murphy for more information.