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Report finds substantial increase in Orange County homeless deaths

February 28, 2023

Deaths among those in Orange County’s homeless community have risen substantially over the past decade as the number of accidental deaths has begun outpacing natural ones, according to a county report released on Monday.

The Homeless Death Review Committee found that deaths among the local homeless rose from 103 in 2012 to 395 in 2021, with drugs becoming the leading cause of death.

According to the report, the number of accidental deaths among the homeless surpassed natural deaths beginning in 2020. More than 75 percent of the accidental deaths that year were drug related, according to the report, and three-quarters of the drug-related deaths involved fentanyl.

The committee wrote that the rise in fentanyl-involved deaths was particularly concerning. The powerful synthetic opioid was found to be a factor in 144 of the 395 homeless deaths in 2021, according to the report.

Members of the committee also raised particular concerns about the suicide and homicide rates among Orange County homeless, both of which were significantly higher than the national average and pointed to a population more at risk of crime and mental illness.

Looking at the deaths in 2021, the committee found that 300 of the 309 homeless individuals had spent at least some time in jail in Orange County during the five previous years.

Orange County Sheriff Don Barnes — whose department runs the jails and whose coroner division led the Homeless Death Review Committee — said the findings were “telling,” adding that “it’s clear we have challenges ahead to reduce the number of deaths among people experiencing homelessness.”

“We continue to enhance efforts to address the fentanyl epidemic and provide critical resources to those trapped in addiction,” Barnes said in a prepared statement. “It will be imperative that we also look at the clear correlation between incarceration of people experiencing homelessness and work to increase the number of people taking advantage of programs while they’re in custody.”

The committee — which also included experts from county agencies, city police departments, hospitals and non-profits — was created to look at the root causes of homeless deaths and determine if there are ways to prevent future deaths. The report released on Monday is the first from the committee, which was created in January 2022.

The report found that the number of deaths among the homeless increased incrementally from 2012 to 2019 before jumping substantially — by 55 percent — between 2019 and 2020, the first year of the pandemic.

Among the recommendations outlined in the report was pursuing legislation that would allow a case by case review of each death by the committee — which is currently limited to viewing aggregate data — as well as expand options for substance abuse treatment, increase the availability of Narcan — a medicine that can reverse an opioid overdose — and explore changes to sentencing laws that would focus on substance abuse treatment in lieu of incarceration.

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