California leads the nation in fentanyl deaths with 7,203 in 2023—up 330% from 1,675 in 2019. That's nearly 20 Californians dying every single day from fentanyl alone. The state saw deaths surge from 247 (2015) to 449 (2016) to 1,006 (2018) to today's crisis levels. Despite the epidemic, California has resisted tougher penalties for fentanyl dealers.