The opioid crisis has not gripped California in the same way it has other states. Overdose deaths peaked in 2009 and have since dropped 15 percent, according to health officials. Still, nearly 4,100 people were hospitalized for overdoses in the state last year. Nearly 2,000 people died. According to the California Department of Public Health, 70 percent of the deaths involved prescription opioids. And there remain several hot spots of addiction, mostly in rural California counties. In addition, deaths from street heroin, often a cheaper alternative for those whose addiction begins with costly pills, have risen 57 percent since 2012, according to the state.

In 2014, California authorities began working on the issue after a challenge from the national Association of State and Territorial Health Officials, said Karen Smith, director of the state Department of Public Health. The state had been tracking drug deaths for years, and officials could see where problem pockets were developing.