As Fentanyl Surges into the Drug Supply, America’s Youth at Highest Risk Ever for Drug Overdoses

Paramedics on the street

American parents must understand that, although the rate of teen drug use has declined in recent years, the act of drug use is more dangerous for teens today than at potentially any moment in American history. If parents don’t act now, the rate of teen drug-related fatalities may overtake adult fatalities. In fact, there is already provisional reporting suggesting that this has occurred.

Fentanyl-Induced Overdose Deaths on the Rise Among U.S. Teens

Overdosed young man get attended by paramedic

A new report published in the Journal of the American Medical Association shows that, even though teen and young adult drug use rates have declined somewhat, young people who use drugs are dying at rates previously unheard of. Study author Joseph Friedman, a medical researcher at the University of California, Los Angeles, highlighted the concerning development. “This is not coming from more teens using drugs,” he said. “It’s actually coming from drug use becoming more dangerous.” According to Friedman’s study and others that support it, adolescent overdose deaths in the United States more than doubled from 2010 to 2021, jumping from 518 to 1,146 deaths annually.

“It’s actually coming from drug use
becoming more dangerous.”

The researchers examined toxicology reports for young people in the years analyzed, comparing the results to previous years. According to their findings, not only did youth fatalities spike 94% in just one year (2020) and 20% the very next year (2021), but fentanyl-related overdose deaths leaped 350% over the brief study period. The researchers found that fentanyl was associated with 77% of adolescent overdose deaths in 2021, the highest rate of fentanyl involvement in teen deaths ever recorded.

Fentanyl graph
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The findings come at a time when fentanyl has become widespread in the drug supply, often being mixed into other drugs without users knowing. That likely means most teens who’ve lost their lives to fentanyl did not know they were using a fentanyl-tainted drug. The Drug Enforcement Administration reported the number of drug busts where fentanyl-laced drugs were found skyrocketed from under 20,000 in 2015 to 117,045 in 2020. Meanwhile, the number of fentanyl pills (often called “counterfeit pills” because they’re marketed and sold to users as pharma-made prescription painkillers) increased nearly 50-fold from the first quarter of 2018 to the last quarter of 2021.

Not only have deaths connected to drugs exceeded 100,000 annually, but at least two-thirds of all drug-related fatalities are proven by toxicology reports to have been caused by fentanyl or a similar synthetic opioid. That percentage almost doubled in just two years, from a little more than one-third of all deaths caused by synthetic opioids in 2021.

Teens are Using Drugs but Not Knowing What’s in Them

Kids trading drugs at school

Drug use is dangerous because drugs are dangerous, but even more critically, users can never fully know with confidence what drugs they’re using. Many teens choose to use what they think are prescription drugs they bought from a dealer because they believe drugs made by pharma companies will be safer. Not only is that belief not true, but the drugs they buy from dealers are often counterfeit pills, made by clandestine drug lab operations to look like legitimate prescription drugs but which actually contain a dangerous cocktail of potentially lethal substances, fentanyl included.

Such developments put young people at extreme risk, as the findings show. Joseph J. Palamar, Ph.D., M.P.H., associate professor at the N.Y.U. Grossman School of Medicine and co-investigator on the NIDA-funded National Drug Early Warning System, spoke about the pressing concern present in the growing trend of fentanyl being added into clandestine drug supplies nationwide. “For the first time, we can see this rapid rise in pills adulterated with fentanyl, which raises red flags for increasing risk of harm in a population that is possibly less experienced with opioids,” he said. “We absolutely need more harm reduction strategies, such as naloxone distribution and fentanyl test strips, as well as widespread education about the risk of pills that are not coming from a pharmacy. The immediate message here is that pills illegally obtained can contain fentanyl.” Young people should assume that any pills someone offers them will contain fentanyl.

Increasing adolescent overdose deaths, a rate of death rising faster than that of all age groups and demographics in the U.S., is cause for alarm. Given that the sinister addition of fentanyl into the drug supply is the primary culprit behind these deaths, there is a clear and present need for education and prevention programs for adolescents. There is also a clear need for greater access to naloxone for first responders and civilians alike. Finally, young people need access to services for mental health and substance use behaviors so they have a way to receive the help they need when they become addicted to the very drugs that could easily kill them.

Seeking Help for Those Affected by the Addiction Epidemic

It should be celebrated that young people are using drugs less often. That means educational efforts to teach young people the truth about drugs have been effective. But the fact that drug use is considerably more dangerous should serve as a stark warning for all parents and loved ones of young Americans. It means everyone must put in a consistent, dedicated, and organized effort to inform youths about the dangers of using drugs, even just once. Any drug exposure can produce a fatal outcome.

While educating young people is the best tool for preventing future drug use, some youths are already hooked on drugs and will almost certainly not be “educated out of their addiction.” For these individuals, getting them help at a residential drug and alcohol rehab center is critical. If you know someone who is using drugs and who cannot stop, please help them enter a qualified drug treatment center as soon as possible. Don’t wait until they overdose from a drug that has fentanyl laced into it.

Sources Cited:

  • C.D.C. “Provisional Drug Overdose Death Counts.” Centers for Disease Control and Prevention, 2023.
  • JAMA. “Trends in Drug Overdose Deaths Among U.S. Adolescents, January 2010 to June 2021.” Journal of the American Medical Association, 2022.
  • CNN. “Teen overdose deaths are rapidly rising – but not because more of them are using drugs.” CNN, 2022.
  • N.I.H. “Law enforcement seizures of pills containing fentanyl increased dramatically between 2018–2021.” National Institutes of Health, 2022.



After working in addiction treatment for several years, Ren now travels the country, studying drug trends and writing about addiction in our society. Ren is focused on using his skill as an author and counselor to promote recovery and effective solutions to the drug crisis. Connect with Ren on LinkedIn.