Drug overdose deaths among America's teens have skyrocketed during the pandemic, and not because drug use is more common, researchers report.
In 2020, overdose deaths among adolescents nearly doubled, compared with 10 years before the pandemic. They rose another 20% in the first six months of 2021, a new study finds.
"Teen drug use rates are at historic lows, so this is really because drug use is becoming more dangerous," said lead researcher Joseph Friedman, an addiction researcher at University of California, Los Angeles.
"There's really been a spread of counterfeit pills that look like prescription pills, but, in fact, they're made in underground labs and sold on the illicit market, and they contain illicit fentanyl," he said.
The majority of drug deaths were caused by fake versions of prescription drugs such as Xanax, an anxiety drug, and narcotic painkillers such as Percocet and Vicodin that were laced with fentanyl, Friedman said.
Fentanyl, a synthetic opioid, is 80-100 times stronger than morphine, according to the U.S. Drug Enforcement Administration.
Of the 1,100-plus teens who died from drug overdose in early 2021, Friedman said most were unaware that the pills they took were much more powerful than what they expected.
"Unfortunately, kids are going to experiment with these things," Friedman said. However, "there are ways they can stay safe, such as never using drugs alone. There should always be someone who's not using who can call for help. And Narcan [naloxone], which can reverse overdoses, needs to be available in schools and in other places where teens hang out."
Pat Aussem, an associate vice president at the Partnership to End Addiction, pointed out that the 12-month period ending April 2021 was the deadliest year for drug overdoses on record, across all ages.
"We experienced over 100,000 heartbreaking overdose deaths in our country -- the highest it's ever been. Over 270 people a day," she said. "Teens and young adults haven't been spared, and the rate of drug overdose deaths has been steadily increasing."
Aussem agreed that fentanyl is largely to blame. Besides contaminating faux prescription drugs, fentanyl is also found in illicit drugs like heroin, cocaine, meth and MDMA.
"Teens may decide to try a pill like Percocet, Adderall or Xanax or a powder-like cocaine, which is risky itself, but if it's laced with fentanyl, it can be deadly," Aussem said. "Even pills from the same supplier can have no fentanyl or differing amounts -- there's no quality control, and teens will have no way of knowing."
Using a database from the U.S. Centers for Disease Control and Prevention, Friedman and his colleagues calculated drug overdose deaths per 100,000 teens aged 14 to 18 that happened from January 2010 to June 2021.
They found 518 deaths, a rate of 2.4 per 100,000, among teens in 2010. That rate continued through 2019. In 2020, however, overdose deaths jumped to 954 deaths (4.6 per 100,000), and in early 2021, rose to 1,146 deaths (5.5 per 100,000).
Overdose rates rose among all racial and ethnic groups, the researchers found.
Among American Indian/Alaska Natives, there were nearly 5 deaths per 100,000 in 2010, rising to almost 7 through 2019, then increasing to nearly 8 per 100,000 in 2020, and 12 in 2021 -- the highest overdose rate compared to other groups.
Among Black teens, the rate rose from .7 per 100,000 in 2010 to 1.5 through 2019, 3.7 in 2020, and 3.1 in early 2021.
Among Hispanic teens, the overdose death rate was 7 per 100,000 in 2021, up from 1.4 in 2010. Among whites, the teenage death rate from drugs topped 5.3 in the first part of 2021, up from about 3.3 in 2010.
These deaths started spiking on the West Coast, Friedman said. But he expects the increases in overdose deaths to spread across the country.
"Unfortunately, this is still the very early days of this issue," he said. "If it behaves like other overdose outbreaks we've seen, we would expect it to spread to the rest of the country and only get worse as counterfeit pills spread more widely."
Sheila Vakharia, deputy director of research and academic engagement at the Drug Policy Alliance, said teens need to be taught about the dangers of fentanyl and what to do if someone overdoses.
"Young people aren't taught about this potential, they're not taught about the importance of not mixing drugs," she said.
"They're not taught about how to identify overdose. They're not taught about how to respond with naloxone. They're not taught about how, in certain jurisdictions, there are Good Samaritan laws where if you call 911 for help, you won't get arrested. They're not taught about other medications like buprenorphine and methadone and how to get treatment that could help. There's huge gaps, clearly, if we're seeing an increase in overdose deaths among young people," Vakharia said.
The report was published April 12 in the Journal of the American Medical Association.
For more on drug overdose, see the U.S. National Library of Medicine.
SOURCES: Joseph Friedman, MPH, addiction researcher, Center for Social Medicine and Humanities, University of California, Los Angeles; Sheila Vakharia, PhD, LMSW, deputy director, Department of Research and Academic Engagement, Drug Policy Alliance, New York City; Pat Aussem, LPC, associate vice president, consumer clinical content development, Partnership to End Addiction; Journal of the American Medical Association, April 12, 2022