Even as Teen Drug Use Declines, ODs Are on the Rise

teen drug use

This counterintuitive finding in a new study can be traced to the growing lethality of certain substances

By Jason Langendorf

As overdose death rates skyrocket among U.S. teenagers, a new study indicates that young people aren’t using drugs more often but that the substances are becoming more dangerous.

Joseph Friedman

In a research letter published on the JAMA Network, researchers at UCLA’s David Geffen School of Medicine found that the rate of overdose deaths among American teens nearly doubled in 2020, then rose another 20% in the first half of 2021, compared with the 10 years before the pandemic.

The exponential increase in overdose deaths within the cohort is the first of its kind, according to the paper’s lead author, Joseph Friedman, MD, an addiction researcher at UCLA. And he attributes it to a specific shift in the drug market: “The increases are almost entirely due to illicit fentanyls, which are increasingly found in counterfeit pills,” Friedman said. “These counterfeit pills are spreading across the nation, and teens may not realize they are dangerous.”

Friedman and his colleagues found that fentanyl was involved in more than 77% of adolescent overdose deaths in 2021. Yet the development comes at a time when teen drug use is actually decreasing: While the percentage of 10th-graders reporting any illicit drug use in the previous 12 months changed little between 2010 and 2020 (from 30.2% to 30.4%), that figure declined to 18.7% in 2021.

Friedman highlighted the uncertain doses in counterfeit prescription drugs such as Xanax, Percocet and Vicodin as a factor in the rise in adolescent overdose death rates.

Based on the nature of the study, researchers weren’t able to determine causation (only correlation), and the role of factors related to the pandemic—such as suicidal ideation, mental illness and social isolation—couldn’t be determined. But Friedman highlighted the uncertain doses in counterfeit prescription drugs such as Xanax, Percocet and Vicodin as a factor in the rise in adolescent overdose death rates. Additionally, he called for stronger education and prevention measures, as well as increased access to the overdose-reversal medication naloxone.

“Teens urgently need to be informed about this rising danger,” Friedman said. “Accurate information about the risk of drugs needs to be presented in schools. Teens need to know that pills and powders are the highest risk for overdose, as they are most likely to contain illicit fentanyls. Pills and powders can be tested for the presence of fentanyls using testing strips, which are becoming more widely available.”

Top photo: Danie Franco