The U.S. noticed a big rise in adolescent drug overdose deaths in 2022, primarily as a result of fentanyl-laced counterfeit drugs, regardless of a decline in total teen drug use. Research suggests centered academic efforts, coverage intervention in high-risk areas, and elevated entry to naloxone in colleges as vital measures to fight this escalating disaster.
In 2022, the United States witnessed the deaths of roughly 22 youngsters aged between 14 and 18 each week as a result of drug overdoses, with the mortality price for this demographic rising to 5.2 per 100,000. This surge has been attributed to the prevalence of fentanyl-laced counterfeit drugs, based on latest research.
Adolescent overdoses had greater than doubled amongst this group between 2019 and 2020, and have since intensified to such an extent that the demise rely equals a high faculty classroom every week, and is now the third largest explanation for pediatric deaths behind firearm-related accidents and motorcar collisions.
The Role of Fentanyl and Counterfeit Pills
The improve is, nevertheless, not as a result of extra illicit drug use – which has in truth fallen over the years; for instance, excluding hashish, the price of any illicit drug use amongst simply 12th graders had fallen from about 21% to 8% in the 20 years since 2002. Instead, the improve is the results of medicine changing into deadlier as a result of fentanyl, which is more and more discovered in counterfeit oxycodone, benzodiazepines, and different prescription drugs that fall into the arms of adolescents.
But educators, physicians, and psychological health practitioners will be instrumental in serving to to stem this tide via pointed questions and steerage about drug use and the risks that counterfeit drugs present, the researchers write in a paper revealed in the New England Journal of Medicine. In addition, policymakers can give attention to “hotspot” counties, most in western states, with significantly high overdose deaths.
“Teenagers are likely to be unaware of just how high-risk experimenting with pills has become, given the recent rise in counterfeit tablets,” mentioned examine co-author Joseph Friedman, a researcher at UCLA. “It’s often impossible to tell the difference with the naked eye between a real prescription medication obtained from a doctor and a counterfeit version with a potentially deadly dose of fentanyl. It’s urgent that teenagers be given accurate information about the real risks, and strategies to keep themselves and their friends safe.”
The researchers discovered that adolescent overdoses had been occurring at double the nationwide common in Arizona, Colorado, and Washington State between 2020 and 2022. They recognized 19 hotspot counties – that’s, these with at the least 20 overdose deaths and demise charges larger than the nationwide common, with Maricopa County in Arizona and Los Angeles County having the most deadly overdoses at 117 and 111, respectively, throughout this era.
The different 17 counties are Orange County, California (61 deaths), Cook County, Illinois (56), San Bernardino County, California (54), King County, Washington (52), Riverside County, California (41), San Diego County, California (36), Tarrant County, Texas (35), Clark County, Nevada (31), Kern County, California (30), Pima County, Arizona (29), Adams County, Colorado (25), Denver County, Colorado (24), Jackson County, Missouri (24), Santa Clara County, California (24), Bernalillo County, New Mexico (23), Davidson County, Tennessee (21), and Marion County, Indiana (21).
In addition, American Indian and Alaska Native adolescents had 1.82 instances the overdose charges of whites between 2020 and 2022. And adolescents are total likelier to make use of the capsule type of the drug reasonably than powder, which was beforehand the primary fentanyl supply. For occasion, whereas 0.3% of high faculty seniors in 2022 reported utilizing heroin, which comes in powder kind, 5% reported nonmedical use of prescription drugs the identical 12 months.
Recommendations for Prevention and Education
The researchers present the following suggestions to fight these tendencies:
- Pediatricians, different main care physicians, and psychological health practitioners ought to ask their adolescent sufferers in the event that they or their friends had been approached both in person or through social media about shopping for drugs, or if they’ve used them with out prescriptions
- Educators, together with mother and father, can talk about with adolescents the risks related to counterfeit drugs; these efforts must be particularly prioritized in hotspot places
- Clinicians, educators, and oldsters can spotlight the Safety First curriculum that emphasizes abstinence from medicine and supplies details about danger discount for individuals who do experiment with medicine, equivalent to the place to search out and use the overdose-reversal agent naloxone
- Finally, naloxone must be accessible in colleges, which also needs to undertake “no-questions-asked” pill-disposal applications in addition to present nameless mechanisms equivalent to messaging providers that college students can use to ask about counterfeit drugs and substance use with out danger of punishment or embarrassment.
“Fentanyl has rapidly become a leading cause of death in American teens,” mentioned Dr. Scott Hadland, chief of adolescent medication at Mass General for Children and senior writer on the paper. “Policymakers, clinicians, families, and communities need to partner together to address this worsening public health threat.”
Reference: “The Overdose Crisis among U.S. Adolescents” by Joseph Friedman and Scott E. Hadland, 5 January 2024, New England Journal of Medicine.
DOI: 10.1056/NEJMp2312084
