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As fatal drug overdoses rise among teenagers, is U.S. drug education working?

Fentanyl pills, often created to look like less powerful opioids, have caused a surge in drug overdose deaths among teenagers. (Cuyahoga County Medical Examiner's Office via AP)
Fentanyl pills, often created to look like less powerful opioids, have caused a surge in drug overdose deaths among teenagers. (Cuyahoga County Medical Examiner's Office via AP)

Teen overdose deaths spiked in 2020 and 2021, according to a new study in the Journal of the American Medical Association.

The deaths are not a result of more experimentation with drugs: Federal data show that overall teen drug use has been falling.

They are fueled instead by a rise in synthetic opioids such as fentanyl, illicit drugs more powerful and deadlier than heroin. Synthetic opioids are becoming more common in pills bought off the street, and teenagers are feeling the impact.

Joseph Friedman, a public health researcher at the University of California and lead author of the JAMA study, says U.S. drug education programs that focus on abstinence do not prepare children to stay alive in the face of a changing drug supply.

Parents and teachers should tell kids that abstinence — or at least delaying drug use until their 20s — is the best option, he says. But they should present that along with other, realistic information about how to experiment safely with substances.

Looking for resources on drug education? Try the Drug Policy Alliance’s Safety First curriculum.

Interview Highlights

On the role of synthetic opioids in the rise in overdose deaths

“Synthetic opioids like fentanyls have been driving increases in the U.S. overdose crisis for more than a decade. What’s changing now is that synthetic opioids are being packaged as counterfeit pills, which teens are more likely to report experimenting with. For decades, teens have reported experimenting with prescription pills, and overdose deaths didn’t rise because those pills are actually much safer, relatively speaking. But now that those pills are being replaced by illicit fentanyls, we’re seeing deaths go up.”

On the racial and geographic disparities that his study found

“Teens on the West Coast have been hit the hardest by this. And Native and Latinx teens are disproportionately burdened as well. Some of that has to do with where these pills are spreading geographically. Also there are very important inequalities in access to services, counseling and healthcare that people need to stay safe in the face of such a dangerous drug supply.”

On whether U.S. drug education is prepared to handle the crisis

“I’d say we are woefully under-equipped to handle this situation. As a country, we have really focused on abstinence-only drug education for decades, and even now with teen drug use rates at historic lows it’s still 40% of 12th graders report having experimented with an illicit drug. … Unfortunately, teens are simply going to experiment with drugs. It’s just part of American culture. What we really need to be doing is equipping them with skills and understanding to stay safe. That means understanding that pills and powders are the highest risk. It also means knowing to encourage their friends never to use alone, making sure there’s someone there to call 911 if things go bad. And making sure there’s naloxone on hand, because opioid overdoses are 100% preventable and reversible if naloxone is on hand quickly.”

This article was originally published on WBUR.org.

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