Researchers at UCLA, Harvard, and the Local Public Safety Coordinating Council in Portland, OR, just published a research letter in JAMA highlighting increases in overdose deaths of teens. Using CDC WONDER data, the researchers calculated the rate of drug overdose deaths per 100,000 population for teens aged 14-18 from jan 2010-June 2021.

Overdose Deaths by the Numbers

They found that “There were 518 deaths among adolescents (2.40 per 100 000 population) in 2010, with rates remaining stable through 2019 with 492 deaths (2.36 per 100 000). Deaths increased to 954 (4.57 per 100 000) in 2020 and to 1146 (5.49 per 100 000) in 2021. Between 2019 and 2020, overdose mortality increased by 94.03% and from 2020 to 2021 by 20.05%. In the overall population, numbers of overdose deaths were higher and rates increased steadily from 2010 (n = 38 329; 12.4 per 100 000) to 2020 (n = 91 799; 27.86 per 100 000) and 2021 (n = 101 954; 31.06 per 100 000). The percent change was 29.48% from 2019 to 2020 and 11.48% from 2020 to 2021. Among adolescents, fentanyl-involved fatalities increased from 253 (1.21 per 100 000) in 2019 to 680 (3.26 per 100 000) in 2020 and to 884 (4.23 per 100 000) in 2021. In 2021, fentanyls were identified in 77.14% of adolescent overdose deaths, compared with 13.26% for benzodiazepines, 9.77% for methamphetamine, 7.33% for cocaine, 5.76% for prescription opioids, and 2.27% for heroin. American Indian and Alaska Native adolescents experienced the highest overdose rate in 2021 (n = 24; 11.79 per 100 000), followed by Latinx adolescents (n = 354; 6.98 per 100 000).”(Friedman et al., 2022)

Overdose Deaths Linked to Fentanyl

The researchers conclude that “Beginning in 2020, adolescents experienced a greater relative increase in overdose mortality than the overall population, attributable in large part to fatalities involving fentanyls. In the context of decreasing adolescent drug use rates nationally, these shifts suggest heightened risk from illicit fentanyls, which have variable and high potency. Since 2015, fentanyls have been increasingly added to counterfeit pills resembling prescription opioids, benzodiazepines, and other drugs, which adolescents may not identify as dangerous and which may be playing a key role in these shifts.” (Friedman et al., 2022)

Limitations “include the observational design that cannot establish causality, that race and ethnicity may be incorrectly assigned in some death investigations, that results from 2021 were provisional and include proportionally scaled values from January to June, and small numbers in some subgroups. In addition, the contribution of factors unique to the COVID-19 pandemic, such as suicidal ideation, mental illness, social isolation, and disruptions to illicit drug markets, cannot be discerned.”(Friedman et al., 2022)