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For the first time in years, adolescent mortality in the United States increased dramatically in 2020 and will continue to rise by 2021. This is according to the results of a new study published in JAMA on Tuesday.
Joe Friedman, a public health researcher at the University of California, Los Angeles and lead author of the new study, said: “And now, for the first time, the crisis of overdose is reaching teens.”
Friedman and his colleagues found that the level of fatal overgrowth among adolescents nearly doubled from 492 in 2019 to 954 in 2020, an increase of 94%. There was an additional 20% increase in 2021 compared to the previous year. And the highest rates were among Native American and Alaskan Native teens, followed by Latino teens.
“It’s very worrying because what we’ve seen in other parts of the population is that when the death toll starts to rise, they continue for a while,” Friedman said. “So I would say that we are still in the early days of adolescent overdose. And that makes it a particularly important time to intervene.”
It has been shown that a large number of adolescents do not use drugs to increase mortality – substance use within this age group actually decreased during epidemics – but use the dangerous and extremely potent form of fentanyl. The study found that fentanyl-related deaths increased from 253 in 2019 to 680 the following year. And in 2021, fentanyl is involved in 77% of all adolescent overdose deaths.
However, in contrast to the overdose deaths in adults, it is not the fentanyl of heroin that is responsible for adolescent deaths, says Dr. Nora Volko, director of the National Institute on Drug Abuse, who was not involved in the new study.
“Teenagers don’t look for illegal opioids, [but] They look for prescription opioids and it is always one of their favorite drugs: vicodin, oxycontin, hydrocodone, “he says.” And they also look for benzodiazepines.
And they often buy counterfeit versions of these drugs – counterfeit that look like commonly used prescription drugs – that have become increasingly contaminated with fentanyl over the past few years.
“It is estimated that at least one-third of these illegally made pills are contaminated with fentanyl,” Volko said, something most teenagers and their families are unaware of.
“In the past, you just calmed down,” he added. “Now you can take a benzodiazepine, a pill and it can kill you.”
This means that occasional or recreational users may be at risk of death, said Sheila Bhakaria, deputy director of research and academic engagement at the Drug Policy Alliance.
That’s why teenagers need to be better educated about the risks of counterfeit pills and given the tools to help them use them safely, he says.
Friedman agrees: “It’s pretty clear teenagers don’t realize that many of the pills on the street right now are counterfeit. [and containing fentanyl]”
It is also important to educate them that not all drugs are equally dangerous, he added. “Of course alcohol and marijuana are not risk-free. But we know that drugs have never been found to be contaminated with fentanyl, where pills and powders are at high risk of contamination.”
Vakharia said it was important to give children more information about drug use.
“Many of our young people are so busy teaching non-drug use that when they come in contact with or are surrounded by it, they have very little information to keep themselves or their friends safe. They decide on drugs,” Says.
Vakharia and colleagues have developed a school curriculum called Safety First, which teaches young people about the risks of drug use and how to detect and deal with overdose symptoms.
Vakharia said a pilot study of the curriculum in schools across the country showed that the trainees knew the symptoms of overdose and how they could react to it.
He added that schools need to play an important role in tackling this, not only by adopting the curriculum developed by him and his colleagues, but also by making the easily available overdose drug naloxone available to their students.
“Naloxone … is an incredibly safe drug that we want to see in school first aid kits,” she says. “And training our young people about these drugs and using them for extra doses.”