The United States is experiencing a troubling rise in overdose deaths among young individuals, primarily linked to synthetic opioids.
According to the US Centers for Disease Control and Prevention, the number of drug overdose deaths from synthetic opioids, particularly fentanyl and its analogs, increased more than 20-fold from 2013 to 2022.
These overdoses are now the third leading cause of death for those under 20, following fatalities from firearms and car accidents.
A recent study published in Pediatrics noted that overdose deaths among US youth aged 15 to 24 climbed from 4,652 in 2018 to 6,723 by 2022. There was a slight decrease in this figure from 2021 to 2022.
The sharpest rise was observed in fatalities involving solely synthetic opioids; since 2020, deaths attributed to these substances surpassed those caused by overdoses of multiple substances. Additionally, male youths are nearly 2.5 times more likely to overdose than their female counterparts, and those aged 20 to 24 are over twice as likely to be affected compared to 15 to 19-year-olds.
As a concerned parent, I found myself questioning the nature of synthetic opioids—why are they so perilous? What measures are available for treating overdoses? How can individuals determine if the substances they are using contain these opioids? And importantly, what can families do to mitigate the possibility of an overdose?
To delve deeper into these concerns, I reached out to Dr. Leana Wen, an expert on wellness, who has extensive experience as an emergency physician and has previously served as Baltimore’s health commissioner overseeing opioid prevention strategies.
CNN: What are synthetic opioids and their uses?
Dr. Leana Wen: Prescription opioids are intended for managing severe pain but should be administered cautiously. When taken inappropriately—whether in excess or without proper guidance—they can lead to serious side effects, including respiratory issues and even death.
Opioids can be categorized based on their origin. Natural opioids come from the poppy plant, like morphine and codeine. Semisynthetic opioids include substances such as oxycodone and hydrocodone, while synthetic opioids are artificially manufactured.
Fentanyl is the synthetic opioid most frequently associated with lethal overdoses, according to the National Institute on Drug Abuse. There are also others, including tramadol and methadone, the latter of which is sometimes utilized to treat opioid use disorders. It’s essential to note that CDC statistics and the recent Pediatrics study do not factor methadone into their overdose rates for synthetic opioids. Most of the synthetic opioid overdose deaths in the US involve fentanyl or its derivatives.
CNN: Does fentanyl have legitimate medical uses?
Wen: Yes. Fentanyl is often deployed in emergency environments for acute pain relief. It’s crucial for individuals who, say, have sustained serious injuries in a car accident. Some cancer patients experiencing unmanageable pain may rely on fentanyl in the form of patches or lozenges.
The recent surge in youth overdoses isn’t largely attributed to fentanyl being misappropriated from medical sources. The current issue stems from illegal production of fentanyl in illicit laboratories.
Fentanyl is commonly sold illegally in various forms, such as powders, droppers, nasal sprays, and even counterfeit pills that mimic legitimate prescriptions.
Moreover, fentanyl is frequently mixed with other drugs. Many individuals unknowingly consume it while believing they’re taking substances like amphetamines, cocaine, or ecstasy. Depending on the amount of fentanyl ingested, this can lead to fatal overdoses.
CNN: Why is fentanyl particularly dangerous?
Wen: Fentanyl is an extraordinarily potent opioid—50 to 100 times more powerful than morphine. Even a tiny quantity can result in oversedation and potential death. Many users might not realize they are taking fentanyl or misjudge its danger. Tragically, numerous high school and college-age individuals have lost their lives after consuming fentanyl-laced pills.
CNN: How are overdoses managed?
Wen: Opioid overdoses are typically addressed with naloxone, which is often branded as Narcan. It’s available as a nasal spray and injection and can be found over the counter for less than $50. Some health insurance policies may cover it, while certain health departments may provide it for free. Administering naloxone soon after someone becomes unconscious can reverse the overdose and save lives.
Those who regain consciousness after receiving naloxone should still seek medical help. They may require further doses and treatment for any other potentially dangerous substances in their system.
CNN: How can people identify if their drugs contain synthetic opioids?
Wen: This is a crucial point—it’s quite challenging for individuals to determine if their drugs contain fentanyl. Counterfeit medications can closely mimic genuine prescriptions. Furthermore, it’s impossible to discern fentanyl’s presence visually, as it is colorless and odorless.
Fentanyl test strips can be utilized to verify if fentanyl is in a drug supply. However, while these strips may lower overdose risks, a negative result on one pill does not guarantee that others are safe. Additionally, these strips do not detect other potentially harmful contaminants.
I want to highlight that among the counterfeit prescription pills tested by the US Drug Enforcement Administration in 2022, 6 out of 10 contained a probable lethal dose of fentanyl. This alarming statistic serves as a warning against using counterfeit medications or illegal substances.
CNN: What can parents and family members do to minimize overdose risks?
Wen: Parents should initiate discussions with their children about the hazards of counterfeit and illegal drugs. It doesn’t matter if they experimented with drugs in their youth; today’s substances are much more potent and hazardous.
No one should consume medications not prescribed to them. They cannot be sure of the source, the drug’s integrity, or if it contains drugs like fentanyl, which can have deadly consequences.
I also believe it’s wise to keep naloxone readily available. As mentioned, it’s accessible over the counter, and anyone can learn how to use it effectively.
