09-06-2025
Youth Overdose Deaths From Synthetic Opioids Surge
While youth overdose deaths from any substance rose by 40% between 2018 and 2022, deaths involving only synthetic opioids, such as fentanyl, increased by 168% and surpassed deaths from polydrug combinations, a new study showed.
METHODOLOGY:
The National Center for Health Statistics, National Vital Statistics System, and Multiple Cause of Death datasets were used to examine trends in overdose deaths among US youth aged 15-24 years from 2018 to 2022 across ages, sexes, races and ethnicities, and regions.
Researchers identified drug poisoning deaths through the International Statistical Classification of Diseases and Related Health Problems, 10th Revision .
. Fatal overdoses involving synthetic opioids alone or in combination with benzodiazepines, cocaine, heroin, prescription opioids, and other stimulants were analyzed using multiple/contributing cause of death fields.
Investigators calculated the prevalence and rates of overdose per 100,000 youth using annual US Census Bureau population estimates by race and ethnicity.
TAKEAWAY:
Youth overdose deaths from any substance increased from 4652 to 6723 (10.9 to 15.2 per 100,000 people) between 2018 and 2022. Fatal overdoses involving only synthetic opioids increased from 1.6 to 4.3 deaths per 100,000 youth over the same period, whereas deaths involving synthetic opioids and heroin decreased by 85%.
In 2022, males had 2.5 times the rate of fatal overdoses involving synthetic opioids alone compared to females (95% CI, 2.3-2.8), with both sexes showing similar increases over the study period.
By 2022, fatal overdoses involving only synthetic opioids among American Indian/Alaska Native non-Hispanic youth increased to 2.3 times the rate compared to White non-Hispanic youth (95% CI, 1.6-3.1).
The highest annual changes in rate of overdose deaths involved synthetic opioids and other stimulants (incidence rate ratio [IRR], 1.5; 95% CI, 1.3-1.7), synthetic opioids only (IRR, 1.3; 95% CI, 1.1-1.4), and synthetic opioids and cocaine (IRR, 1.2; 95% CI, 1.2-1.3).
IN PRACTICE:
'Before we looked at the data, we thought we would find that the majority of fatal youth overdoses involved fentanyl combined with other substances, such as prescription opioids or cocaine. Instead, we found the opposite — that most deaths were caused by fentanyl alone,' study co-investigator Noa Krawczyk, PhD, New York University Grossman School of Medicine, New York City, said in a press release.
'These findings highlight the changing risks of the drug supply and the need for better access to harm-reduction services to prevent deaths among youth,' the investigators wrote.
SOURCE:
This study was led by Megan Miller, MPH, Department of Population Health, New York University Grossman School of Medicine, New York City. It was published online on May 20 in Pediatrics .
LIMITATIONS:
This study was limited by potential residual misclassification in mortality coding practices, small sample sizes for examining youth who identify as more than one race, and lack of information about sexual orientation.
DISCLOSURES:
This study was supported by the National Institute on Drug Abuse. Krawczyk reported receiving compensation for expert witness testimony as a part of ongoing opioid litigation. The other investigators reported having no relevant financial disclosures.
