Study points to dangers of pure fentanyl overdose deaths for U.S. youth Image By HPN Staff Key Points A Pediatrics study found a 168% increase in overdose deaths among people aged 15–24 caused by fentanyl alone, signaling a shift from mixed-drug overdoses to counterfeit pills made entirely of fentanyl. While overall U.S. drug overdose deaths fell by 27% in 2024, fentanyl’s growing role in counterfeit drugs means youth overdoses remain persistently high. Federal and state officials are urging expanded harm-reduction measures — including fentanyl test kits, naloxone distribution, and public awareness campaigns — to combat counterfeit pills marketed as legitimate prescriptions. Surprising new research suggests the danger of counterfeit drugs made purely of fentanyl is rising for the nation’s youth, even as the overall number of opioid overdose deaths has started to decline. In a study recently published in the journal Pediatrics, New York University’s Grossman School of Medicine examined five years of data on fatal youth overdoses to better understand the mix of drugs that were to blame. As expected, they found that synthetic opioids — primarily fentanyl — were often mixed in with other drugs, including prescription opioids, benzodiazepines, heroin, cocaine and other stimulants. But the researchers were shocked to discover a 168% increase in the number of fatalities involving pure fentanyl among young people aged 15 to 24. Why it matters “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,” said Assistant Professor Noa Krawczyk, Ph.D., one of the authors of the study. “Instead, we found the opposite — that most deaths were caused by fentanyl alone. Our analysis sheds light on the changing nature and risks of the drug supply and how they impact key demographic groups. Some may think they are taking one substance but are actually exposed to another.” The findings suggest that young people are at much higher risk, even as the total number of drug overdose deaths appears to be falling from its COVID-era highs. Overall, the U.S. Centers for Disease Control and Prevention (CDC) reported a 27% reduction in drug overdose deaths in 2024 and a 36% reduction in opioid-related deaths. Additional context “Youth overdose deaths have remained elevated in recent years as the illicit drug supply has become increasingly contaminated with fentanyl and other synthetics,” the study concluded. “There is a need to better understand fatal drug combinations and how trends have changed over time,” the researchers said. “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 bigger picture State and federal health officials are sounding the alarm over drugs containing illicit fentanyl, especially counterfeit versions of prescription pharmaceuticals. “Criminal drug networks are mass-producing fake pills, falsely marketing them as legitimate prescription pills,” the Texas Health and Human Services Commission is warning as part of its “One Pill Kills” campaign. “Some counterfeit pills are made to look like prescription opioids like oxycodone (OxyContin, Percocet), hydrocodone (Vicodin) and alprazolam (Xanax), or stimulants like amphetamines (Adderall).” Earlier this year, the federal Substance Abuse and Mental Health Services Administration (SAMHSA) released updated guidance for preventing fatal drug overdoses, including those caused by “illicitly manufactured fentanyl.” The guidance recommends that anonymous “drug checking” services — such as testing kits for fentanyl — should be made available at music festivals and other public events where drug users are likely to attend. Community organizations and public health officials should also make naloxone and other “opioid overdose reversal medications,” or OORMs, readily available.
