Teenage drug and alcohol use is on the decline and, for the primary time in recent times, drug overdose deaths amongst teenagers have barely decreased. Adolescent overdose fatalities first spiked with the onset of the pandemic, almost doubling from 282 deaths in 2019 to 546 deaths in 2020. These deaths decreased from 721 in 2022 to 708 in 2023, a small discount that marked a plateau and probably the beginning of a decline in adolescent overdose deaths. Whereas it’s too early to find out what the route of overdose deaths could also be, components that will have contributed to the small decline embody a lower in pandemic-related stressors together with insurance policies geared toward lowering overdose deaths. Via the Biden-Harris Administration, naloxone was made out there over-the-counter, entry to substance use remedy and schooling was expanded, together with in faculties, and the Youngsters On-line Well being and Security Process Drive was launched, which goals to forestall teenagers from buying medication by way of social media. With the 2024 Presidential election approaching and each candidates’ plans to deal with the youth drug disaster differing broadly, future coverage efforts will rely on election outcomes.
This problem transient analyzes CDC WONDER information – together with provisional information from 2023 – and information from nationwide surveys of adolescent youth to spotlight developments in substance use and overdose deaths. It explores how and the place youngsters obtain substance use data and remedy and the way faculty settings might be leveraged to boost prevention measures. Lastly, it examines federal and state prevention efforts and social media’s function within the drug disaster.
How have substance use and associated deaths amongst adolescents modified in recent times?
Adolescent drug fatalities greater than doubled in recent times – primarily because of opioids – however barely decreased by the top of 2023. There have been 708 adolescents drug fatalities in 2023, in comparison with 721 in 2022 (Determine 1). Moreover, a latest KFF evaluation discovered that opioid-related deaths amongst adolescents decreased within the second half of 2023. Though these findings signify the primary lower in drug overdose fatalities in recent times, they continue to be greater than twice as excessive because the variety of adolescent overdose fatalities previous to the pandemic (708 deaths in 2023 vs. 282 deaths in 2019, Determine 1).
Fentanyl overdose deaths elevated by 2% from 2022 to 2023, marking the smallest annual improve in fentanyl deaths amongst adolescents for the reason that pandemic started. The artificial opioid, fentanyl, has largely pushed the rise in adolescent drug fatalities for the reason that pandemic started. Within the first yr of the pandemic, adolescent overdose deaths involving fentanyl elevated by 177% (from 128 deaths in 2019 to 354 in 2020, Determine 1). Whereas these deaths stay increased than pre-pandemic ranges, the rise slowed to 2% from 2022 to 2023 (527 and 539 deaths, respectively).
The share of all drug overdose deaths that concerned fentanyl elevated quicker amongst adolescents than adults in recent times (Determine 2). Fentanyl deaths as a share of all adolescent drug overdose deaths elevated considerably from 32% in 2018 to 65% in 2020. This improve marked the primary time the share of drug fatalities involving fentanyl was increased amongst adolescents than adults (65% vs 62% in 2020). This hole has continued to slowly widen – in 2023, 76% and 69% of adolescent and grownup drug fatalities concerned fentanyl, respectively. Whereas the share of fentanyl deaths elevated extra amongst adolescents than adults over time, the quantity and charges of those deaths stays a lot decrease amongst adolescents in comparison with adults (539 vs. 72,000 deaths; and a couple of.1 vs. 27.6 deaths per 100,000 in 2023).
Adolescents might receive medication by social media, and these medication are sometimes contaminated with fentanyl. In 2023, seven out of each ten counterfeit opioid drugs have been discovered by the Drug Enforcement Administration to comprise a doubtlessly lethal dose of the drug. Fentanyl is exceedingly deadly and is commonly used to lace medication as a result of it’s low-cost and extremely potent. With the onset of the pandemic, fentanyl unfold rapidly into drug provides and is commonly trafficked by U.S. residents (though misinformation incorrectly hyperlinks the unfold of fentanyl to undocumented immigrants). Adolescent fentanyl overdoses are regarded as principally unintentional, as teenagers seek for prescription opioids or different medication, both for leisure or self-medication functions, however as a substitute encounter fentanyl-contaminated drugs. Adolescents might purchase medication by social media platforms, that are often scrutinized for missing regulation round unlawful drug gross sales. The Nationwide Crime Prevention Council estimates that eight in ten teen and younger grownup fentanyl overdose deaths are related to social media contact.
Regardless of the rise in drug overdose deaths amongst adolescents in recent times, their use of medication and alcohol has barely declined (Determine 3). In 2023, 10% of highschool college students reported ever utilizing choose illicit medication, together with cocaine, heroin, inhalants, methamphetamines, ecstasy, or hallucinogens, a slight lower from 2017 (13%). Declines have been additionally reported in opioid misuse (14% vs. 12%) and present alcohol use (30% vs. 22%) amongst highschool college students throughout the identical interval. Marijuana use has fluctuated, however finally decreased barely since 2017 (20% vs. 17% in 2023). Nevertheless, adolescent marijuana use could also be linked to the onset of psychotic issues, together with melancholy and suicidality. Amongst highschool college students, the usage of e-cigarettes declined from 14% in 2022 to 10% in 2023, though e-cigarettes stay probably the most usually used tobacco product amongst this inhabitants in recent times. Elements that will have contributed to the general decline in substance use amongst adolescents embody public schooling initiatives and earlier intervention.
As adolescent substance use and associated deaths confirmed slight indicators of enchancment in 2023, so did adolescent psychological well being. The share of highschool college students reporting emotions of unhappiness and hopelessness – which might be indicative of depressive dysfunction – elevated from 30% in 2013 to 42% in 2021, earlier than barely declining to 40% in 2023. The co-occurrence of poor psychological well being and substance use is frequent, with one in 5 youth who had a significant depressive episode within the final yr additionally having a substance use dysfunction. In a latest, CDC comfort pattern survey of teenagers (ages 13 to 18) who used substances within the final 30 days, many youngsters reported utilizing substances to deal with damaging feelings. Though it’s too early to know whether or not adolescent substance use and poor psychological well being will proceed to say no, efforts to determine and harness the driving components behind this modification might assist proceed the downward pattern.
How and the place do adolescents obtain substance use messaging and remedy?
Greater than 6 in 10 adolescents report receiving data on drug and alcohol use dysfunction and prevention in class (Determine 4). This data is disseminated in a number of types, together with particular substance use schooling courses, substance use-related movies, lectures, and discussions outdoors of sophistication, or substance use curricula built-in into well being or bodily schooling courses. An analogous share of adolescents (63%) seen messaging on substance use prevention outdoors of faculties, whereas roughly half spoke with their dad and mom on substance use harms (51%), and a small share participated in prevention applications outdoors of faculty settings (7%).
In 2023, solely 2 out of 10 adolescents with a substance use dysfunction acquired remedy up to now yr. In 2023, 8.5% of adolescents (or 2.2 million) had a substance use dysfunction up to now yr. Amongst these adolescents, 19.3% (or 423,000) acquired substance use dysfunction remedy up to now yr.
Adolescents face quite a few limitations to substance use remedy, together with restricted entry to residential remedy services and buprenorphine. Among the many whole adolescent inhabitants, remedy for any substance use problem was extra generally acquired in an outpatient setting (3.3%) (i.e. at a medical clinic, physician’s workplace, or therapist’s workplace), adopted by an inpatient setting (1.4%) (i.e. at a hospital or residential remedy heart) in 2023. Many residential habit remedy services don’t settle for adolescent sufferers, and amongst services that do, beds is probably not instantly out there. The variety of remedy services by state varies tremendously, as do prices. Moreover, few services present buprenorphine, a drugs that may scale back withdrawal signs and cravings, to adolescents with opioid use dysfunction or discontinue it previous to discharge. Buprenorphine, a regular remedy for opioid use dysfunction is just not authorized to be used by these below the age of 16, although it is suggested by the Society for Adolescent Well being and Drugs. Nonetheless, some pediatricians really feel uncomfortable prescribing it to adolescent sufferers.
Which efforts have been carried out in response to the adolescent drug disaster?
Latest federal efforts, together with proposed bipartisan laws, purpose to strengthen youth substance use prevention applications in faculties. The bipartisan Preserving Medicine Out of Faculties Act was lately launched, requesting federal authorization of seven million {dollars} per yr over 5 years for elementary, center, and excessive faculties to enhance their drug prevention applications. The Biden-Harris administration additionally continues to reply to the youth drug disaster, most lately by allocating $94 million to group efforts to forestall youth overdoses by way of the Drug Free Communities Help Program, an initiative that usually entails partnering with faculty districts to scale back youth substance use. Additional, the Biden-Harris administration’s Safer Communities Act facilitated expansions of behavioral well being providers in faculties by Medicaid sources.
Many states have insurance policies permitting faculties to inventory naloxone (the opioid overdose reversal drug), an effort that’s supported by the Biden-Harris administration, American Medical Affiliation, and Nationwide Affiliation of College Nurses. Most states have handed legal guidelines explicitly permitting faculties to inventory, naloxone, however only some states, together with Rhode Island and Washington, require it. Moreover, as of 2023, simply over half of the nation’s largest faculty districts reported they mandate stocking naloxone. A number of faculty districts, together with, most lately, Virginia’s Loudon County College Board, have proposed or handed insurance policies permitting college students to hold and administer naloxone at college, after assembly sure necessities comparable to finishing overdose-recognition coaching and acquiring written permission from their guardians. Some states, comparable to Washington and Oregon, have additionally handed laws that integrates fentanyl schooling into faculty curricula. Amongst faculties that don’t inventory naloxone, some fear that doing so will impression their picture and label the college as having a drug drawback, whereas others imagine that there are simpler makes use of for restricted faculty funds, as faculties are pretty low frequency overdose areas.
Exterior of faculties, federal and state lawmakers are trying to deal with adolescent substance use by on-line security laws. On the federal stage, accompanied by the Surgeon Normal’s advisory on social media and youth psychological well being, the Biden-Harris Administration introduced the Youngsters On-line Well being and Security Process Drive, which goals to boost the well being and security of kids on the web. Equally, the Youngsters On-line Security Act, a invoice designed to extend regulation and accountability for social media corporations, has been handed by the Senate, and President Biden said he’ll signal it if it passes the Home. Moreover, senators have launched bipartisan laws that goals to guard the privateness and wellbeing of kids on-line. A number of states have launched laws centered on media literacy, age verification, and the web distribution of managed substances. Social media platforms are dealing with strain from dad and mom and lawmakers alike to extend regulation and to forestall on-line drug gross sales. These tech corporations are protected by Part 230 of the Communications Decency Act, which states that they aren’t accountable for materials posted on their platforms by third events. In July of 2024, the Supreme Courtroom turned away a case that will have warranted an intensive assessment of Part 230, thereby preserving the immunity of those social platforms. With mounting strain, some social media corporations are creating security options to guard younger customers, together with Meta’s lately introduced Teen Accounts function.
