![]() Educating adolescents on mitigating practices can also be beneficial, including emphasis on not initiating drug use, not using drugs while alone, using fentanyl test strips, ¶¶¶¶ and having naloxone readily available for rapid use.Īpproximately 41% of decedents had evidence of mental health conditions or treatment mental health conditions are known risk factors for substance use. ![]() Educating family and friends to recognize warning signs of drug use, effectively respond to overdose, and monitor adolescents exhibiting risk behaviors associated with drug use might improve bystander response and prevent deaths. In addition, 30% of deaths had evidence that naloxone was administered, suggesting that naloxone might not have been administered soon enough or at a sufficient dosage, or its effectiveness was affected by polydrug use. Although nearly all deaths involved opioids, just 35% of decedents had documented opioid use history, suggesting recent initiation or lack of awareness by family and friends. However, bystanders responded infrequently to the overdose because they were spatially separated (e.g., in another room) or were not aware that the decedent used drugs. Potential bystanders were present during two thirds of overdose deaths among adolescents a majority of deaths occurred at home, where bystanders were often family or friends. Local public health and safety officials should consider issuing warnings regarding counterfeit pills and IMFs to schools, and parents and guardians. ![]() Regardless, messages that highlight the potential presence of illicit drugs in pills and emphasize that pills should only be used if they are prescribed are important to include in prevention materials for adolescents. The proliferation of counterfeit pills is particularly concerning for adolescents given marketing aimed toward this population and the availability of such pills via social media.**** ,†††† Whether adolescents intended to take legitimate pharmaceutical medications or were aware pills were counterfeit is unclear. ¶¶¶ This percentage is likely underestimated because pills found at scenes were rarely noted as having been tested, and identifying pills as counterfeit based on appearance alone is challenging. §§§Īpproximately 25% of adolescent deaths had evidence of counterfeit pills, which often mimic the appearance of oxycodone or alprazolam but frequently contain IMFs or other illicit drugs. ![]() Community-based coalitions, in collaboration with public health entities, can work with schools, physicians, youth-serving organizations, faith-based institutions, and the media to emphasize these messages, support naloxone training and access, and address stigma. Overdose prevention messaging aimed toward adolescents that highlights the dangers of IMFs and co-use of opioids and stimulants, and the expansion of naloxone access and training, are essential. In 2021, among the general population, 73% of overdose deaths involved IMFs among adolescents, a higher proportion (84%) involved IMFs, nearly all involved an opioid, and approximately 20% involved both IMFs and stimulants. This increase occurred in the context of decreasing illicit drug use among adolescents during 2019–2020, suggesting that more potent drugs rather than increased use accounted for the increase. From July–December 2019 to July–December 2021, median monthly overdose deaths among adolescents increased 109%.
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