2023-12-10 15:48:06
In the United States, fatal overdoses are constantly increasing. Between May 2022 and May 2023, they cost the lives of more than 112,000 Americans, according to Centers for Disease Control and Preventionan increase of 37% compared to the period which extended from May 2019 to May 2020.
The vast majority of those who died were adults. However, there is an unprecedented increase in fatal overdoses among adolescents: the number of monthly deaths increased from 31 in July 2019 to 87 in May 2021 (the most recent period for which data is available).
As a researcher, I work on drug use. My work focuses on the specificities existing within different age groups. When we look at overdose deaths, we see significant differences between adolescents and adults, not only in terms of the types of drugs involved, but also in the gender of the users or ethnic origin.
Because of these differences, the groups that should be considered high risk are not the same among adolescents and adults. Strategies put in place to prevent overdoses must take this into account.
Who are the victims ?
When the Centers for Disease Control and Prevention (CDC) looked at data for American youth ages 10 to 19, they found that, as with adults, most teens who died from drug overdoses were of either gender. male. However, we also note that the proportion of young girls among these adolescent deaths is higher than the proportion of women in the adult age groups.
Among preteens and teens, more than two boys die from drug overdoses for every girl in this age group. Among adults, the ratio is more like three men for every two women.
The proportion of fatal overdoses among non-Hispanic Caucasian adolescents is significantly higher than among their non-Caucasian peers – even more so than among adults (from July 2019 to December 2021, of 2,231 adolescents who died by overdose, more than two thirds (69.0%) were male, and the majority were considered “non-Hispanic white” (59.9%), editor’s note.).
Fentanyl often involved
Another difference between adolescents and adults lies in the substances causing these fatal overdoses.
Among adults, users who use more than one drug are more likely to die from an overdose than those who use only one drug. The most commonly seen combinations involve fentanyl, a powerful opioid painkiller (opioids are substances with effects similar to those of opium, editor’s note). It is one of the most powerful opioids available: it is estimated to be approximately 100 times more potent than morphine, another very powerful opioid often used in hospital settings.
In misuse, fentanyl is often combined with either another opioid, such as a prescription-only medication, or a stimulant, such as cocaine or methamphetamine.
Among adolescents, the main cause of fatal overdoses is fentanyl alone: it is involved in 84% of them, and 56% of all overdoses involved this molecule alone.
Teens and preteens generally have little tolerance to opioids because they often have not been exposed to them before, and fentanyl’s high potency makes them more likely to overdose.
Many accidentally ingest fentanyl while taking counterfeit pills that they believe to be prescription opioids or stimulants. It also happens that these pills contain other illicit drugs, without them knowing it.
This finding is consistent with our research results, which indicate that misuse of prescription opioids decreased between 2015 and 2019 among adolescents and young adults. It’s also consistent with other data showing that deaths from overdoses involving heroin have also declined in recent years.
This unintentional use increases the risk of overdose because people who are unaware they are taking fentanyl are less likely to have naloxone, a drug used as an antidote to opioid overdoses, on hand. or test strips to detect fentanyl.
Read more: Do you know about naloxone, a powerful antidote for opioid overdoses?
Being prepared can, however, change the outcome of an overdose: the analysis of deaths occurring among adolescents has in fact shown that in 67% of cases a witness was present and could have intervened. Naloxone was administered in fewer than half of these cases, even though the substance prevents fentanyl and other opioids from causing an overdose by blocking access to opioid receptors in the brain.
Little or no history
Only one in ten adolescents who died of a drug overdose had a history of treatment for a substance use problem, and only one in seven had ever experienced a nonfatal overdose. Furthermore, adolescent victims of a fatal overdose generally did not have a problem with alcohol or other substances, premises which usually constitute risk factors and should generally raise alarms.
This finding highlights the importance for parents to discuss issues related to substance use with their children, from the age of 12. Expressing disapproval has been found to tend to prevent or delay drug taking. It is important to keep in mind, however, that it may be unrealistic, or even unhelpful, to hope that your children will never resort to any mind-altering substances – after all, most adults drink alcohol, at least occasionally.
As a parent, it may be wiser to emphasize to your children that at their age, the brain is still under construction and is therefore undergoing rapid and significant changes. Avoiding the use of drugs or alcohol during your youth therefore helps promote healthy brain development.
What else can we do?
It is important to have naloxone available. This potentially life-saving drug is easy to use, but the cost of its over-the-counter version, which in the United States can exceed $50 for two doses, makes it inaccessible to some of the people who need it most.
However, you should consider it as the equivalent of car insurance: you prefer to avoid having to resort to it, but it is important to take out one regardless, in case something goes wrong.
And even if one’s own child will never try any drugs, having naloxone on them might allow them to be able to intervene and save a friend who overdoses.
In this regard, everyone should be trained to recognize the symptoms of an opioid overdose: shallow breathing (small volumes of air are inhaled and exhaled, minimally inflating the lungs) or no breathing, difficulty remaining conscious, cold, clammy skin. Faced with such a situation, you must be ready to intervene quickly.
To conclude, one last point is particularly important to highlight: more than four out of ten adolescent victims of a fatal overdose had a history of mental health problems. This is consistent with our own work, which found a link between poorer mental health and opioid misuse among adolescents. This strong association between mental health problems and drug overdoses also exists among adults.
For this reason and many others, such as the increasing rates of depression among adolescents, I recommend that all adults (not only healthcare professionals, but also those who have preteens and teens among their loved ones) ), to remain attentive to the evolution of their mental health. And if you have the slightest doubt, recommend treatment if you are a caregiver, or consult a professional as soon as possible if you are not.
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