Fentanyl is involved in at least 75% of adolescent overdose deaths,1 often because it is added into other drugs such as counterfeit pills. Rates of overdose mortality among adolescents doubled from 2019 to 2020 and have remained elevated since.1,2 As a result, drug overdoses are now the third leading cause of death among US youth.3 In 2023, an average of 21 US high school–aged youth died of an overdose each week, approximately the size of a typical high school classroom.1,4
Although public awareness is a central component of current strategies to prevent overdoses,5-9 the proportion of US adolescents who perceive great risk of harm from fentanyl use is not known. This study addresses this gap by presenting, to our knowledge, the first nationally representative estimates of perceived risk of fentanyl use among US 8th-, 10th-, and 12th-grade students. This information is important to assess whether additional public awareness efforts are needed, and to identify demographic groups that may warrant targeted prevention strategies going forward.
In this cross-sectional survey study of 3820 students in the 8th, 10th, and 12th grades, the majority (52.2%) of 8th-grade students did not attribute great risk to experimental use (1 or 2 times) and 33.5% did not attribute great risk to regular use. These percentages were significantly greater for older adolescents, although in the 12th grade 30.2% did not attribute great risk to experimental use and 15.2% did not attribute great risk to regular use.
Results of this study suggest that there is a need to inform adolescents about the lethal dangers of fentanyl use.
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