The findings in this report are subject to at least three limitations. First, analyses included 32 to 47 jurisdictions; results might not be generalizable to the entire United States or to other jurisdictions. Second, toxicology testing might differ over time and across jurisdictions; thus, emerging drugs, including new IMFs, might not have been identified. Finally, circumstances surrounding overdose deaths are likely underascertained because of limited investigative information.
Drug overdose deaths among adolescents increased substantially beginning in late 2019. Although deaths appear to have begun declining in late 2021, they are still alarmingly higher than in 2019. Urgent efforts to prevent overdose deaths among adolescents are needed and include 1) preventing substance use initiation and promoting protective factors; 2) strengthening partnerships between public health and public safety to reduce availability of illicit drugs; 3) expanding efforts focused on resilience and connectedness of adolescents to help prevent substance misuse and related harms; 4) educating about dangers of IMFs and counterfeit pills; 5) promoting safer drug use for those who use drugs, such as not using drugs while alone and having naloxone readily available; 6) expanding naloxone access and training family and friends in overdose recognition and response; and 7) ensuring access to effective, evidence-based substance use disorder and mental health treatment. Collaboration among public health and safety agencies, physicians, mental health and substance use treatment providers, and educators to implement these efforts could save lives.