New JAMA Study Finds Spike in Teen Overdose Deaths Despite Low Rates of Drug Use

Today, the Journal of the American Medical Association released a research letter showing an alarming spike in teen overdose deaths between 2020 and 2021 after decades of low and stable rates. Conducted by Joseph Friedman and colleagues, the study found that among young people ages 14-18, the overdose death rate doubled between 2019 and 2020 and rose another 20% in the first half of 2021.

"This study shows us that fifty years into the war on drugs, punitive approaches are failing young people and their families, particularly racial and ethnic minorities," said Sheila Vakharia, PhD, Deputy Director of the Drug Policy Alliance's Department of Research and Academic Engagement. "Now more than ever, teens need reality-based drug education that teaches them how to keep themselves and others safe-when and should they encounter drugs-including access to harm reduction interventions such as naloxone, the opioid overdose reversal medication, and drug checking, which allows people to know if there is fentanyl in the drug supply. Minority youth need more access to evidence-based medications, like methadone and buprenorphine, which can cut the risk of overdose death in half."

Despite the increase in deaths, rates of drug use among teens remains at an all-time low, suggesting that an increasingly adulterated drug supply is the cause. Drug use is becoming more dangerous, not more common. The authors found that the increase in deaths was almost entirely driven by illicitly-produced fentanyl and its analogs, potent opioids that are mixed into many drugs, including counterfeit pills.

The study also found alarming racial disparities in youth overdose death rates. The overdose death rate among Indigenous youth increased by 50% between 2020 and 2021, and they have had the highest overall overdose rate among all youth since 2010. Meanwhile, the overdose death rate among Latinx youth rose by 30% between 2020 and 2021, and they had the second highest rates of overdose deaths since 2019.

The Drug Policy Alliance developed Safety First, the nation's first harm reduction-based drug education curriculum for high school students. A harm reduction approach to drug education discourages young people from using alcohol and other drugs, but also provides teenagers with information to keep themselves and others safe if and when they encounter these substances. Safety First has been independently evaluated as effective, has seen over 4,000 downloads, and is now actively used in an ever-growing number of schools across the U.S.