Over the last 10 years, the number of annual teen deaths from drug overdoses more than doubled. The increase is not coming from more teens using drugs, but rather from drug use becoming more dangerous. In 2021, fentanyl was involved in more than 77% of adolescent overdose deaths. In addition, the Office of National Drug Control Policy just declared an “emerging threat” about another drug that has increasingly been mixed with fentanyl in the illicit drug market. Xylazine has been linked to a rising number of overdose deaths across the nation. About 150 people each day die from fentanyl or xylazine overdoses, most of which are unintentional and accidental overdoses.

Fentanyl is a synthetic opioid that is 100 times more powerful than morphine. It’s an inexpensive way for drug cartels to offer a more powerful high by mixing it with other substances like cocaine, heroin or illegally manufactured pills made to look like a legitimate prescription medication. Because it’s so potent, it can cause respiratory depression resulting in death.

Xylazine, also called “tranq,” is a powerful large animal tranquilizer and is not approved for human use. Ingesting xylazine can cause drowsiness and amnesia and also slows heart rate, breathing and blood pressure to dangerously low levels. Injecting xylazine can cause flesh wounds, including blackened, rotting tissue that, if left untreated, can result in amputation.

These drugs are widely available in many forms. Fentanyl or fentanyl-laced substances are typically sold online via eCommerce websites, social media like Snapchat or through friends. They can be found as nasal sprays, as a powder, on blotter paper and as pills that are made to look like prescription medications.  In addition, because these drugs are made on the black market, the levels of fentanyl and xylazine can vary widely from pill to pill so that people taking them have no real way to know what they are getting. This variability can mean that while one pill may be taken with very little consequence, the next pill could contain much more fentanyl and be deadly. 

My teen doesn’t use drugs, so why should I be concerned?

While it’s obvious that anyone deciding to recreationally abuse substances is at risk from these trends, some parents who have high achieving kids with no history of drug abuse might think they are in the clear. Unfortunately, the risk to all teens is very real. Many achievement-oriented high school and college students have been known to try to purchase prescription drugs, such as Ritalin, Adderall or Xanax under the false impression that these drugs will help them learn quicker, focus better, and provide extra energy to study longer. Teens tend to think these medications are safe to use because they are prescribed by doctors. Unfortunately, what they think are legitimate prescription pills are actually drugs that were made in the underground market and pressed to look real. Counterfeits are laced with fentanyl and sometimes xylazine, packaged to look near identical to legitimate medicines, and sold through social media referrals to teens who are unaware of the risks they pose. Over the last few years, medical professionals have noted that the majority of individuals who are victims of this overdose had no idea that fentanyl was in what they took.

How do I talk to my teen about fentanyl?

Experts advise parents to revise their drug talks. It’s good to begin by asking our kids what they know, and what they believe, and make sure that we really listen to them with a great deal of patience. In addition, discuss the following:

• Give your teens the facts about prescription stimulants so they are not tempted to use them to improve their grades. While ADHD medications do promote wakefulness, studies have found that they do not enhance learning or thinking ability. Research also shows that students who abuse prescription stimulants have lower GPAs in high school and college than those who don’t.
• Debunk the myth that prescription medications are a “safer” way to get high or improve academic performance.
• Give them the information in the beginning of this article about fentanyl or xylazine, so that they are aware of the dangers of purchasing drugs.
• Teach your teen the signs of a fentanyl overdose. An individual’s speech will be slurred and they may have difficulty standing up and/or staying awake. If a young person becomes unresponsive, or has irregular breathing, it’s important to call 911 immediately.
• Discuss naloxone, which is an opioid reversal agent that, for a brief period of time, reverses overdose. However, let your teen know that it only buys time for emergency responders to arrive; it does not stop the overdose. Also, because xylazine is not an opioid, naloxone does not help in the event of an overdose with this drug.

Some families of adolescents fear that honest conversations about safe practices to reduce overdose deaths could open the door for teens to begin using, but experts say this is untrue. According to the Partnership for a Drug-Free America, teens are 50% less likely to use drugs if they learn about the risks of drug use from their parents. It’s important for trustworthy adults to provide teens with factual information. The facts both empower adolescents to make smarter decisions and give them the message that their families are open to answering their questions and providing assistance when they need it.

What other actions can I take to prevent substance abuse in my family?

• Be engaged in your children’s lives. Have regular conversations with your teen about their life. Ask them questions and listen without judgment. Attend their activities. Become more knowledgeable on subjects that interest your teen. Schedule family time to connect.
• Monitor your teen’s whereabouts and get to know their friends and their friends’ parents.
• Understand when and why teens are bored and provide alternative activities during those times.
• If your teen is prescribed opioids for pain, ask your doctor about alternative pain relievers. Many times, a larger dose of Advil can alleviate pain after surgery or dental work without the risk of addiction. If they must take an opioid, make sure that you personally administer the pills.
• Store medicine safely. If anyone in your household is prescribed a medication that is commonly abused, keep it locked up in a cabinet or safe box. This simply removes the temptation that any teen – yours or friends that visit – might feel.
• Role model healthy prescription use. Make it clear that everyone should only take medications prescribed to them and discuss the importance of taking medication according to the prescription label, and then, follow through on your words.
• Know and be alert for drug abuse warning signs. Pay attention to your teen’s mood, behavior and social circles. Sudden changes should be met with curiosity and not criticism. 
• Teach teens healthy coping mechanisms. Teens are vulnerable to trying drugs when they are stressed out. Be sensitive to your teen’s stress level and teach your child positive coping skills, such as those identified in our earlier blog Developing Coping Skills in Teens.
• Seek professional help for mental health problems. Teens who are struggling with mental health issues, like anxiety or depression, are more vulnerable to turn to drug abuse to cope. If you suspect your teen has a mental health issue, seek professional help immediately.