Fentanyl Crisis and Narcan Overdose Prevention Guide for Families and Communities

The opioid epidemic continues to devastate communities across the United States. Provisional data for 2024 released in 2025 by the Centers for Disease Control and Prevention’s (CDC) National Vital Statistics System predicts a decline in drug overdose deaths compared to previous years. Yet the numbers remain alarmingly high, with about 87,000 overdose deaths recorded between November 2023 and November 2024, the most recent 12-month period for which data was available.

Synthetic opioids are a major contributor to the opioid crisis. Among these substances, fentanyl—a prescription drug developed for severe pain management—is up to 100 times more potent than morphine and has become a leading cause of overdose deaths. Just two milligrams of fentanyl can be fatal, and its growing presence in counterfeit pills has made unintentional exposure a deadly risk, especially to tweens and teens who find them readily available online.

In 2023, more than 70% of drug overdoses in the nation were linked to illegally manufactured fentanyls (IMFs), including the re-emergence of carfentanyl, an especially potent fentanyl analog. As the fentanyl crisis continues to escalate, families, schools and communities grapple with how to respond and protect young people effectively. The potency of synthetic opioids, combined with their widespread availability, demands persistent public health outreach and education.

This national resource guide provides a comprehensive overview of the fentanyl crisis and outlines actionable steps for overdose prevention and response. It’s designed to help families, school officials and peers recognize the dangers of fentanyl use and educate themselves and others on how to act quickly in an emergency. It also calls on healthcare providers, public health leaders, policymakers and community organizations to support education efforts, improve access to lifesaving resources and strengthen outreach at every level.

Fentanyl is a fully synthetic opioid, meaning it isn’t made from the opium poppy plant but in a laboratory. It was first synthesized by Belgian chemist Paul Janssen and introduced to the medical market in the 1960s. Fentanyl is a rapid-onset opioid that effectively manages severe pain, producing relief within 1 to 15 minutes, depending on the route of administration.

As an analgesic, fentanyl is about 50 times stronger than heroin and 100 times more potent than morphine. Due to its strength, the drug was rarely used initially except in hospital operating rooms. It was first used as an intravenous analgesic in Europe in 1963 and in the United States in 1968. Over time, fentanyl has become one of the most widely used analgesic opioids worldwide and is now administered in several ways.

Approved by the Food and Drug Administration (FDA), prescription fentanyl is used under strict medical supervision for treating severe pain, particularly in cancer and post-operative patients. Pharmaceutical fentanyl is available under several trade names and delivery systems, including:

• Abstral® (sublingual tablets held under the tongue)
• Actiq® (lozenges)
• Duragesic® (transdermal patches)
• Fentora™ (effervescent buccal tablets held inside the cheek)
• Lazanda® (nasal spray)
• Sublimaze® (injectable solution)
• Subsys™ (sublingual spray used under the tongue)

While medically prescribed fentanyl serves a legitimate role, illicit production has fueled a national crisis. Illegal laboratories began producing fentanyl and its analogs in 1979 for illicit drug sales. By 2010, illegal production became a growing threat, and by 2013, illegally manufactured fentanyl (IMFs) and fentanyl analogs had flooded the U.S. drug supply. These drugs initially acted as a replacement for white powder heroin, but IMFs eventually became the dominant illicit opioid nationwide.

Unlike regulated pharmaceutical fentanyl, illicit forms are unmonitored and often mixed with other substances, dramatically increasing overdose risks. IMFs are frequently trafficked into the U.S. from foreign labs, making them dangerously accessible, especially to teens and young adults who may not realize the drugs they’re using are counterfeit or laced.

Fentanyl analogs, including fentanyl-laced heroin, have many street names such as Apache, Chiclets, China Girl, China Town, Dance Fever, Friend, Goodfella, Great Bear, He-Man, Jackpot, King Ivory, Murder 8, Perc-O-Pops, Poison, Redrum, Tango and Cash, TNT, White China and white heroin, among others. The massive variety of fentanyl-laced drugs and analogs makes accurately reporting deaths caused by fentanyl overdose challenging.

From 1999 to 2020, drug overdose deaths in the U.S. more than quadrupled. A fentanyl-fueled opioid crisis sparked an increase in deaths between 2014 and 2018. The drug’s extreme potency and unpredictable presence in street drugs contributed to the significant increase.

Fentanyl’s presence in counterfeit drugs makes it especially dangerous to adolescents who may experiment with what they believe are legitimate prescription pills. Again, the potency of fentanyl can make even minuscule amounts lethal, especially if you’re unaware you’re consuming it.

Fentanyl-laced drugs have become common because very small amounts of fentanyl can produce a high, making it a cheaper option. Combining it with other drugs enhances the effects or mimics more expensive substances, making it more profitable for drug traffickers. Fentanyl is often found in fake pills made to look like oxycodone, Xanax or other medications. In 2023, the U.S. Drug Enforcement Agency (DEA) forensic laboratory determined that 7 out of 10 fake pills laced with fentanyl contained a potentially lethal amount of the drug. It has also been found in heroin, cocaine, MDMA (ecstasy) and methamphetamine.

Illicit fentanyl may be smoked, snorted, ingested or injected. Fentanyl powder can be particularly hazardous due to its high potency and difficulty in measuring safe doses. Even accidental exposure through skin contact or inhalation could cause ill effects, but the possibility of overdose is unlikely. However, caution is still advised when handling suspected fentanyl exposures.

An especially dangerous fentanyl analog is carfentanyl, also called carfentanil. The National Institute on Drug Abuse (NIDA) states that carfentanyl is about 100 times stronger than fentanyl and 10,000 times more potent than morphine, making it one of the most potent synthetic opioids used commercially. Originally developed as a tranquilizer for large animals like elephants, carfentanyl isn’t approved for human use. Yet it has increasingly appeared in the illicit drug market, further contributing to overdose deaths.

In November 2024, the U.S. Food and Drug Administration (FDA) estimated that 5.7 million people nationwide, ages 12 and older, were affected by opioid use disorder (OUD). OUD encompasses the misuse of prescription pain relievers, such as fentanyl, as well as illicit opioids like heroin and intravenous fentanyl. The rates of OUD may also be referred to as opioid addiction rates.

While the Substance Abuse and Mental Health Services Administration (SAMHSA) didn’t yet have 2024 fentanyl statistics as of early 2025, it had released its 2023 National Survey on Drug Use and Health (NSDUH) data. This data indicated that 828,000 individuals aged 12 or older misused fentanyl in the past year and 627,000 people used IMFs. However, estimates of IMF use were noted as almost certainly underestimated, as many people are unaware that they’ve used it.

While misuse isn’t the same as clinical addiction, frequent fentanyl misuse carries an exceptionally high risk of dependence and development of a formal OUD, due to the drug’s potency and rapid action on opioid receptors. Potency and lack of oversight in the illicit fentanyl trade also increase the likelihood of fentanyl overdose deaths.

SAMHSA’s comparison of 2022 and 2023 NSDUHs found that opioid and fentanyl misuse had declined, but not by much. While 3.2% of people aged 12 or older misused opioids in 2022, the percentage dropped slightly to 3.1% in 2023.

Likewise, fentanyl misuse among those aged 12 or older dropped from 0.4% in 2022 to 0.3% in 2023. However, of the 991,000 people who misused fentanyl in 2022, about 686,000 used illegally made fentanyl, or about 69%. In comparison, about 627,000 of the 828,000 people who misused fentanyl in 2023 used IMFs, or 76%. This difference demonstrates the rising number of people turning to illegally made fentanyl over prescription fentanyl.

Based on 2023 NSDUH data, of the 828,000 individuals who misused fentanyl, the estimated numbers by age group included:

• 50,000 adolescents (12 to 17 years old)
• 110,000 young adults (18 to 25 years old)
• 668,000 adults (26 years old or older)

Of the estimated 627,000 who used IMFs, the numbers by age group included:

• 36,000 adolescents (12 to 17 years old)
• 78,000 young adults (12 to 17 years old)
• 513,000 adults (12 to 17 years old)

In both groups, adults aged 26 or older had much higher use or misuse than those between the ages of 12 and 25 combined. However, adolescent exposure remains high and concerning, especially as counterfeit fentanyl-laced pills become more accessible to younger populations through fake online pharmacies and social media sources.

According to the 2023 NSDUH data, approximately 3.8 million, or 14.7%, of adolescents aged 12 to 17 reported illicit drug use in the past year, including 2.2 million who reported having a substance use disorder. About 570,000, or 2.2%, reported prescription pain reliever misuse, with 50,000 reporting that they misused fentanyl and 36,000 used IMFs. About 316,000, or 1,2%, of adolescents reported they had a prescription pain reliever use disorder, with the same number reporting an opioid use disorder.

SAMHSA’s 2023 report indicated that females were less likely to use illicit drugs (14.6% or 2.1 million females) compared to males (19.1% or 26.5 million), but females (0.8% or 1.2 million) were just as likely to misuse opioids as males (0.9% or 1.3 million). The report indicated that 4.3 million females aged 12 or older misused opioids in the past year. Of these, 4.1 million or 93.5% misused prescription pain relievers only, with 2.7% misusing heroin only and 3.8% misusing both.

Furthermore, 6.9% of females who misused prescription pain relievers misused prescription fentanyl specifically. Of those who used prescription fentanyl for any reason, 20.2% misused it while 79.8% didn’t.

The same SAMHSA report provided a breakdown on opioid misuse by ethnic groups, but not specifically for fentanyl. Based on this data, 2.4 million people aged 12 or older misused opioids over the past year. The following table breaks down misuse by ethnic groups.

Overall, opioid misuse remains highest among non-Hispanic Whites, Hispanics and non-Hispanic Black Americans, with American Indian/Alaska Native populations experiencing the highest rate proportionally.

In 2023, about 39.1% of individuals aged 12 or older who misused prescription pain relievers got their pain pills from a friend or relative, either by being given the drugs, buying them or taking them without permission. However, the National Crime Prevention Council estimates 80% of teen and young adult fentanyl-related deaths can be traced to social media.

While an analysis by KFF indicates that drug use among teens has declined in recent years, drug overdose deaths remain twice as high as they were before 2020. Experts caution that despite fewer teens using drugs overall, the drug supply has become far deadlier. The presence of fentanyl-laced counterfeit pills has become a leading threat.

The DEA’s “One Pill Can Kill” campaign highlights how many adolescents are unknowingly exposed to fentanyl when purchasing pills marketed as Xanax, Percocet or Vicodin. Many adolescents initiate drug misuse through experimentation with what they believe are authentic prescription medications. According to DEA laboratory testing, 7 out of 10 fake pills analyzed in 2023 contained potentially lethal amounts of fentanyl, and they looked nearly identical to legitimate prescription pills.

DEA data shows that seizures of illicit fentanyl are at record levels, with seizures of fentanyl powder nearly doubling and fentanyl pills almost tripling between 2021 and 2023. In total, the DEA seized over 29,000 pounds of powder and more than 79 million pills in 2023.

The normalization of prescription pill misuse among teens, combined with the presence of fentanyl in the counterfeit drug supply, has made fentanyl addiction and fatal overdose among teenagers a far greater concern than just a few years ago. This trend underscores the critical need for parents, schools and community organizations to monitor access to medications, promote prevention efforts focused on youth-specific risks and educate teens on the dangers of counterfeit pills, even when they appear safe.

Polysubstance use—using fentanyl in combination with other drugs—is a growing and deadly trend, particularly among teens and young adults. However, many individuals exposed to fentanyl aren’t intentionally seeking it. Instead, they’re using counterfeit pills or street drugs contaminated with fentanyl without their knowledge.

According to the DEA, fentanyl is increasingly being found mixed with a range of substances, including heroin, cocaine, methamphetamine and MDMA. In some regions, the majority of overdose deaths now involve multiple substances, often with fentanyl as a hidden component.

A particular concern is the detection of xylazine, a veterinary sedative not approved for human use, found in approximately 30% of fentanyl powder samples seized by the DEA in 2023. This percentage is up from 25% in 2022. Xylazine, sometimes called “tranq,” doesn’t respond to naloxone (Narcan) reversal and can worsen the effects of a fentanyl overdose.

For adolescents experimenting with pills or powders, the danger is especially high. Many are unaware that what they think is a single drug, such as cocaine, ecstasy or a legitimate painkiller, may in fact be a deadly mixture containing fentanyl. This unintentional polysubstance exposure significantly increases the risk of overdose, complicates emergency treatment and accelerates the potential for developing a severe opioid addiction.

SAMHSA reported in 2023 that 2% or 5.7 million people aged 12 or older had an opioid use disorder in the previous year. This number included:

• 5 million people aged 26 or older
• 396,000 young adults between 18 and 25
• 316,000 youth between 12 and 17

However, opioid misuse extends beyond those with formal OUD diagnoses. About 8.9 million people aged 12 or older misused opioids in the past year. Among them:

• 92.6% misused prescription pain killers, including prescription fentanyl
• 3.6% misused heroin
• The remainder misused both prescription opioids and heroin

Breaking down opioid misuse by age group:

• 7.5 million adults aged 26 or older
• 846,000 young adults between 18 and 25
• 574,000 adolescents between 12 and 17

Of the 8.6 million individuals aged 12 or older who misused prescription pain relievers, about:

• 3.6 million (42.8%) misused hydrocodone products
• 2.6 million (31.3%) misused oxycodone products
• 5.6% misused prescription fentanyl

However, the fentanyl figure doesn’t include IMF use, which is often under-reported since many people don’t know they’re using IMFs. While the number of people misusing fentanyl may seem low compared to hydrocodone or oxycodone, the DEA warns that the shift from using plant-based drugs like heroin and cocaine to chemical-based, synthetic drugs like methamphetamine and fentanyl is fueling the deadliest drug crisis the nation has ever faced.

According to the CDC, nearly 108,000 drug-related deaths were reported in 2022, with fentanyl and other synthetic opioids responsible for about 70% of them. In comparison, methamphetamine and other synthetic stimulants were responsible for the other 30%.

Hospital emergency departments are also seeing the shift. SAMHSA reported that nearly half of opioid-related emergency department (ED) visits in 2023 involved prescription or other opioids. Of these, oxycodone was the most common opioid reported. In comparison, about a third of opioid-related ED visits included 27% for heroin and 31.5% for fentanyl. Between 2022 and 2023, opioid-related ED visits for heroin use decreased by almost 41% while fentanyl cases increased by 46%.

Fentanyl misuse, whether pharmaceutical or illicit, represents one of the most dangerous forms of opioid use today. As heroin use continues to decline nationwide, fentanyl use steadily rises. Fentanyl is now the most common synthetic opioid, driving new cases of opioid addiction and drug-related deaths across all age groups. This shift underscores the urgent need for prevention efforts specifically targeting fentanyl-related dangers rather than focusing solely on more traditionally recognized opioids like heroin.

For many people, fentanyl addiction can begin with the very first dose. As one of the most powerful synthetic opioids, fentanyl carries an extremely high overdose risk even at small doses and causes significant physical, mental and emotional harm over time.

The dangers of fentanyl addiction and overdose aren’t limited to long-term drug users. Teens and young adults experimenting with counterfeit pills, powders or other substances may be exposed to lethal levels of fentanyl without even knowing it. Understanding the unique fentanyl addiction dangers is critical for families, schools and communities working to prevent addiction, support recovery and reduce overdose deaths across all age groups.

Fentanyl addiction poses serious health threats from the earliest stages of use. In the short term, synthetic opioid effects include extreme sedation, slowed or stopped breathing (respiratory depression), confusion, nausea and unconsciousness. Because fentanyl is much stronger than heroin or oxycodone, even a small amount can overwhelm the body’s ability to maintain normal breathing. Initial exposures can easily trigger life-threatening breathing problems, particularly when fentanyl is combined with other depressants like alcohol or benzodiazepines.

Among adolescents and inexperienced users, the danger is even greater. Young people experimenting with counterfeit pills may not realize how fast fentanyl acts, making overdose, often referred to as fentanyl poisoning, far more likely, even with a single use.

Over the long term, repeated fentanyl use damages nearly every major organ system. Chronic respiratory issues, cardiovascular problems like irregular heartbeat or heart failure and severe gastrointestinal complications such as constipation and bowel obstruction are common. Fentanyl addiction also weakens the immune system, leaving individuals more vulnerable to infections.

As fentanyl misuse continues, users may experience irreversible organ damage, particularly to the lungs, liver and kidneys. Nutritional deficiencies, hormonal imbalances and neurological impairments are also frequent outcomes. Physical health often deteriorates rapidly compared to other opioid addictions, reflecting the unique and devastating impact of synthetic opioids on the body over time.

Without intervention, these physical effects, combined with the severe overdose risk, can quickly lead to permanent disability or death, especially among young users whose bodies are still developing.

Beyond physical harm, fentanyl addiction causes intense and often rapid deterioration of mental health. Even early on, misuse can trigger serious psychological effects, including severe depression, anxiety disorders and cognitive impairments such as memory loss and reduced attention span.

These impacts are often even more pronounced among adolescents and young adults, whose brains are still developing. Regular fentanyl misuse can disrupt critical neurological pathways, damaging emotional regulation, decision-making skills and impulse control.

Fentanyl addiction dangers also include a heightened risk of suicidal ideation, social isolation and aggressive or erratic behavior. Emotional instability often worsens as addiction progresses, leading many individuals into cycles of escalating use, deepening isolation and worsening mental health crises.

Long-term fentanyl misuse can permanently alter brain chemistry, intensifying cravings and significantly reducing the brain’s ability to experience pleasure naturally. This rewiring of the brain can lead to relentless relapse cycles and make recovery more difficult compared to addiction to other drugs.

For teens and young adults, these changes can derail academic performance, strain family relationships, increase risk-taking behaviors, and in some cases, contribute to irreversible psychiatric conditions. Without intervention, the mental health consequences of fentanyl misuse can be just as deadly as the physical risks.

One of the most critical dangers of fentanyl is its extreme overdose risk. Just two milligrams, roughly equivalent to a few grains of salt, can cause a fatal overdose. Illicit fentanyl is often mixed unpredictably into other substances, including counterfeit pills, methamphetamine, cocaine and heroin, making it impossible for users to gauge potency. In 2023, illicitly manufactured fentanyl was involved in over 70% of opioid-related overdose deaths in the United States.

Accidental exposure, especially through fentanyl-laced drugs, increases overdose risk even among people who don’t intentionally seek opioids. It has also become a leading cause of overdose among teens and young adults. First-time experimentation with what appears to be a legitimate pill can result in sudden death within minutes.

While naloxone (Narcan) can reverse fentanyl overdoses, multiple doses are often needed because of the drug’s potency. Quick recognition of overdose risk signs is critical to saving a life. Without immediate intervention, fentanyl overdoses/poisoning often progress too quickly for emergency help to arrive in time. Education, early prevention and ready access to naloxone are essential tools for protecting individuals from fatal outcomes.

Treating fentanyl addiction is significantly more challenging compared to other opioid use disorders. Because fentanyl is a synthetic opioid that binds more tightly and rapidly to opioid receptors than heroin or oxycodone, withdrawal symptoms tend to be more intense, longer-lasting and harder to manage.

Fentanyl withdrawal can set in quickly, sometimes within hours of the last use, and often includes severe muscle and bone pain, gastrointestinal distress, extreme anxiety and insomnia. These symptoms may last for weeks and are frequently more difficult to control than withdrawal symptoms from other opioids.

The difficulty of stabilizing individuals after fentanyl misuse often requires higher doses or more frequent administration of medication-assisted treatments (MAT) to curb cravings and withdrawal symptoms. Even then, the risk of early relapse remains high.

Medication for opioid use disorder (MOUD), such as methadone, buprenorphine and naltrexone, is the current standard of care for managing opioid addiction. However, in 2023, only about 18% of the 5.7 million individuals with an opioid use disorder received MOUD treatments, highlighting a major gap in access and utilization.

Treatment for fentanyl use disorder may be even more complicated than other OUDs. According to the American Journal of Psychiatry, no clinical trials have yet directly compared MOUD treatment outcomes for fentanyl addiction versus other opioid addictions. The lack of specific research leaves some clinicians struggling to find the most effective protocols for fentanyl patients, especially those with severe dependence or repeated relapses.

Treatment options for adolescents are even more limited. Of the FDA-approved MOUD options, buprenorphine is the only medication authorized for individuals aged 16 or older. While methadone isn’t FDA-approved for minors, it can be prescribed to patients under 18 if they’ve had two unsuccessful treatment attempts previously and a parent or guardian provides consent.

Fentanyl addiction moves quickly, and the consequences—both physical and mental—can be devastating. The unique challenges of fentanyl withdrawal, treatment and relapse make early recognition and intervention critical. For parents, families and community leaders, understanding the specific dangers of fentanyl is the first step toward preventing tragedy and supporting recovery efforts that save lives.

According to provisional data from the CDC’s National Vital Statistics System, the U.S. had about 87,000 drug overdose deaths during the 12 months ending in September 2024. This figure marks a remarkable 24% decline from about 114,000 deaths recorded during the same period in the previous year.

While this is a promising shift after years of increases, synthetic opioids, primarily fentanyl, remain the leading cause of overdose deaths. In 2023 alone, fentanyl was involved in an estimated 72,000 deaths. IMFs, including potent analogs like carfentanyl, contributed to approximately 70% of these fatalities.

Despite progress, the fentanyl crisis continues to drive preventable loss of life across all age groups. It remains a growing threat to adolescents and young adults experimenting with counterfeit or contaminated drugs.

Age-specific data from 2023 shows that adults between the ages of 35 and 44 continued to have the highest drug overdose death rates in both 2022 and 2023. However, overdose death rates shifted across various age groups:

• Decreases in overdose death rates dropped among the following age groups (figures are per capita or 100,000 people):
  • Ages 15 to 24 (drop of 1.6, from 15.1 to 13.5)
  • Ages 25 to 34 (drop of 5, from 50.6 to 45.6)
  • Ages 35 to 44 (drop of 2.3, from 63.1 to 60.8)
  • Ages 45 to 54 (drop of 2, from 55.3 to 53.3)

• Increases in drug overdose death rates were seen in the following age groups:
  • Ages 65 and older (increase of 1.5, from 13.2 to 14.7)
  • Ages 55 to 64 (increase of 1.1, from 48.1 to 49.2)

Although overall overdose death rates declined among younger adults and adolescents in 2023, fentanyl continues to pose a severe and growing risk to teens and children. Facing Fentanyl™, a grassroots fentanyl awareness organization, states that children under age 14 are dying of fentanyl poisoning faster than any other age group.

Furthermore, data from KFF indicates that fentanyl-related overdose deaths among adolescents increased by 2% from 2022 to 2023. While this marks the lowest increase since the pandemic began, it confirms that overdose deaths among youth continue to rise.

Data from Texas State University also highlights that adolescent boys are more likely to die from drug overdoses than girls, though female overdoses are also far too common.

Regional analysis of IMF-involved overdose deaths from 2022 to 2023 reveals significant differences across the nation. The West was the only region to experience an increase, with a substantial rise of nearly 34% during this period. In contrast, other regions saw decreases:

• Midwest: 7.8%
• Northeast: 3.2%
• South: 2.8%

While overall IMF-related deaths declined nationally, overdose deaths involving carfentanyl increased by about sevenfold. Only 29 reported carfentanyl deaths occurred between January and June of 2023, compared to 238 during the same period in 2024. By mid-2024, carfentanyl-related overdose deaths had been reported in 37 states, underscoring the unpredictable and evolving dangers in the drug supply.

Gender and ethnic disparities continue to shape the overdose crisis. According to a Fentanyl Overdose Mortality Report released in May 2024 by Multnomah County, Oregon, the majority of fentanyl-related deaths occurred among white males aged 35 to 44.

National trends reflect similar patterns. A study reported by NIDA found that during 2020–2021, men were 2 to 3 times more likely to die from opioid overdoses, including fentanyl and heroin, than women.

Significant disparities also exist among ethnic groups. Based on 2023 per capita measurements (100,000 people), the following statistics were notable:

• American Indian and Alaska Native individuals had the highest overdose death rate at 65 per capita.
• Asian individuals had the lowest overdose death rate at 5.1 per capita.
• Native Hawaiian or Other Pacific Islander non-Hispanic individuals experienced a 39.4% increase in overdose death rate.
• Black non-Hispanic individuals saw a 1.4 per capita increase in overdose death rate.
• White non-Hispanic individuals experienced a 7% drop in overdose death rate.

These disparities highlight that while fentanyl poses a risk to people across all backgrounds, certain groups, mainly Native American, Black and Pacific Islander populations, face a disproportionate burden. Recognizing these patterns is vital for building effective prevention strategies that reach every community.

While fentanyl affects every demographic, behind the statistics are young lives lost too soon. The rise in overdose deaths among adolescents stands out as one of the most urgent and devastating aspects of the fentanyl crisis, highlighting the critical need for targeted prevention efforts.

While overall drug use among adolescents remained below pre-pandemic levels in 2023, per data from NIDA, overdose deaths among youth continue to rise. According to a 2024 report from KFF, adolescent drug overdose deaths more than doubled between 2019 and 2020, driven largely by the spread of illicitly manufactured fentanyl.

While the overdose deaths among adolescents slightly declined by about 2% from 2022 to 2023, the overall fatality rate remains twice as high as it was before the COVID-19 pandemic. A major factor behind these deaths is the increasing presence of fentanyl-laced counterfeit pills made to resemble prescription medications like oxycodone and Xanax. Between 2022 and 2023, overall overdose deaths dropped from 721 to 708, but deaths due to fentanyl rose from 527 to 539.

Note: 2023 CDC WONDER data are provisional. Opioid overdose deaths were identified using the International Classification of Disease, Tenth Revision (ICD-10), based on the ICD-10 underlying cause-of-death codes X40-44, X60-64, X85, Y10-14, T40.0-40.4, T40.6. Multiple types of drugs may be involved in an overdose death, so sub-categories may not be mutually exclusive. Fentanyl is a synthetic opioid classified as T40.4.
Source: KFF analysis of CDC Wonder Data, 2018-2023

Unlike earlier decades, where fatal overdoses were often linked to years of substance misuse, today’s adolescent overdose deaths frequently involve first-time or occasional use of a fentanyl-laced pill. Experts at Children’s Health emphasize that even one encounter with a counterfeit, fentanyl-laced pill can be fatal due to the drug’s extreme potency.

Alarmingly, KFF also noted that the share of overdose deaths involving fentanyl is increasing faster among adolescents compared to adults. In 2020, the share of fentanyl-related deaths among adolescents was 65%, compared to 62% among adults, making it the first year the share reversed. By 2023, the gap widened further, with 76% of adolescent drug fatalities involving fentanyl compared to 69% of adult fatalities.

Note: In 2023, 708 adolescents died due to a drug overdose, 539 of which involved fentanyl. In the same year, 103,991 adults died due to a drug overdose, including 72,000 which involved fentanyl.
Source: KFF Analysis of CDC WONDER, 2018-2023Source: KFF Analysis of CDC WONDER, 2018-2023

Social media has played a significant role in the fentanyl crisis, especially among adolescents. According to a 2024 analysis from KFF, many teens access counterfeit pills through popular social media and messaging apps and platforms, making dangerous substances more readily available than ever before. The National Crime Prevention Council estimates that 80% of fentanyl poisoning deaths among teens and young adults are traceable to social media.

Lack of regulation and the convenience of social media are often touted as significant reasons behind it becoming a leading venue for drug distribution. Easy access, combined with misinformation about pill safety, has contributed to the surge in fentanyl-related fatalities among adolescents.

Even limited experimentation with drugs can lead to tragic consequences. Understanding these risks is critical for parents, educators and peers seeking to protect young lives.

Although the number of drug overdose deaths with IMFs detected began to decline nationwide in 2023, overdose deaths remain high. Recognizing fentanyl overdose symptoms early can mean the difference between life and death. Overdoses involving fentanyl progress faster and are harder to reverse than those caused by many other opioids. Learning how to spot overdose emergency signs and respond quickly is critical for parents, peers and anyone who may encounter someone in distress.

Note: In 2023, 708 adolescents died due to a drug overdose, 539 of which involved fentanyl. In the same year, 103,991 adults died due to a drug overdose, including 72,000 which involved fentanyl.
Source: KFF Analysis of CDC WONDER, 2018-2023Fentanyl overdose symptoms can escalate rapidly due to the drug’s potency. Key warning signs to watch for include:

• Slowed, shallow or stopped breathing
• Extreme drowsiness or inability to stay awake
• Cold, clammy skin
• Blue or grayish tint to lips and fingernails
• Pinpoint pupils
• Gurgling or choking sounds
• Loss of consciousness or unresponsiveness
• Limp body or inability to move

Opioid overdose recognition is critical. Even if you’re unsure whether fentanyl is involved, treating it as an overdose emergency can save a life. When in doubt, always treat the situation as an overdose emergency and act immediately.

Rapid collapse and the potential for “rebound overdose” risk make fentanyl-related emergencies far more dangerous than traditional opioid overdoses.

Fentanyl overdoses often progress much faster than overdoses from other opioids like heroin or oxycodone. The time to intervene is shorter, with collapse and respiratory failure sometimes occurring within minutes of ingestion, inhalation or injection. Rapid recognition of fentanyl overdose symptoms and overdose response is essential.

Additionally, fentanyl is much more potent and binds more strongly to opioid receptors than many other opioids, meaning higher doses of naloxone (Narcan) or multiple doses are often needed to reverse the overdose. Fentanyl effects are also longer-lasting compared to other opioids. Naloxone wears off after about 30 to 90 minutes (Narcan lasts up to 120 minutes), so fentanyl overdose symptoms can return after this occurs.

Fentanyl overdoses are true medical emergencies. Brain damage and death can occur within 4 to 6 minutes due to a lack of oxygen. Immediate action is critical, including calling 911 to get emergency medical attention. Delays, even of just a few minutes, can dramatically reduce survival chances. Carrying naloxone and knowing how to use it are vital parts of effective fentanyl overdose response strategies that every family member, friend, teacher and coach should learn.

Widespread fear about secondhand exposure to fentanyl, such as touching powder or breathing it in during an emergency, has created dangerous myths. However, scientific evidence consistently shows that the risk of accidental fentanyl overdose from casual contact is extremely low during routine overdose response.

While fentanyl powder should always be handled with caution, trained first responders and Good Samaritans should never hesitate to provide life-saving aid. Wearing gloves and avoiding direct contact with visible powder are sensible precautions, but fears of instant overdose from casual contact alone are unfounded.

Research by the Expert Fentanyl Response Team and guidance from the CDC confirm that:

• Fentanyl powder can’t be absorbed through intact skin.
• Accidental overdose would require fentanyl to enter the bloodstream through an open wound, or by immediately touching your eyes, nose or mouth after direct contact with fentanyl.
• Briefly touching fentanyl powder or a pill containing fentanyl without ingestion or injection carries a very low risk of harm.

During rescue breathing, there may be trace residues of fentanyl on a victim’s face or saliva. Theoretically, exposure is possible, but the amount is too small to cause an overdose in most rescue scenarios. In contrast, delaying or withholding aid during an opioid emergency dramatically increases the risk of brain injury or death.

In a suspected fentanyl overdose, every second counts. Because fentanyl acts so quickly and powerfully, immediate action is essential to prevent brain injury or death. Anyone—parent, friend, teacher, bystander—can save a life by knowing how to respond to an overdose and taking the right steps without delay.

Following a clear emergency overdose response protocol improves the chance of survival and reduces the risk of permanent harm. The following offers a step-by-step guide based on the SAMHSA Five Essential Steps for First Responders.

In a fentanyl overdose, speed saves lives, and naloxone is the most important emergency tool available today. Naloxone, commonly referred to as Narcan, is a medication known as an opioid reversal drug. It rapidly blocks the effects of opioids in the body, helping to restore breathing and consciousness during an overdose. Having naloxone readily available, knowing how to use it and acting fast can increase a person’s chances of survival.

Naloxone works by binding to the same receptors in the brain that opioids like fentanyl attach to. By displacing the opioids, naloxone can reverse respiratory depression, restore normal breathing and revive the person temporarily until medical help arrives.

Naloxone begins working within 2 to 3 minutes of administration, but it’s not a permanent cure. Opioids, especially fentanyl, can remain active longer than naloxone’s effects. Naloxone/Narcan appears to work for about 90 to 120 minutes, so multiple doses and continued monitoring are often necessary. Overdose symptoms can return once this medication wanes.

Narcan can cause abrupt opioid withdrawal if the person is physically dependent. Administration may cause body aches, chills/hot flashes, nausea, vomiting, anxiety, irritability, shaking, fast heart rate or other withdrawal symptoms.

There are two primary forms of naloxone available for emergency overdose response:

Naloxone Nasal Spray (Narcan):

• A pre-filled device that sprays medication into the nostril.
• Simple to use and requires no needles.
• Preferred for public use and non-medical responders.

Injectable Naloxone:

• Administered by intramuscular injection into the shoulder or thigh.
• Requires training to use safely and correctly.

Both forms are highly effective in reversing opioid overdoses, but naloxone nasal spray is more widely recommended for use by the general public.

Narcan instructions are designed to be simple, even during high-stress situations, making it the preferred option. Here’s a step-by-step guide on how to properly use Narcan ready-to-use nasal spray:

1. Check responsiveness to confirm a suspected overdose.
2. Lay the person flat on their back and tilt their head up.
3. Remove Narcan from its packaging.
4. Hold the device with your thumb on the bottom of the plunger and two fingers on the nozzle.
5. Insert the nozzle gently into either nostril until your fingers are against the nose.
6. Press firmly on the plunger to release the entire dose of medication into the nostril.
7. Call 911 immediately after administering this dose.
8. Wait 2 to 3 minutes.
9. Administer a second dose using a new device in the other nostril if there’s no improvement in breathing or responsiveness.
10. Repeat dosing every 2 to 3 minutes with a new device until the person wakes up.
11. Stay with the person and monitor closely until emergency help arrives.

Always inform first responders how many doses were given and at what intervals. You can’t overdose on Narcan, so it’s safe to give a person multiple doses. It’s also safe to give it to a person without opioids in their system, but it will only counter opioid overdose.

Narcan should be stored at room temperature and has a shelf life of 4 years. Check the expiration date before administration to ensure it’s still good.

Because fentanyl overdoses can happen so quickly and unpredictably, many organizations recommend that anyone at risk or connected to someone at risk should carry naloxone. While anyone can carry Narcan to help respond to an overdose, you should consider carrying naloxone nasal spray if you’re:

• A parent, caregiver or friend of someone who uses prescribed or illicit opioids
• A teacher or coach in a school or athletic setting
• A first responder, security officer or community volunteer
• Living in a region with high rates of opioid overdose deaths
• Anywhere counterfeit pills or unknown substances may be circulating (parties, high school or college campuses, etc.)

Any person at a high risk of opioid overdose should also carry Narcan and let people they’re normally around know they have it in case it’s needed.

Use naloxone immediately if you suspect an opioid overdose, even if you’re unsure whether fentanyl is involved. There’s no harm in giving Narcan to someone who isn’t actually overdosing, but not giving it to them during an opioid overdose can be fatal. Quick naloxone administration combined with emergency medical help offers the best chance of survival in a fentanyl-related emergency.

Access to naloxone has expanded significantly in recent years. Narcan is available online and in all 50 states. Pharmacies in most states and other retailers offer Narcan without a prescription at the original prescription strength.

There are likely several places within your community with Narcan access, making it easier to obtain and help prevent opioid overdose deaths. Whether you’re wondering where to get Narcan for yourself, your family, your school or your organization, turn to trusted naloxone options available near you.

National initiatives help distribute free naloxone to communities for distribution to individuals at risk. These initiatives often support statewide or local programs that provide free naloxone through health departments or non-profit organizations, such as:

• SAMHSA Support for the Use of Opioid Overdose Reversal Medications: SAMHSA provides funding to communities nationwide to purchase and distribute naloxone and other opioid overdose reversal medications to help reduce overdose deaths.
• CDC Overdose Data to Action (OD2A) Program: CDC helps fund 49 state health departments, the District of Columbia and 40 city, county and territorial health departments to expand overdose prevention efforts, including naloxone access.

Harm reduction organizations often offer free naloxone kits, training sessions and overdose prevention education to individuals. Some of these programs may only serve people who use drugs, but others also serve their families, friends and the broader community. Many harm reduction groups also offer free mail-order naloxone for eligible participants.

• National Harm Reduction Coalition: Provides a Naloxone Finder with vetted programs by state that offer naloxone free of charge to those who use drugs.
• NEXT Distro: A national online harm reduction program that mails naloxone kits discreetly to eligible individuals in many states through collaborations with over 30 harm reduction programs nationwide.
• North American Syringe Exchange Network (NASEN): Provides a directory of harm reduction locations where you can filter options to highlight those that distribute naloxone by state or zip code.

These and similar programs strive to ensure no one is left without access to lifesaving tools, regardless of location or financial status.

In most states, naloxone is available at pharmacies without a traditional prescription. Standing orders allow pharmacists to dispense naloxone directly to anyone who requests it. Some states even allow minors to obtain naloxone without parental consent. While there currently isn’t a federal standing order, all 50 states have laws giving you access to naloxone through State Standing Orders.

The cost for non-prescription Narcan varies by location, but your insurance may cover some or all of it. Many pharmacies offer manufacturer coupons to reduce out-of-pocket costs. GoodRx also provides savings on naloxone medications. If you’re unsure where to get Narcan locally, ask your pharmacist if your state has a standing order or statewide protocol for naloxone access.

Innovative strategies are expanding community Narcan access to hard-to-reach populations that might not seek traditional healthcare or social services. These populations might face barriers, such as a lack of transportation or financial resources, homelessness, substance use disorder (SUD) or untreated mental illness.

Community outreach sometimes fills the gap. Some communities now have mobile outreach vehicles that travel to underserved or high-risk areas. Many of these mobile units distribute free naloxone, along with needle exchange services, pill disposal assistance, SUD treatment referrals, fentanyl test strips and various health screening and services.

Across the nation, naloxone vending machines or self-service Narcan distribution boxes are being placed in areas where numerous opioid overdoses have been reported. In mid-2024, at least 33 states and the District of Columbia had varying numbers of vending machines or distribution boxes to dispense naloxone kits, usually for free. Some vending machines also dispense fentanyl test strips to use on questionable pills and potentially help prevent overdoses before they occur.

Rural communities often face greater barriers to healthcare and treatment, often leading to higher OUD or SUD death rates from overdose. Specific programs target these areas to improve community Narcan access, including:

• Rural Communities Opioid Response Program (RCORP): Provides grants to rural communities to prevent or treat OUDs, including a program specifically for Overdose Response, administered through the Health Resources & Services Administration.
• State-Level Services: In many states, the Department of Mental Health and Substance Abuse Services or the Department of Public Health offers free naloxone and fentanyl test strips, which may include mail-order services to reach rural communities.

If you live in a rural area, check with your county health department, community health center/clinic or nearest hospital for free naloxone options. As mentioned above, harm reduction programs offer directories listing free Narcan available by state and often through the mail.

Finding naloxone may be simpler than you think and often free. Taking a few minutes today could save a life tomorrow.

As fentanyl and other synthetic opioids continue to drive overdose deaths nationwide, prevention efforts have expanded beyond treatment and emergency response. Communities are now adopting a range of overdose prevention strategies focused on harm reduction, education and peer engagement to save lives before an overdose happens. Whether you’re a parent, educator, healthcare provider or advocate, the strategies below can help reduce risk in both individuals and community settings.

Harm reduction is a public health approach that focuses on minimizing the risks associated with drug use rather than requiring abstinence as a condition for support. Programs may include distributing free naloxone, offering overdose response training and educating people on safe use practices and signs of overdose. Workshops, community outreach events, school-based health programs and public awareness campaigns have proven effective in expanding education to both high-risk groups, youth and the general public.

For example, KFF noted in October 2024 that 65% of adolescents received alcohol and drug use disorder and prevention in school. This information was either integrated into health or physical education classes or provided through special substance abuse classes, lectures, substance abuse-related films and discussions outside of class.

While 63% of adolescents said they viewed substance use prevention messaging outside of school, only about half of them (51%) said they’d spoken to their parents about the harms of substance abuse.

Opioid safety programs aim to reduce overdose risk for individuals who use opioids, particularly those who are not ready or able to stop. These programs also provide connections to treatment resources when individuals are prepared to seek help. Key recommendations include:

• Never using drugs alone
• Using small test doses first, especially when switching sources
• Having naloxone nearby and visible
• Avoiding mixing opioids with depressants like alcohol or benzodiazepines

Programs like Never Use Alone offer real-time phone support during drug use when you’re alone. These programs are simple but life-saving examples of safe-use interventions in action.

Syringe exchange programs (SEPs) are often misunderstood, but they’re one of the most effective tools in overdose prevention and harm reduction. SEPs offer:

• Access to sterile syringes and safe disposal of used ones
• Free naloxone and fentanyl test strips
• Referrals to substance use treatment and healthcare services
• Education on safer injection and overdose response

These programs reduce the spread of infectious diseases, build trust in healthcare systems and provide a direct line to support.

Fentanyl test strips are small strips of paper you can use on various forms of drugs to see if they contain fentanyl. They’re a low-cost, easy-to-use tool that lets you confirm the presence of fentanyl before taking a drug. These strips help individuals make more informed decisions and may reduce the risk of accidental overdose.

Originally designed for urine testing, fentanyl test strips can be used on pills and powders by dissolving a sample in water. Because fentanyl doesn’t have a specific taste, smell or color, it’s nearly impossible to tell whether a substance contains fentanyl without testing it.

Many harm reduction programs distribute these strips for free alongside naloxone kits. In 2021, the CDC clarified that using fentanyl test strips is a legitimate public health strategy and recommended removing legal barriers to their use.

Peer-based education and overdose response training empower those with lived experience and those closest to high-risk individuals to become advocates and life-savers. Community organizations often train peer educators and family members to:

• Recognize overdose symptoms
• Safely administer naloxone
• Provide post-overdose support
• Reduce stigma around substance use

These training courses are offered through health departments, nonprofits, universities and even schools, often in collaboration with opioid safety programs.

Policy-level solutions are essential for long-term, system-wide change. Some of the most effective public health actions include:

• Establishing Good Samaritan laws to protect those who call 911 during overdoses
• Funding local harm reduction centers and naloxone distribution
• Supporting education initiatives in schools and community centers to reach adolescents before they become a statistic
• Expanding access to fentanyl test strips and naloxone through mail, vending and mobile delivery programs

Many cities and counties now operate community overdose prevention task forces, bringing together healthcare, law enforcement, policy makers, educators, social services and nonprofits to coordinate a response tailored to local needs.

Together, these strategies offer a multi-layered approach to overdose prevention to help save lives, restore hope and create a foundation for recovery and resilience across all communities.

Effective treatment for fentanyl addiction involves a combination of medical care, counseling and long-term recovery resources. Because fentanyl is a highly potent synthetic opioid, individuals often require specialized care to manage withdrawal symptoms, stabilize physically and build sustainable coping strategies. A growing number of evidence-based options are available, including medication, therapy, structured rehab programs and community-based support systems.

Medication-Assisted Treatment (MAT) is one of the most effective approaches to treating opioid use disorders, including fentanyl addiction. However, clinical trials comparing medication for opioid use disorder treatment outcomes for fentanyl addiction versus other opioid addictions are limited, with fentanyl treatment potentially more complicated than other OUDs. Lack of research could make finding the most effective protocols for patients with fentanyl OUD more challenging, especially for those with repeated relapses or severe dependence.

Typically, MAT for opioid addiction utilizes FDA-approved medications to help reduce cravings, prevent withdrawal symptoms and block the effects of opioids during recovery. The three primary medications include:

• Methadone: A long-acting opioid agonist dispensed through certified clinics. It reduces withdrawal symptoms and cravings without producing a high if taken as prescribed.
• Buprenorphine: A partial opioid agonist available through office-based providers. It helps stabilize the brain’s chemistry and can be combined with naloxone (Suboxone) to reduce potential misuse.
• Naltrexone: An opioid antagonist that blocks the euphoric effects of opioids. It requires full detox before use and is ideal for individuals who have already gone through withdrawal.

Contrary to the beliefs of some, these medications don’t “replace one drug with another.” They’re part of a science-based treatment model proven to lower the risk of relapse and reduce opioid overdose deaths. MAT for opioid addiction is most effective when combined with counseling and behavioral therapy, creating a comprehensive foundation for long-term recovery.

Therapy is essential for addressing the emotional and psychological aspects of fentanyl addiction. Two widely used, evidence-based therapies include:

• Cognitive Behavioral Therapy (CBT): Helps individuals identify unhealthy thinking and behavior patterns that contribute to substance use and replace them with healthier coping mechanisms.
• Contingency Management: Uses a reward-based system to encourage positive behaviors such as staying in treatment, passing drug tests or attending counseling sessions.

Group therapy, trauma-informed care and family counseling are often integrated into treatment plans to promote healing, accountability and long-term motivation.

Opioid rehab programs vary in structure and intensity depending on the individual’s needs. Options include inpatient (residential) and outpatient settings, with the right fit based on the severity of addiction, access to support at home and other personal factors.

• Inpatient Programs: Offer 24/7 medical supervision, residential housing and immersive treatment in a controlled environment. Inpatient programs are often best for individuals with severe fentanyl addiction, co-occurring mental health disorders or unstable living situations.
• Outpatient Programs: Include intensive outpatient programs (IOP) and partial hospitalization programs (PHP) that allow individuals to live at home while attending structured therapy to maintain their daily lives. This model works well for those with a strong support system and a lower risk of relapse.

Some people begin with inpatient care and step down to outpatient treatment as they stabilize. IOPs allow individuals to regularly attend group or individual therapy sessions several times per week, while PHPs offer a higher level of support with individuals receiving treatment daily but neither requires an overnight stay.

Fentanyl is highly lipophilic, meaning it combines easily with fat, often making detox more intense and complex than detoxing from other opioids. Because fentanyl binds more tightly to opioid receptors and has a longer half-life, withdrawal symptoms may appear quickly and last longer. Body composition, such as having a higher body fat percentage, has been shown to slow the clearance of fentanyl from the body, potentially causing lengthier withdrawal. Symptoms can include intense cravings, anxiety, body aches, nausea, insomnia and mood disturbances, among others.

Furthermore, addiction doctors have found that starting patients with fentanyl addiction on buprenorphine treatment is more difficult. Buprenorphine is one of the most commonly prescribed medications to treat opioid addiction. It’s normally used to ease withdrawal, but it often makes withdrawal worse for those addicted to fentanyl. However, doctors have found a variety of methods to make buprenorphine induction for individuals using fentanyl possible to keep withdrawal symptoms at bay.

Due to the severity of withdrawal symptoms and various fentanyl detox challenges, medically supervised detox is strongly recommended. Withdrawal should be managed in a facility that can offer round-the-clock care, hydration support, non-opioid symptom relief and preparation for transition into ongoing treatment.

Detoxing without medical support can lead to severe physical and psychological distress, including suicidal thoughts. However, adolescents under 18 have limited options for inpatient treatment nationwide. Furthermore, most residential treatment centers treating adolescents don’t offer buprenorphine, the one medication for OUD approved for use in adolescents. Many facilities have waiting lists, making it even more difficult for young people to find timely, evidence-based care.

Finding licensed, evidence-based care is essential for safe and effective treatment across all ages. Several national directories offer state-by-state listings of vetted opioid rehab programs, including those that specialize in fentanyl addiction treatment:

• SAMHSA FindTreatment.gov Services Locator: Confidential, anonymous resource provided by SAMHSA, a leader in the substance abuse and mental health field.
• National Association of Addiction Treatment Providers: NAATP provides an Addiction Industry Directory with listings of addiction services and supporters.
• RehabNet: A respected, stigma-free resource hub for people seeking treatment for substance abuse disorder and addiction recovery.

These directories can help families and individuals find programs that offer therapy and supportive services for long-term recovery.

Recovery doesn’t end after rehab. Peer-led groups and ongoing emotional support are vital for maintaining sobriety. These groups offer emotional encouragement, accountability and a nonjudgmental space to share experiences.

Popular options are free, widely accessible and may be available in person or online, such as:

• Narcotics Anonymous (NA): A 12-step support program for individuals recovering from opioid or other substance use disorders.
• SMART Recovery: A science-based alternative to 12-step groups emphasizing self-empowerment, goal-setting and evidence-based cognitive techniques.
• Nar-Anon Family Groups: Support groups for families and friends affected by a loved one’s substance use that help them cope and set healthy boundaries.

Joining a support group can make the recovery process feel less isolating and help participants stay connected to a healing community.

Empowering youth with knowledge, support and access to resources is a critical part of addressing the fentanyl crisis among adolescents. While families play a central role, schools and community organizations serve as vital frontline allies in both prevention and response. Through partnerships, education and outreach, these groups are helping to protect young people from the devastating impact of fentanyl and other opioids.

School-based and community efforts are often supported through government initiatives. Several national agencies provide leadership and funding for school-based opioid education and community fentanyl outreach.

• Centers for Disease Control and Prevention: The CDC co-administers the Drug-Free Communities (DFC) Support Program, which provides up to 10 years of funding to community-based coalitions working to prevent youth substance use. The program focuses on promoting positive youth engagement and addressing conditions that drive youth substance use locally.
• Substance Abuse and Mental Health Services Administration: SAMHSA resources include Project AWARE (Advancing Wellness and Resiliency in Education), which aims to develop sustainable infrastructure for school-based mental health programs and services. The program supports efforts to expand mental and behavioral health services and create a healthier school environment.
• Drug Enforcement Administration: The DEA, in collaboration with Discovery Education, offers Operation Prevention, a nationwide program that educates students in grades 3 – 12 on the impact of addiction and equips them with refusal skills. The program provides no-cost online tools and resources to support prevention efforts in schools and communities.
• U.S. Department of Health and Human Services: HHS supports various prevention programs and tools, including evidence-based approaches and media campaign materials, to combat the opioid crisis. These resources are designed to aid prevention efforts and promote positive mental health in communities.

These agencies collectively support local initiatives to prevent youth opioid misuse and expand access to education, treatment and care through essential resources and guidance.

Effective opioid education goes beyond drug facts and scare tactics. The most impactful school-based programs help students build social and emotional skills, understand the science of substance use disorders and recognize how to respond in high-risk situations. Education initiatives also promote protective factors such as academic success, school connectedness and strong relationships with trusted adults.

Through skills-based instruction, youth learn how to avoid or delay drug use, practice refusal strategies, recognize early warning signs of substance use problems and access school or community resources for help. Substance use prevention programs that include these strategies have also been shown to improve outcomes in areas like mental health, bullying prevention and suicide risk reduction.

Classroom-based education is only part of the equation. School staff, including nurses, counselors, social workers, coaches and health educators, are vital partners in promoting student wellness. These adults help connect youth to appropriate services, model healthy behaviors and reduce the stigma around seeking help.

To be truly effective, prevention education must acknowledge the root causes of substance use. Young people may be more vulnerable to drug misuse due to trauma, racism, discrimination, adverse childhood experiences (ACEs) or lack of stable support systems. Inclusive, culturally responsive education helps students feel seen, respected and connected. All these factors are essential for long-term well-being.

By focusing on risk and protective factors, schools can better support students handling tough situations at home or school or dealing with identity-based prejudice or discrimination. Inclusive education also benefits students who may be at risk of isolation or struggle to find trusted adults they can turn to.

Outside the classroom, community organizations provide essential services that extend and strengthen the reach of school-based efforts. These partnerships help bring opioid education funding into schools and neighborhoods while expanding the availability of prevention, treatment and recovery resources for youth.

Faith-based groups, local nonprofits, health departments, medical clinics and tribal governments often run after-school programs, host parent workshops, offer mental health support or distribute opioid overdose reversal medications like naloxone. Some organizations even operate mobile health units or school-based health centers, making services more accessible for students in underserved areas.

Community partners play a vital role in:

• Supporting harm reduction strategies for youth
• Strengthening family engagement
• Providing professional development to educators and administrators
• Offering trauma-informed, culturally grounded care

School districts can increase impact by building referral networks and integrating local organizations into school health and wellness efforts. Developing formal protocols for referrals and regularly promoting available resources to students, parents and staff ensures no student falls through the cracks.

Together, schools, families and community groups can form a unified response that gives adolescents the tools to avoid substance use and the support to thrive.

The escalating fentanyl crisis has prompted a multifaceted response from U.S. lawmakers, law enforcement and public health officials. Recent opioid legislation aims to curb the supply of illicit fentanyl, enhance access to treatment and reevaluate punitive measures that may inadvertently hinder overdose prevention efforts.

Congress provided funding in the American Rescue Plan Act of 2021 for syringe services programs and other harm reduction initiatives. Federal harm reduction strategies have often involved distributing naloxone to reverse opioid overdose and test strips to detect fentanyl in drug samples.

The U.S. government has also enacted several key pieces of opioid legislation to address the fentanyl epidemic and enhance fentanyl trafficking laws, including:

• Fentanyl Eradication and Narcotics Deterrence (FEND) Off Fentanyl Act: This bill would designate international fentanyl trafficking as a national emergency. It would also authorize the President to impose sanctions on transnational criminal organizations and individuals involved in fentanyl trafficking, aiming to disrupt the financial networks of drug cartels. As of April 2024, this bill was with the Committee on Banking, Housing and Urban Affairs, though it had strong bipartisan support and was widely seen as a legislative priority.
  Eradicating Narcotic Drugs and Formulating Effective New Tools to Address
• National Yearly Losses of Life Act (END) FENTANYL Act: Signed into law in March 2024, this act mandates U.S. Customs and Border Protection to regularly update its policies to prevent drug smuggling, including fentanyl, and human trafficking, and report changes to Congress.
• Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act: Signed into law in October 2018, this act improved access to evidence-based treatment, supported the SUD treatment workforce, expanded the number of SUD providers and expanded Medicaid coverage of medication-assisted treatment for opioid use disorder.
• Comprehensive Addiction and Recovery Act (CARA): Signed into law on July 22, 2016, CARA authorized more than $181 million in new funding each year to fight the opioid epidemic and address prevention, treatment, recovery, law enforcement, criminal justice reform and overdose reversal.

Additionally, the Biden-Harris Administration expanded access to naloxone by making it available over the counter and launched initiatives like the Kids Online Health and Safety (KOHS) Task Force to prevent youth from purchasing drugs via social media platforms. The task force also focuses on youth mental health, cyberbullying, child sexual exploitation and other serious online safety risks.

Law enforcement agencies, especially those on the southern border, have increasingly focused on dismantling fentanyl trafficking operations rather than penalizing individual users. Department of Homeland Security (DHS), partnering with U.S. Customs and Border Protection (CBP) officers and state, local, tribal, territorial and international law enforcement, has initiated various strategies to stop fentanyl from entering the country, including:

• Operation Plaza Spike targeted plaza bosses and cartels that facilitate the flow of deadly fentanyl and its analogs, precursors and tools to make dangerous drugs (Launched April 2024).
• Operation Apollo is a counter-fentanyl operation that disrupts drug and chemical supplies, collects and shares intelligence and leverages valuable state and local law enforcement partnerships in southern California (Launched October 2023).
• Operation Blue Lotus combined resources to Southwest Border Ports of Entry (POEs) and worked with state, local, Tribal and territorial partners to expose fentanyl trafficking networks (Launched in March 2023).
• Operation Artemis targeted the illicit fentanyl supply chain, utilizing multidisciplined interagency teams at strategic locations.

These approaches aim to reduce the availability of illicit fentanyl while acknowledging the importance of treating substance use disorders as public health issues rather than solely criminal matters.

Drug-induced homicide (DIH) laws allow prosecutors to charge individuals with homicide if someone dies from overdosing on drugs they provided. While these laws have existed since the 1980s, usage didn’t increase until 2011. Then, according to the Drug Policy Alliance, DIH charges quadrupled between 2011 and 2016. In 2023 and 2024, new legislation related to DIH was introduced in 21 states.

These laws have sparked significant debate. Critics argue that these laws:

• Deter Emergency Calls: Fear of prosecution may discourage individuals from seeking emergency assistance during overdoses.
• Exacerbate Racial Disparities: Enforcement of DIH laws has been shown to disproportionately affect communities of color.
• Lack Deterrent Effect: Research indicates that DIH laws don’t effectively reduce drug use or overdose deaths.

Advocates for reform suggest focusing on harm reduction and treatment rather than punitive measures that may hinder overdose prevention efforts.

The landscape of drug policy in the U.S. is shifting towards a more health-centered approach:

• Public Opinion: A 2024 poll revealed that 75% of Americans view substance use disorders as health issues rather than criminal problems, reflecting growing support for treatment-focused policies.
• Decriminalization Efforts: Some states are exploring decriminalization of personal drug possession and investing in harm reduction services, such as supervised consumption sites and expanded access to treatment. As of April 2025, only Oregon has decriminalized possession and reclassified it as a civil violation.
• Policy Reevaluation: Critics argue that revising existing drug laws to better align with public health objectives and reduce the stigma associated with substance use disorders is critical for health equity.

These trends indicate a potential shift away from punitive approaches towards policies that prioritize prevention, treatment and recovery support.

The fentanyl epidemic continues to dominate headlines in 2025, with overdose cases, especially among young people, still front and center. The emergence of additional, even more potent synthetic opioids and growing concerns over social media’s role in drug distribution also make headlines. These and other developments dominate the 2025 fentanyl crisis update and continue to lead fentanyl news coverage across mainstream media outlets, shaping public awareness and policy responses nationwide.

Tragic stories of fentanyl-related overdoses have galvanized public attention and advocacy. One such case is that of Becca Schmill, an 18-year-old who died after consuming cocaine laced with fentanyl purchased through a dealer on Facebook. Her mother, Deb Schmill, has since founded the Becca Schmill Foundation to raise awareness about the dangers of social media and advocate for phone-free schools to protect children from online predators and easy drug access.

In response to the escalating crisis, an annual National Fentanyl Awareness Day celebrated on April 29, unites corporations, community groups, nonprofits, government agencies, schools, campuses and families to educate the public about the dangers of illicit fentanyl and counterfeit prescription pills. National Fentanyl Prevention and Awareness Day takes place on August 21 and brings together fentanyl awareness groups and families impacted by fentanyl to educate the public about the dangers of illicit fentanyl.

Multiple states and cities have declared emergencies to address the fentanyl crisis. In Oregon, Governor Tina Kotek declared a State of Emergency on January 30, 2024, specifically targeting fentanyl use in Portland. This coordinated effort included declarations from Multnomah County and the Mayor of Portland. Notably, Multnomah County reported a nearly 40% decrease in fentanyl-related overdose deaths over six months following the end of the 90-day emergency declaration.

In San Francisco, Mayor Daniel Lurie was granted expanded powers in early 2025 to address the city’s severe fentanyl crisis. This expansion included the authority to bypass competitive bidding for certain contracts and solicit private donations. The city plans to open a new 24/7 behavioral health center in the Tenderloin district to provide urgent care for individuals struggling with addiction and mental illness.

A new class of synthetic opioids known as nitazenes is significantly stronger than other opioids, including fentanyl, and has emerged as a significant threat. Initially developed over 60 years ago as alternatives to morphine, nitazenes were never approved for medical use due to their high overdose potential. The rise in nitazene-related overdoses signals a disturbing shift in synthetic opioid trends, drawing concern from toxicologists and public health officials alike.

These substances, including isotonitazene, metonitazene and etonitazene, are often sold as white or brown powders and have been found in counterfeit pills and mixed with other illicit drugs. The United Nations Office on Drugs and Crime (UNODC) reported that by early 2025, it had identified 26 different nitazene compounds across 30 countries, including the United States, and data collection wasn’t even complete. It issues just one of many drug alerts anticipated for this new threat.

Social media platforms have become conduits for the distribution of fentanyl and other illicit substances, particularly among adolescents. Teens often purchase what they believe to be prescription medications like Xanax or oxycodone through social media, only to receive counterfeit pills laced with fentanyl.

While many popular social media platforms have been called out for their part in illegal sales of fentanyl, Snapchat’s “disappearing” message format makes this platform particularly vulnerable to the drug trade. The National Crime Prevention Council specifically urged an investigation into Snapchat due to drug dealers’ ability to hide behind encrypted technology and take advantage of posts that would disappear in 24 hours or less.

In October 2022, a group of parents sued Snapchat for wrongful death and negligence, claiming their children bought fentanyl through drug dealers they met on the platform. That case is still pending, but the Court of Appeals permitted plaintiffs to resume their case and proceed to trial in December 2024.

Public health experts continue to emphasize the need for collaboration with social media companies to monitor and restrict the sale of illicit substances online. Programs like “Living the Example” train youth ambassadors to disseminate prevention messages within their social media networks and schools, aiming to reduce adolescent drug use and distribution.

This guide is filled with facts, figures and policies, but the fentanyl crisis isn’t just about numbers. It’s about people. Many of them are young people who didn’t know the pill they got online could be fatal. Behind every overdose statistic is a shattered family, a friend grieving, a life cut short.

If you suspect or know that your child is using fentanyl or other drugs, the most important thing to remember is this: there’s still time. Fentanyl is dangerous, but intervention and support can save a life. What you do next matters.

Try not to approach the situation with anger or blame. Teens are often scared, confused or unaware of the risks. Focus on safety first. Let your child know you’re concerned and want to help, not punish. Keep the conversation open and judgment-free.

If your teen admits to using pills or drugs, try to find out what, how often and whether they’re aware of the fentanyl risk. Many teens don’t know the pills they’re using are counterfeit or laced with fentanyl.

If you think your teen may be using opioids, even just “experimenting,” it’s critical to have naloxone (Narcan) in the home. Learn how to recognize overdose symptoms, teach others in your household how to respond and consider storing fentanyl test strips if your child continues to use them. Also, consider reaching out to:

• A pediatrician or family doctor
• A school counselor or nurse
• A local substance use helpline or treatment center
• Harm reduction organizations that work with youth

Even if your child isn’t ready to stop, harm reduction strategies can lower their risk of overdose until they’re ready to seek help.

You’re not alone and don’t have to figure it out alone. Organizations like Facing Fentanyl Now and The Lives Project share memorials, advocacy tools and prevention resources for families. These stories are heartbreaking but also galvanizing, showing just how quickly and quietly fentanyl can take a life.

• Kaden Chapel, age 15, from Kokomo, Indiana, died after taking half of a counterfeit M30 pill that was actually fentanyl.
• Stone Carpenter, age 18, from St. Charles, Missouri, died after using what he thought was a Percocet purchased online that was fentanyl in disguise.
• Zachariah Plunk, age 17, Mesa, Arizona, died after purchasing what he thought was a Percocet from a dealer on Snapchat that contained five times the lethal amount of fentanyl.
• Issaiah Gonzales, age 15, Sacramento, California, died after taking a pill passed off as Percocet from someone he trusted, which contained a lethal dose of fentanyl.

Their stories aren’t isolated. Hundreds of teens across the country have died from a single pill. Knowing the signs and acting early can prevent another loss.

If you believe your teen is at risk, don’t wait to seek support. Watch for changes in behavior, secrecy, new friend groups or unexplained health issues. Most importantly, trust your instincts and reach out to professionals who can guide you in finding the right path forward.

The fentanyl crisis is real, but so is recovery. The earlier you act, the more options your child will have and the more likely they are to survive and heal.

The fentanyl crisis is one of the most urgent public health challenges of our time, but it’s not unsolvable. The devastating impact demands a collective response from all sectors: families, schools, public health leaders, government agencies and every community organization willing to step forward. Together, we can change the outcome.

A strong fentanyl public health response must include access to treatment, harm reduction tools and youth-focused prevention. It starts with removing stigma, expanding resources and continuing to raise overdose awareness across every neighborhood and social platform.

This opioid prevention guide was created to empower not just policymakers or clinicians, but parents, teachers, students and friends. Anyone can help save a life. Education and advocacy are tools we all can use. We encourage you to share what you’ve learned, talk with your community and stay engaged as the fight continues. We all have a role to play and still have time to make a difference.

If you or someone you know is struggling with fentanyl abuse or opioid addiction, reach out to RehabNet today. Our free, confidential resource connects individuals and families to vetted treatment centers and support programs nationwide. Call our helpline for guidance, compassion and real help.