Facing the Fentanyl Era: Helping Young People Look Up, Reach Out and Stay Safe

Fentanyl, a powerful synthetic opioid, remains the leading driver of overdose deaths—and buying fentanyl-laced drugs (even accidentally) can be as easy as hitting an app on your phone. Counterfeit pills sold on online platforms can make drug access easier for young people and harder for adults to recognize. That reality makes “just say no” an incomplete and ineffective prevention message. Young people need facts about what’s in the drug supply, trusted adults who make honesty safe, and clear guidance on how to seek help before a crisis occurs.

AFT’s broader “devices down, eyes up, hands-on” vision for education emphasizes that young people need more opportunities to connect with the people and places around them. When students are anxious, isolated or primarily engaging through screens, it becomes harder for adults to notice when something is wrong and harder for young people to ask for help. Substance use prevention should therefore not only be about warning young people away from danger but also about creating conditions that help them look up, reach out and stay safe.

Overdose Deaths Are Declining, But the Crisis Is Not Over

According to the Centers for Disease Control and Prevention, overdose deaths peaked at roughly 108,000 in 2022 and fell by 27percent to just under 80,000 in 2024. However, death counts do not capture the full scale of overdose harm. Many people survive one or more overdoses before a fatal event occurs. The burden also remains uneven. Data from KFF, a nonpartisan health policy research organization, show that overdose death rates remain higher among men and especially high in some communities, including American Indian, Alaska Native and Black residents.

Dr. Olsen explained that the decline in overdose deaths likely reflects several factors working together. Increased access to the overdose reversal medication naloxone and fentanyl test strips has helped communities prevent fatal overdoses. Improved overdose surveillance and stronger local response systems have made it easier for public health agencies, healthcare providers, and community organizations to identify trends and deploy resources more quickly.

Many of those strategies fall under harm reduction, a public health approach focused on keeping people alive, reducing risk and creating opportunities for care. However, harm reduction is often misunderstood as encouraging drug use, when its purpose is to help people survive and stay connected long enough to seek treatment.

Fentanyl Is the Leading Driver, But Hidden Risks Are Multiplying

Even as overdose deaths have declined, fentanyl remains at the center of the overdose crisis. According to KFF, 76 percent of teen overdose deaths in 2023 involved fentanyl. Although teen overdose deaths declined between 2023 and 2024, they remained more than twice pre-pandemic levels.

Fentanyl is described as up to 50 times stronger than heroin and 100 times stronger than morphine. Small amounts can be deadly, especially when someone does not know fentanyl is present. That hidden exposure is one of today’s greatest risks. Fentanyl can be mixed into cocaine, methamphetamine and counterfeit pills without a person’s knowledge, and it has no taste or smell.

Counterfeit pills are especially concerning for young people because they may look like real prescription medications for anxiety, attention-deficit/hyperactivity disorder or pain but may contain fentanyl or other synthetic substances. Social media and other online platforms can also make drugs easier to find and harder for adults to detect.

At the same time, communities are seeing other substances appear in the illicit drug supply, including veterinary sedatives such as xylazine and medetomidine. Olsen noted that some of these substances are not intended for human use. That adds to the concern around polysubstance use, which is when more than one substance is consumed. Sometimes that can be intentional, but often people do not know what they are taking.

As the drug supply becomes more mixed and synthetic, overdoses can be harder to recognize, treat and reverse.

Breath Is Life: Responding to an Overdose

Knowing how to respond in an emergency can be lifesaving. Signs of overdose may include unconsciousness, slow or shallow breathing and very small pupils. If an overdose is suspected, the response should be immediate: Try to wake the person up, give naloxone if available, call 911 and support breathing.

The Substance Abuse and Mental Health Services Administration (SAMHSA)’s Overdose Prevention and Response Toolkit emphasizes a simple phrase: “Breath is life.” The goal of an overdose response is not to just wake the person up, but to restore breathing. Naloxone can help restore breathing during an opioid overdose and will generally not harm someone who is not experiencing one. However, naloxone may not be enough if non-opioids or sedatives are also involved, making rescue breathing that much more important.

Knowing which resources are available in your community is also important. Naloxone is increasingly available at pharmacies, through community organizations and in some schools and public spaces. For people experiencing a mental health or substance use crisis, the 988 Suicide & Crisis Lifeline and SAMHSA’s National Helpline may provide free, confidential support and information.  

Prevention Starts with Connection

Knowing how to respond to an overdose can save a life, but emergency response is not where prevention begins. Long before a crisis, young people’s substance use risk is shaped by the relationships, environment and support around them.

It’s important to recognize that substance use and substance use disorder are not the same, and not everyone who uses substances develops a substance use disorder. Olsen noted that early substance use is one of the strongest risk factors for later substance use disorder, particularly when use begins before age 14. That risk is especially important during adolescence, when the brain is still developing in areas involved in judgment and decision-making.

Adverse childhood experiences, or ACEs, can also shape risk. ACEs may include violence, household substance use or traumatic experiences. These experiences are associated with higher risk for substance use, mental health challenges and other health impacts.

This is where connection becomes a part of prevention. Young people are more protected when they have stronger peer and family support and community connection. Those connections make it easier for adults to notice when something changes and easier for young people to ask for help.

Conversations about substance use can feel awkward, but the goal is not to say everything perfectly. The goal is to build enough trust that young people know they can come to an adult if they are scared or in danger. A simple “don’t do drugs” message is usually not enough in today’s drug landscape. A better approach is to ask what young people have heard, share age-appropriate facts and make clear that asking for help will not be met with immediate shame or punishment.

Empathy is part of that prevention strategy. As Olsen put it, the antidote to stigma is caring about people as people. That means paying attention not only to what you say, but also to how you say it. Language matters because it shapes whether young people feel seen as human beings or reduced to a label. When adults respond with care instead of judgment, young people are more likely to trust them when something feels unsafe.

Connection cannot eliminate every risk, but it can give young people more reasons to look up, reach out and stay alive long enough to get help.