Fentanyl, an open border and teenage deaths

Teen overdose deaths have doubled in three years, an alarming trend amid a historic decline in drug and alcohol use among high school students.  

The main reason is fentanyl. Fentanyl is a synthetic opioid, which has proliferated on the underground market of counterfeit pills for the past several years. Teens consume it unwittingly, packaged in counterfeit pills tailored to resemble less potent prescription medications. Drug traffickers lace pills with fentanyl to boost the black-market “high”. Dangerously addictive, fentanyl can be lethal, especially to children experimenting with drugs. Inexpensive, easily manufactured and powerfully addictive, fentanyl has emerged as the narcotic of choice for drug traffickers and dealers. The Hill.

Fentanyl has increased the stakes in the decades-long drug war, inflaming the preexisting opiate crisis and bickering over border security, with a heightened lethality not shared by other recreational drugs.

The GOP has put a spotlight on fentanyl, portraying it as the connective tissue among immigration, crime, border chaos and the overdose epidemic. In recent weeks the drug has been a fixture of GOP hearings, with House Homeland Security Chairman Mark Green (R-Tenn.) claiming “backpacks full of fentanyl [are] pouring into our country” while border officers are stretched thin in responding to migrants. 

Its path to the U.S. is surprisingly straightforward; data from U.S. Customs and Border Protection shows 90 percent or more of fentanyl seizures have happened at U.S. ports of entry, while a fraction of fentanyl is captured between ports of entry. And U.S. Sentencing Commission data shows that the vast majority of those convicted of trafficking fentanyl into the U.S. are American citizens.

Increase in deaths of young people caused by fentanyl 

There were 518 deaths among adolescents in 2010, with rates remaining stable through 2019 with 492 deaths. Deaths increased to 954 in 2020 and to 1146 in 2021. Between 2019 and 2020, overdose mortality increased by 94.03% and from 2020 to 2021 by 20.05%.

In the overall population, numbers of overdose deaths were higher and rates increased steadily from 2010 to 2020 and 2021. The percent change was 29.48% from 2019 to 2020 and 11.48% from 2020 to 2021. 

Among adolescents, fentanyl-involved fatalities increased from 253 in 2019 to 680 in 2020 and to 884 in 2021. In 2021, fentanyls were identified in 77.14% of adolescent overdose deaths, compared with 13.26% for benzodiazepines, 9.77% for methamphetamine, 7.33% for cocaine, 5.76% for prescription opioids, and 2.27% for heroin.

American Indian and Alaska Native adolescents experienced the highest overdose rate in 2021. 

JAMA