U.S. Youth Perspectives on Fentanyl

Context In 2023, fentanyl overdosing resulted in the deaths of nearly 75,000 people in the United States. Youth are especially falling prey to fentanyl in counterfeit pills, with 22 adolescents between the ages of 14 and 18 dying each week in 2022 from drug overdoses. Although youth are being directly impacted, their perspectives are often absent in policy-making, leading to ineffective policies.

Objective The aim of this study was to assess youth perspectives on fentanyl and Narcan, and preferences on where Narcan (Naloxone) should be available.

Study design/Population Studied: We posed 3 open-ended questions to MyVoice participants via a nationwide text message cohort of United States youth aged 14–24. These questions collected youth perspectives on current knowledge about fentanyl, beliefs on how youth are exposed/gain access, how youth can be protected from exposure, and thoughts on Narcan. Qualitative content analysis was used to develop a codebook.

Outcome Measures Responses were independently coded by four reviewers with discrepancies discussed to reach consensus. Descriptive statistics were calculated for demographics and frequency of codes.

Results Of the 748 participants, 561 (RR=75%) responded to at least one question. Respondents had a mean age of 20.3 (SD: 2.6) and were a majority female (51.7%). 52% of respondents were white, 11.2% were black, and 24.4% reported low socioeconomic status. Nearly all (92%) of youth in our sample reported potential access/exposure to fentanyl through means such as pain medication or prescriptions, accidental exposure through lacing of illicit drugs, and acquiring it through friends and family members. About half (47%) of youth wanted better fentanyl and Narcan education, 23% called for an increase in access to testing strips, Narcan, and rehabilitation, and 15.7% believe changes in public health policies could protect youth from the effects of fentanyl.

Conclusions Improved education on fentanyl and its effects, as well as information about Narcan are desired by youth in our sample. Our findings suggest that youth have varied experiences and knowledge about fentanyl, and believe that medical and illicit means are the most common method youth get exposure/access to fentanyl.