Fewer than one in three teenagers with opioid use disorder receive treatment, according to a study published in Health Affairs journal examining the disorder in minors from 2022 to 2023. In 2023, 557 teens died of opioid overdose, nearly threefold the number in 2018, while adult opioid deaths increased by only 65 percent during the same period. Drug overdoses are now among the leading causes of death for U.S. teenagers.
One major factor driving the rise is the availability of counterfeit pills containing fentanyl, manufactured to look like prescription opioids. Manuel Cano, associate professor of social work at Arizona State University and lead author of the study, noted that “ten years ago, illicitly manufactured fentanyl was primarily something that people with a history of opioid use were using via injection or smoking,” but now teenagers experimenting with drugs are more likely to encounter these pills or purchase them through social media. Jessica Calihan, an adolescent medicine physician at Massachusetts General Hospital, noted that treatment access remains severely limited even in well-resourced areas. “I’m in Boston—probably one of the most well resourced medical cities in the country,” Calihan said, “but we still struggle with getting young people into intensive care.”
Treatment Barriers and Medication Access
Medication-assisted treatments like naltrexone, suboxone, buprenorphine, and methadone are the most effective available for opioid use disorder. However, less than 10 percent of the fraction of teenagers in treatment receive medication-assisted treatment. Until 2024, doctors were legally required to try other treatments for minors before prescribing medication-assisted therapy. Marc Fishman, an addiction psychiatrist at Johns Hopkins University, criticized this approach: “There’s prejudice and misunderstanding and a sense that we ought to let young people at least try non-medication treatment first… But that’s nuts. That’s not what the evidence says.”
Effective strategies for adolescents differ from adult approaches. Fishman found success involving family and community members in treatment, with support persons tracking appointments through group chats. Another strategy involves rewarding adherence through contingency management—providing prizes, money, and bonuses for medication compliance. Calihan emphasized that early intervention is vital not only for preventing overdose but for preventing severe use disorders from developing into adulthood.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.theguardian.com/us-news/2025/sep/26/us-teen-drug-overdoes-opioids