Fentanyl deaths among the young are dropping. Can the trend continue?

Summary

Consider This from NPR

Episode: Fentanyl deaths among the young are dropping. Can the trend continue?
Release Date: June 10, 2025

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Introduction: A Shifting Landscape in Drug Overdoses

In this compelling episode of NPR's Consider This, host Ari Shapiro delves into a surprising and hopeful trend amidst the otherwise devastating opioid crisis: a significant decline in fentanyl-related deaths among young Americans. Through personal narratives, expert insights, and recent data, the episode explores whether this positive trend can be sustained.

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Personal Stories: Surviving the Crisis

The episode opens with the harrowing personal account of Justin Carlile, a young man from Kensington, Philadelphia, whose decade-long battle with addiction highlights both the peril of fentanyl and the lifesaving impact of interventions like Narcan.

• Justin Carlile (00:05): “I was a real young man. I was 13 or 14 when I first tried cocaine, crack cocaine for the first time.”

• Carlile (00:21): “Yeah, I've had three overdoses. Two of the times I was definitely Narcan.”

Carlile emphasizes the critical role of Narcan (naloxone) in his survival:

• Carlile (00:26): “Without it, I wouldn't be alive today.”

His experience underscores a broader narrative of increased survival rates among young individuals facing opioid overdoses.

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Data-Driven Insights: Declining Overdose Rates

NPR's Brian Mann presents the latest federal data revealing a sharp decline in drug-related deaths, particularly from fentanyl, among young people.

• Nabarun Desgupta, researcher at the University of North Carolina, highlights a significant reduction:

  • Desgupta (00:45): “What we're seeing is a massive reduction in overdose risk among Gen Z in particular.”

• The data shows a 47% decrease in overdose risk for individuals aged 20 to 29:

  • Desgupta (00:52): “Ages 20 to 29 lowered their risk by 47%. Cut it right in half.”

This demographic, typically among the most vulnerable to overdoses, now experiences the lowest rate of drug deaths in over a decade, offering a beacon of hope for families and communities devastated by the opioid epidemic.

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Community and Parental Perspectives

John Epstein, a parent who lost his son to fentanyl, expresses cautious optimism about the declining trends.

• John Epstein (01:17): “What has happened with the 20 to 29 year olds? They beat fentanyl.”

Reflecting on his personal loss and the recent data:

• Epstein (01:39): “We continue to look at the data and we're super heartened to finally see the teens dropping.”

His sentiments resonate with many parents who have long feared for their children’s safety amid rising overdose rates.

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Contributing Factors: Why Are Rates Declining?

Several factors contribute to the decrease in fentanyl-related deaths among young people:

1. Behavioral Shifts:

   • Keith Humphries, an addiction researcher at Stanford University, attributes the decline to significant changes in drug use behaviors:

     • Humphries (03:32): “There's fewer people initiating use of these substances, and that should work in our favor.”

   • A University of Michigan study highlighted a sharp decline in drug use among high schoolers, a trend that began during the COVID-19 pandemic and has continued to decline.

2. Diversion from High-Risk Drugs:

   • Desgupta (04:00): “Alcohol and opioids are on the out among Gen Z, and instead we see cannabis and psychedelics, and those are inherently safer drugs.”

3. Increased Availability of Narcan:

   • Greater distribution of naloxone has empowered more individuals to reverse overdoses, directly saving lives.

4. Enhanced Addiction Care:

   • Improvements in addiction treatment, including the use of medications like Suboxone, provide better support for those struggling with addiction, even though challenges remain.

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Ongoing Challenges and Vulnerable Populations

Despite the encouraging data, significant challenges persist:

• Justin Carlile shares the difficulty of overcoming addiction, highlighting that many young people are still entrenched in full-blown addiction struggles:

  • Carlile (04:28): “What I'm used to is getting high, you know?”

  • Carlile (04:46): “I wish I had the answer to that. And I know all of us that are fighting addiction right now wish we had that answer.”

• The risk remains high for individuals already dependent on opioids, and sustaining the decline in overdose rates requires continued and enhanced efforts.

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Frontline Efforts: Street Outreach and Support

Field workers like Kevin Howard and Dominic Maurizio, both in recovery themselves, play a pivotal role in outreach and harm reduction:

• Kevin Howard (05:55): “I see it as me saving lives. Anytime that I give someone Narcan or just checking on them to see if they're alive, I believe we're winning.”

Their hands-on efforts in Philadelphia’s City Drug Response Team exemplify the importance of community-based interventions in maintaining and advancing the positive trends in overdose rates.

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Policy Implications and Future Outlook

The episode raises critical concerns about the sustainability of current improvements in fentanyl-related deaths, especially in the face of potential policy changes under the Trump administration.

• The Trump-supported Republican budget proposal threatens to cut billions from addiction programs, which could reverse the progress made:

  • Brian Mann: “A lot of the family members, doctors and researchers I've been talking to are really worried that important frontline programs that are helping young people could be scaled back or shut down entirely.”

• Dominic Maurizio highlights positive indicators that the trend might continue:

  • Dominicio Maurizio (06:48): “So we've now seen two straight years of improvement in drug deaths for young people. Now we're at the lowest level since 2013.”

• Brian Mann emphasizes the need for continued support and funding to maintain these gains:

  • Brian Mann (07:04): “Some of the families and activists I've been talking to believe teens and 20 somethings are finally getting the message that drug experimentation is far riskier in the age of fentanyl.”

The episode concludes with a call to action, stressing the importance of sustained public health initiatives and supportive policies to ensure the downward trend in fentanyl deaths among young people not only continues but accelerates.

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Conclusion: A Moment of Hope and Caution

NPR’s Consider This episode effectively balances hope and caution, showcasing the remarkable decline in fentanyl-related deaths among young Americans while highlighting the fragile nature of this progress amidst shifting political landscapes. The stories of survivors like Justin Carlile and the dedication of frontline workers underscore the importance of comprehensive, community-based approaches in tackling the opioid crisis. As policymakers deliberate on funding and support for addiction programs, the insights shared in this episode serve as a critical reminder of what is at stake and the lives that depend on sustained, compassionate intervention.

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Produced by Alejandra Marquez Hanse and edited by Andrea De Leon and Courtney Dorning. Executive Producer: Sammy Yenigun.

Transcript

[Ari Shapiro]

Justin Carlile is part of a trend that has stunned drug addiction experts.

[Justin Carlile]

I was real young man. I was 13 or 14 when I first tried cocaine, crack cocaine for the first time.

[Ari Shapiro]

He's been using drugs for a decade in the rough neighborhood of Kensington, Philadelphia. From crack, Carlile moved on to the deadly synthetic opioid fentanyl.

[Justin Carlile]

Yeah, I've had three overdoses. Two of the times I was definitely Narcan.

[Ari Shapiro]

Narcan is the medication that reverses opioid overdoses. It's also called naloxone. Without it, Carlyle says, he wouldn't be alive today. And his survival makes him part of this remarkable shift. After years when drug deaths among young Americans kept spiraling higher and higher, far more are now surviving.

[Nabarun Desgupta]

What we're seeing is a massive reduction in overdose risk among Gen Z in particular.

[Ari Shapiro]

Overall drug deaths in the United States are declining fast. And the latest federal data show young people are seeing the biggest improvements.

[Nabarun Desgupta]

Ages 20 to 29 lowered their risk by 47%. Cut it right in half.

[Ari Shapiro]

People in that age group are usually among the most vulnerable to overdoses. Today they have the lowest rate of drug deaths in more than a decade. Parents like John Epstein have been waiting for a moment of hope like this one.

[John Epstein]

What has happened with the 20 to 29 year olds? They beat fentanyl.

[Ari Shapiro]

In 2020, his 18 year old son Cal died from fentanyl. He was one of 28,000 people under the age of 35 to die from drugs. That and the numbers kept climbing until last year when fatal overdoses suddenly dropped by 40%.

[John Epstein]

We continue to look at the data and we're super heartened to finally see the teens dropping.

[Ari Shapiro]

Consider this. Fentanyl deaths among young people are plummeting at an unprecedented rate. The question now is how to keep that trend going. From npr. Hi, I'm Ari Shapiro.

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[Ari Shapiro]

It'S Consider this from NPR. Over the last decade, fentanyl and other street drugs killed more than 230,000 people under the age of 35. New federal data obtained by NPR's Brian Mann show a stunning reversal in that trend. And one factor appears to be much lower, drug use among young people. Mann dug into the reasons why and picks up the story from here.

[Brian Mann]

Keith Humphries, an addiction researcher at Stanford University, credits this behavioral shift with helping save lives.

[Unknown]

There's fewer people initiating use of these substances, and that should work in our favor.

[Brian Mann]

One study by researchers at the University of Michigan found drug use among high schoolers dropped sharply during the COVID pandemic and has continued to decline, hitting a new low last year. Nabarundasgupta at the University of North Carolina says after a decade of devastation caused by fentanyl and other opioids, and many people in their teens and twenties appear to be taking fewer risks.

[Nabarun Desgupta]

Alcohol and opioids are on the out among Gen Z, and instead we see cannabis and psychedelics, and those are inherently safer drugs.

[Brian Mann]

So lots of good news here. Roughly 15,000 fewer drug deaths among young people last year compared with the deadly peak of the fentanyl crisis. But researchers say keeping this progress going could be difficult. That's because many of the young people still most vulnerable aren't just experimenting with drugs.

[Justin Carlile]

What I'm used to is getting high, you know?

[Brian Mann]

Many like Justin Carlisle, the 23 year old I met in Philadelphia, are already struggling with full blown addiction. He tells me he's tried to quit fentanyl repeatedly, even using the medication Suboxone that helps curb cravings for opioids. But it hasn't worked.

[Justin Carlile]

I wish I had the answer to that. And I know all of us that are fighting addiction right now wish we had that answer.

[Brian Mann]

But there's hope here, too. Researchers say fentanyl being sold by dealers appears less potent, less deadly. No one's sure why. There's also more naloxone on the street, reversing overdoses. That matters because drug policy experts say when people facing severe addiction stay alive long enough, most eventually recover.

[Kevin Howard]

All right, anything we can help you with? You're hungry? Need water.

[Brian Mann]

There's also a growing effort around the US to reach young people in addiction programs that ramped up fast over the last four years with federal funding from the Biden Administration.

[Kevin Howard]

Want to go inpatient? Want to go into the shelter?

[Brian Mann]

Kevin Howard and Dominic Maurizio do street outreach with Philadelphia's City drug response team. They kneel next to a man huddled in a bus stop.

[Justin Carlile]

You seem like a young man. He's about 22.

[Kevin Howard]

Got too much going for you as far as age?

[Brian Mann]

Howard and Maurizio are themselves in recovery. They survived addiction to heroin and crack cocaine in their 20s. I ask if they think this outreach work is helping.

[Justin Carlile]

I think that if we help one person, we're winning in some capacity.

[Brian Mann]

How do you see that?

[Kevin Howard]

I see it as me saving lives. Anytime that I give someone Narcan or just checking on them to see if they're alive, I believe we're winning.

[Ari Shapiro]

Reporting there from NPR's Brian Mann, who joined me to talk through more of the reasons behind the drop and where things might go from here. Brian, do researchers think fentanyl deaths will keep coming down?

[Dominic Maurizio]

This part's really cool. There are some signs that this trend could be solid and could push forward. Nabarone Desgupta at the University of North Carolina, he's been looking at real time overdose reports collected in just the last few months in cities and rural counties around the US Found that drug deaths for young people appear to still be.

[Nabarun Desgupta]

Dropping from these fast reporting jurisdictions. I see the trend continuing and accentuating.

[Dominic Maurizio]

So we've now seen two straight years of improvement in drug deaths for young people. Now we're at the lowest level since 2013.

[Ari Shapiro]

Big positive shifts like this don't usually happen with street drugs. Do drug policy experts know what is helping young people survive?

[Dominic Maurizio]

Some of the families and activists I've been talking to believe teens and 20 somethings are finally getting the message that drug experimentation is far riskier in the age of fentanyl. Studies suggest many high school students, for example, are more cautious now than they used to be when it comes to drug use. But researchers point to lots of other possible factors. There's a lot more Narcan, also known as naloxone, being distributed. There's more and better addiction care. Researchers are also seeing evidence that the supply of fentanyl into US Communities is being disrupted by all of that could mean fewer kids exposed.

[Ari Shapiro]

These improvements you're describing came during the last two years of the Biden administration. Now that President Trump is in office, is the national response to fentanyl changing?

[Justin Carlile]

Yeah.

[Dominic Maurizio]

The Biden team invested a massive amount of federal money in public health and science programs that are all part of this fentanyl fight. They also encouraged the use of Medicaid as the insurance to pay for addiction care. The Republican budget passed by the House with President Trump's support would cut billions of dollars from those programs and the congressional budget as millions of low income Americans would likely lose Medicaid coverage if the Senate passes this bill. Many of those people would be young people. NPR asked the Trump administration how they think those cuts would affect this fentanyl fight. The U.S. health and Human Services Department sent a statement saying the goal is to streamline resources and eliminate redundancies. But a lot of the family members, doctors and researchers I've been talking to are really worried that important frontline programs that are helping young people could be scaled back or shut down entirely. If that happens, they say this dramatic recovery for people under 35 could stall.

[Ari Shapiro]

That is NPR addiction correspondent Brian Mann. Thank you for your reporting.

[Dominic Maurizio]

Thank you.

[Ari Shapiro]

This episode was produced by Alejandra Marquez Hanse. It was edited by Andrea De Leon and Courtney Dorning. Our executive producer is Sammy Yenigun. It's Consider this from and welcome back to gonpr. I'm Ari Shapiro.

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