Consider This from NPR

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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