Fentanyl deaths among the young are dropping. Can the trend continue?
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Justin Carlisle is part of a trend that has stunned drug addiction experts. I was real young, man. I was 13 or 14 when I first tried cocaine, crack cocaine, for the first time. He's been using drugs for a decade in the rough neighborhood of Kensington, Philadelphia. From crack, Carlisle moved on to the deadly synthetic opioid fentanyl. Yeah.

Yeah, I've had three overdoses. Two of the times I was definitely Narcan. Narcan is the medication that reverses opioid overdoses. It's also called naloxone. Without it, Carlisle 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. What we're seeing is a massive reduction in overdose risk among Gen Z in particular. Overall, drug deaths in the United States are declining fast.

And the latest federal data show young people are seeing the biggest improvements. Ages 20 to 29 lowered their risk by 47 percent, cut it right in half. 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. What has happened with the 20 to 29-year-olds? They beat fentanyl. 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 year.

And the numbers kept climbing until last year when fatal overdoses suddenly dropped by 40%. We continue to look at the data and we're super heartened to finally see the teens dropping. 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, I'm Ari Shapiro.

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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. Keith Humphreys, an addiction researcher at Stanford University, credits this behavioral shift with helping save lives. There's fewer people initiating use of these substances, and that should work in our favor.

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. Nabarundas Gupta at the University of North Carolina says after a decade of devastation caused by fentanyl and other opioids, many people in their teens and 20s appear to be taking fewer risks.

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

What I'm used to is getting high, you know? Many, like Justin Carlyle, 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. 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. I

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.

All right. Anything we can help you with? You're hungry, need water? There's also a growing effort around the U.S. to reach young people in addiction, programs that ramped up fast over the last four years with federal funding from the Biden administration. You want to go inpatient? You want to go into shelter? Kevin Howard and Dominic Maurizio do street outreach with Philadelphia's city drug response team. They

They kneel next to a man huddled in a bus stop. You seem like a young man. He's about 22. He's got too much going for you for his age. 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. I think that if we help one person, we're winning in some capacity. How do you see that? I see that as me saving lives.

Any time that I give someone Narcan or just checking on them to see if they're alive, I believe we're winning.

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? This part's really cool. There are some signs that this trend could be solid and could push forward. Nabaron Descupta 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 U.S. He

he found that drug deaths for young people appear to still be dropping. From these fast-reporting jurisdictions, I see the trend continuing and accentuating. 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. Big positive shifts like this don't usually happen with street drugs. Do drug policy experts know what is helping young people survive?

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 U.S. communities is being disrupted. All of that could mean fewer kids exposed.

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? Yeah, 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 Office says 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 in

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.

That is NPR addiction correspondent Brian Mann. Thank you for your reporting. Thank you. This episode was produced by Alejandro Marquez-Hance. It was edited by Andrea DeLeon and Courtney Dourning. Our executive producer is Sammy Yenigan. It's Consider This from NPR. I'm Ari Shapiro.

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