Story at a Glance
- 84 percent of all teen overdose deaths in 2021 were related to fentanyl.
- Fentanyl-related adolescent overdose deaths nearly tripled between 2019 and 2021, and a quarter of those deaths involved counterfeit drugs—pills like Valium, Xanax, or Percocet, often obtained from friends or bought through social media.
- Fentanyl is an incredibly potent synthetic opioid. It’s 50 times stronger than heroin and 100 times stronger than morphine. Just 2 milligrams, equal to 10 to 15 grains of table salt, can be lethal.
- Having the right tools, such as fentanyl test strips and Narcan (naloxone) in your home or school medical kit, can also save lives. Never buy fentanyl tests from friends or online. Always get them from your local health department or a trusted community organization, such as addiction recovery programs, as counterfeit tests are in circulation. Also, make sure they’re legal to obtain in your state.
- Drug makers are now working on anti-opioid vaccines: one for heroin, one for oxycodone, and one for fentanyl. The fentanyl vaccine is said to work by preventing the drug from entering the brain, thus eliminating the “high” users experience, as well as the risk of respiratory depression. The other vaccines work on the same premise.
“Fentanyl accounted for more than 67,000 preventable deaths in 2021, which represents a 21% increase since 2020, according to the National Safety Council.7 More than 5,600 of those deaths occurred in people ages 15 to 24.”Other data show fentanyl-related adolescent overdose deaths nearly tripled between 2019 and 2021, and a quarter of those deaths involved counterfeit drugs—pills like Valium, Xanax, or Percocet, often obtained from friends or bought through social media.8
While far deadlier than other opioids, fentanyl is much easier and cheaper to manufacture, which is why it’s being used in counterfeits. Its potency, however, makes it risky. If unevenly distributed, you can easily end up with lethal doses in some pills.
We Need to Revive Drug Education
Schools across the country are now struggling with how to best address this new trend. Many do not stock the overdose reversal drug Narcan (naloxone), which could be helpful, but even more importantly, schools rarely educate kids and teens about the dangers of drugs anymore.Most educational programs are currently run by families who lost a child or loved one to fentanyl. Examples include Project 1 Life, founded by Avery Kalafatas, an 18-year-old from the Bay Area whose cousin died from a fentanyl overdose after taking what he thought was a Percocet tablet.
Many also aren’t aware of just how deadly fentanyl can be and how prevalent counterfeit drugs are. Another group focused on fentanyl education for teens is Song for Charlie, founded by Ed and Mary Ternan, who lost their son Charlie to an accidental fentanyl overdose.
“Rather than focus on ‘Don’t do drugs, they might harm you,’ Song for Charlie’s messaging is: ‘You’re getting ripped off. These dealers advertising on social media do not care. They don’t know you, they’re not your friend, and they are lying to you about what they’re selling you,’” NPR writes.13
“That’s what happened to Ternan’s youngest son, Charlie ... In May 2020, Charlie was on his college campus in northern California. He was weeks away from graduation, and was prepping for a job interview. He was also in pain. Ternan says his son had recently undergone back surgery.
“Charlie purchased what he thought was a Percocet off of Snapchat. It contained fentanyl. ‘He actually took it a couple hours before he was supposed to have a job interview on the phone,’ Ternan says. ‘And so he died very quickly in his room at his frat house waiting for the phone to ring at about four o'clock on a Thursday afternoon.’
“After his son’s death, Ternan says most of the information about fentanyl he could find was buried on government websites and in a smattering of news articles.
“‘You can put that information in those places for the next 10 years, and Charlie and his friends would never have seen it because that’s not where they are.’ Where they are is on social media.
“Ternan says their messages also appeal to teenagers’ strong social bonds. He’s learned that telling teens to warn their friends about fentanyl is more powerful than stoking fear of their own harm.”

Increasing Awareness Can Save Lives
Increasing awareness about the risks of fentanyl and counterfeit drugs could save a lot of lives. According to CDC research,14 bystanders were present at two-thirds of teen overdose deaths. Had they recognized the warning signs and known how to respond in case of a suspected overdose, they may have been able to save many of those kids.- Place a small amount of the drug in a clean, dry container.
- Add a small amount of water and mix.
- Place the wavy end of the test strip into the mixture for about 15 seconds.
- Remove the strip and place it on a flat surface for two to five minutes.
- Read the results: A single pink line means fentanyl has been detected (positive result). Two lines mean no fentanyl has been detected (negative result).
Are Fentanyl Tests Legal in Your State?
Also, check your state laws. Fentanyl test strips are still considered illegal “drug paraphernalia” in most states, although several states have exceptions for fentanyl tests, and some have decriminalized them and taken them off the drug paraphernalia list.Utah and Washington have distribution programs that allow certain entities to legally distribute fentanyl test strips, despite being otherwise banned as drug paraphernalia. Similarly, North Dakota and Vermont permit the use of fentanyl test strips by harm reduction programs only.
California, Connecticut, Maine, New Jersey, and Ohio also have specialized distribution programs for fentanyl tests while still legally classifying them as banned drug paraphernalia. So in all of these states, you have to make sure you’re getting them from a legal source. States and territories where fentanyl test strips have been legalized include:
- People who use opioids and benzodiazepines together.
- People who use illicit opioids like heroin.
- People taking high-dose opioid medications prescribed by a doctor. Ideally, ask your doctor to co-prescribe naloxone. You may also want to talk to your doctor about low-dose naltrexone (LDN).
For opioid dependence, the typical starting dose is 1 microgram twice a day, which will allow a user to lower their opioid dose by about 60 percent. When the opioid is taken for pain, the LDN must be taken four to six hours apart from the opioid in order to not displace the opioid’s effects.
How to Use Naloxone
Before you use naloxone,24 first, determine whether the person has overdosed on opioids. Symptoms of an opioid overdose include:- Slowed breathing, gurgling, or no breathing.
- Pupils narrowed to a pinpoint.
- Blue or purple lips and/or fingernails.
- Clammy skin.
- Cannot be roused by shaking and shouting.
- Get the Narcan ready, then tilt the person’s head backward and insert the spray tip into one nostril until both of your fingers are touching the nose. Push the plunger down to administer the dose.
- Call emergency services (911 in the United States) after you’ve given the first dose, as every second counts.
- Next, roll the person onto their side. Place one of their hands under their head and bend the leg that is on top at the knee to prevent them from rolling over. Narcan can trigger acute withdrawal symptoms, including vomiting, so make sure the airways are kept clear to avoid choking.
- If the person has not regained consciousness after two to three minutes, repeat the process and administer the second dose into the other nostril.
- Stay with them until emergency services arrive or for at least four hours to make sure their breathing returns to normal.
A Vaccine Against Fentanyl Overdoses?
Not willing to let a crisis go to waste, the vaccine industry is now hard at work to create an injectable solution. On Nov. 14, 2022, the University of Houston announced positive results from an animal study25 in which they tested a vaccine against fentanyl.26 The vaccine is said to work by preventing fentanyl from entering the brain, thus eliminating the “high” users experience, as well as the risk of respiratory depression.The vaccine includes a deactivated diphtheria toxin and an adjuvant derived from E. coli called dmLT. The researchers reported this adjuvant had been combined with other vaccines in other human clinical trials, but in each of those trials, the dmLT was administered orally and therefore exposed to the digestive tract.
In this case, the vaccine is administered by injection, which means dmLT enters the muscles and bloodstream directly. The shot was given to 28 male and female mice, after which the researchers measured antibodies.
Serum testing showed antibody levels rose significantly after the third dose, between weeks four and six. Researchers tested whether fentanyl had reached the brain by gauging pain reactions since opioids are used to dull pain sensation.
If you ask me, this sounds like another Big Pharma scheme where the companies that create the opioids will end up profiting from anti-opioid vaccines, just like the Sackler family did.
Where to Find Help for Addiction
If you or a loved one is struggling with drug addiction, the Substance Abuse Mental Health Service Administration31 can be contacted 24 hours a day at 1-800-622-HELP. Your workplace Employee Assistance Program may also be able to help.Also, consider having Narcan on hand and fentanyl test strips (where legal). While neither of these does anything to fix the problem of addiction, the test strip can prevent accidental overdosing on a fentanyl-laced drug, and Narcan can save your or someone else’s life in case of an overdose, giving you/them another chance to make a different choice.
◇ References
- 1 CBS News June 6, 2017
- 2, 8, 12, 13 NPR August 30, 2023
- 3, 10, 11, 18 The New Yorker March 28, 2023
- 4 CDC Fentanyl May 3, 2023
- 5 HHS.texas.gov Fentanyl
- 6, 15 USA Today August 21, 2023
- 7 National Safety Council Drug Overdoses
- 9 KCRA June 8, 2023
- 14 CDC MMWR December 16, 2022; 71(50): 1576-1582
- 16 Addiction Resource January 13, 2022
- 17 Spectrum Local News July 7, 2023
- 19 FDA March 29, 2023
- 20 SAMHSA.gov Naloxone FAQ
- 21, 24 CDC Lifesaving
- 22 Nextdistro.org
- 23 Nasen.org
- 25 Pharmaceutics, 2022;14(11): 2290
- 26, 27 University of Houston, November 14, 2022
- 28, 29 Medicalxpress August 29, 2023
- 30 Fox News March 18, 2023
- 31 Substance Abuse Mental Health Service Administration