Polysubstance Involvement in Youth Opioid Overdoses Increases with Age

A new study conducted by the Boston University School of Public Health and Mass General Brigham for Children has found that youth as young as 15 are using multiple substances combined with opioids, and by age 21, youth opioid overdoses more commonly involve other substances, primarily stimulants, rather than opioids alone. The study, published in the journal Pediatrics, examined trends in overdose mortality and found that among youth, opioid overdoses more commonly involved multiple substances than opioids alone, starting at age 21. Polysubstance-involved overdose deaths occurred among youth as young as 15 years old, and rose steadily with age.

Key Takeaways:

• Polysubstance involvement in youth opioid overdoses starts as early as 15 years old and increases with age, with 25% of opioid overdose deaths among 15-year-olds involving multiple substances.
• By age 21, youth opioid overdoses more commonly involve other substances, primarily stimulants, rather than opioids alone.
• Stimulants such as methamphetamine and cocaine were the primary contributors to polysubstance-involved deaths in youth opioid overdoses.
• Fentanyl and other synthetic opioids were involved in more than 93 percent of overdose deaths among youth.
• Polysubstance use drove nearly half of the 23,000 youth opioid overdose deaths from 2020 to 2023.
• Stimulants were involved in 65 percent of polysubstance opioid overdose deaths and 33 percent of all opioid overdose fatalities.
• Among the approximately 23,000 opioid overdose deaths that occurred in youth during this period, polysubstance-involved overdoses contributed to 25% of opioid overdose deaths among 15-year-olds, 40% among 18-year-olds, nearly 53% of these deaths among 21-year-olds, and 58% among 24-year-olds.
• Other than opioids, stimulants were the most common substance involved in overdose deaths, and were used in approximately 12% of opioid overdose deaths among 15-year-olds, 21% among 18-year-olds, 34% among 21-year-olds, and 41% among 24-year-olds.
• Rising rates of mental health conditions, wider availability of illicit drugs, and rising potency of drugs are likely factors driving age-related increases in polysubstance-involved overdose deaths.

Statistics:

• 48.5 million people aged 12 or older had a substance use disorder in the past year.
• Drug overdose deaths more than doubled among adolescents from 2018 to 2022.
• Polysubstance use drove nearly half of the 23,000 youth opioid overdose deaths from 2020 to 2023.
• Stimulants were involved in 65 percent of polysubstance opioid overdose deaths and 33 percent of all opioid overdose fatalities.
• Fentanyl and other synthetic opioids were involved in more than 93 percent of overdose deaths among youth.
• Among the approximately 23,000 opioid overdose deaths that occurred in youth during this period, polysubstance-involved overdoses contributed to 25% of opioid overdose deaths among 15-year-olds, 40% among 18-year-olds, nearly 53% of these deaths among 21-year-olds, and 58% among 24-year-olds.

Sources:

• Boston University School of Public Health
• Mass General Brigham for Children
• Pediatrics (journal)
• U.S. Department of Health and Human Services (n/a)
• 2023 National Survey on Drug Use and Health (n/a)