- Roughly 22 high school students die each week from a fentanyl overdose.
- In a nationally representative survey study, less than half of 8th graders surveyed attributed great risk to experimental use of fentanyl.
- The study’s findings are a “call to action” to better educate children and teens about the synthetic opioid’s risks, a researcher said.
A considerable proportion of younger adolescents may be unaware of the dangers of fentanyl use, according to a cross-sectional survey study.
Among the adolescents surveyed, 47.8% of 8th graders attributed great risk to experimental use of fentanyl, while 57.2% and 66.5% attributed great risk to occasional or regular use, respectively, reported Richard Miech, PhD, of the University of Michigan in Ann Arbor, and colleagues in JAMA Network Open.
For students in 10th grade, 63.6%, 71.5%, and 77.3% attributed great risk to experimental, occasional, or regular use, while these proportions for students in 12th grade were 69.8%, 78.5%, and 84.8%, respectively.
“To the extent that increasing adolescents’ awareness of the dangers of fentanyl is an important tool to prevent overdoses, these results indicate there is room for improvement on this front,” Miech and team wrote. “Warnings to students that fentanyl may be added into counterfeit pills purported to help with studying or anxiety will likely have little protective effect among those who do not believe that using fentanyl can have serious health consequences on first use.”
Miech told MedPage Today that roughly 22 high school students die each week from a fentanyl overdose.
In a setting where someone is using fentanyl, perhaps an older sibling, and an 8th grader is offered some, they may be more likely to say yes if they don’t know what fentanyl is or don’t recognize its risks, he explained. The study’s findings are a “call to action” to better educate children and teens about the synthetic opioid’s risks, he said.
Of note, the survey showed that students in rural areas had the highest levels of perceived risk in 8th and 10th grade.
Miech noted that it was possible that students in these areas were more likely to know someone who had experienced an opioid or fentanyl overdose. He also pointed out that there might be more effective outreach efforts in those areas.
White students were most likely to attribute great risk to fentanyl use in all grades across all three categories of use (experimental, occasional, and regular). In 8th grade, Hispanic students had the lowest levels of perceived risk for all three fentanyl categories, and in 10th and 12th grade, Black students had the lowest levels.
“This combination of low perceived risk with high unfamiliarity highlights the need to identify barriers to effective outreach and to consider whether tailored messaging to these groups is warranted,” Miech and co-authors wrote.
Miech pointed out that “there are many kids who, if you just said, ‘These drugs are dangerous, avoid using them,’ that would be enough, but there are high-sensation-seeking kids and high-risk kids who, if you say, ‘Fentanyl is 50 times more powerful than heroin,’ they might actually take that as a recommendation.”
“So, the message needs to be tailored for the type of kid that you’re talking to,” he added, acknowledging that risk messaging is not his area of expertise.
This study included a nationally representative sample of students in the 48 contiguous U.S. states who filled out surveys in class at school in 2025.
Of the 3,820 adolescents surveyed, 32.8% were in 8th grade, 34.7% were in 10th grade, and 32.5% were in 12th grade. Half of the respondents were girls, 36.1% were white, 35.2% were Hispanic, and 15.2% were Black. Over half (56.5%) had at least one parent with a college degree, 30.9% attended schools in urban areas, 62.3% attended schools in suburban areas, and 6.7% attended schools in rural areas.
The survey excluded students who were homeschooled, quit school, or were absent on the day of survey administration.
In the future, Miech said he hopes to focus on ways to tailor messaging about fentanyl use to different vulnerable groups using social media.
