Top 5 Takeaways:

  1. Median monthly overdose deaths among adolescents aged 10-19 years increased by 109% from July–December 2019 to July–December 2021.
  2. Deaths involving illicitly manufactured fentanyls (IMFs) rose by 182%, with about 84% of deaths involving IMFs.
  3. Approximately 90% of overdose deaths involved opioids, with counterfeit pills present in nearly 25% of cases.
  4. Two-thirds of decedents had potential bystanders present, but most provided no overdose response.
  5. Around 41% of decedents had evidence of mental health conditions or treatment.

Note: With the ever evolving language around drug user health, this summary has opted to use the terms originally found in the article. However, “Drug Poisoning” may be seen as a more appropriate term than drug overdose in many situations.


Original Article Author and Citation

Corresponding Author

Lauren J. Tanz,, 770-488-6717.

Suggested Citation

Tanz LJ, Dinwiddie AT, Mattson CL, O’Donnell J, Davis NL. Drug Overdose Deaths Among Persons Aged 10–19 Years — United States, July 2019–December 2021. MMWR Morb Mortal Wkly Rep 2022;71:1576–1582. DOI:


This report investigates the alarming increase in drug overdose deaths among adolescents (persons aged 10–19 years) in the United States from July 2019 to December 2021. The study utilized data from the State Unintentional Drug Overdose Reporting System (SUDORS).


Data were collected from death certificates, postmortem toxicology testing, and medical examiner or coroner reports. The analysis spanned 32 jurisdictions and focused on unintentional and undetermined intent drug overdose deaths.


Key findings reveal a significant increase in adolescent overdose deaths, particularly involving IMFs and opioids. Counterfeit pills, often containing IMFs, contributed to nearly a quarter of these deaths. A noteworthy aspect is the presence of potential bystanders during most overdoses, yet a lack of effective response. The report underscores the importance of public health measures, including education on the risks of IMFs and counterfeit pills, substance misuse prevention, and mental health support.


Urgent public health actions are needed to address the rising trend of overdose deaths among adolescents. This includes a combined effort in preventing substance misuse, improving drug education, expanding access to naloxone and mental health services, and fostering stronger collaborations between public health, safety agencies, and community organizations. The goal is to create a safer environment for adolescents and effectively tackle the challenges posed by illicit drug use and mental health issues.

In conclusion, this report highlights the critical need for proactive and comprehensive strategies to combat the growing crisis of adolescent overdose deaths in the United States. Public engagement and awareness are essential in addressing this public health emergency.


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