DENVER (KDVR) — Fentanyl is now involved in at least 75% of all adolescent overdose deaths, a new study says, and Colorado has the second highest rate among all 50 states for such deaths, falling behind Arizona.

However, the study found teen drug use is down. The percentage of teens now using drugs is at its lowest point in almost 50 years, according to the author of a study published in the New England Journal of Medicine, but drug overdoses are now more common as counterfeit fentanyl infiltrates supplies.

The study looked at overdose deaths among adolescents 14-18 years old between January 2018 and December 2022. One statistic the study looked at was that on average 22 adolescent Americans between 14-18 years old died every week in 2022 from drug overdoses nationally.

In total, 3,178 people in the age group died from drug overdoses from 2020 through 2022.

This makes drug overdoses now the third-leading cause of pediatric deaths, following firearm-related deaths and motor-vehicle crashes.

Colorado youth overdose rates second-highest in US

One of the study’s authors, Joseph Friedman, provided a list of “hotspots” across the U.S. where teen overdose deaths are concentrated.

The study shows some of the top states are in the western United States. Arizona, Colorado and Washington state’s mortality rates were nearly twice the national average or higher in 2020–2022.

According to the study’s data, Colorado had 125 youth overdose deaths in that three-year time period. This translates to a mortality rate of 11.43 deaths per 100,000 Coloradans between 14-18 years old, about 2.31 times the national average.

According to the study, the top five states for teen overdose deaths, and the number of deaths translated into a relative rate of overdose deaths compared to the national average reported during 2020-2022 are:

Arizona – 181 deaths; 2.55 times the national average

Colorado – 125; 2.31

Washington – 132; 1.97

Kansas – 54; 1.84

Alaska – 12; 1.76

The study also looked at areas that had at least 20 overdose deaths and mortality higher than the national average.

It revealed 19 counties of high concern, referred to as “Hotspot Counties,” with the highest concern falling on Maricopa County, Arizona, and Los Angeles County, California, which had the highest number of fatal overdoses, 117 and 111 deaths, respectively.

In Colorado, those hotspots are Adams and Denver counties, which had 25 and 24 adolescent overdose deaths, respectively. Adams County’s death rate is 4.48 times the national average while Denver’s is 4.61 times the national average.

The increased overdose mortality rate was reported in contrast to the overall decrease in the percentage of adolescents who admit to using drugs. The study found that in 2002, nearly 21% of U.S. 12th graders reported having used an illicit drug besides marijuana within the past year and by 2022 that rate had fallen to 8%.

Native American, Hispanic teens most likely to overdose

Across the nation, these deaths are disproportionately affecting Native American teens, Friedman wrote on X, with a mortality rate around 1.82 times that of non-Hispanic white teens. The next highest rate is for Hispanic teens at about 1.11 times that of their white, non-Hispanic counterparts.

Additionally, male youths are nearly 1.68 times as likely to overdose, according to the study’s data.

Friedman pointed to a rise in counterfeit pills as part of the rising overdose trend.

“Although fentanyl-associated deaths in the general population began to rise sharply in 2013, adolescent deaths weren’t substantially affected until 2019,” the study’s authors wrote in an article discussing their study. “Fentanyl was initially predominantly found in powder forms, as a replacement for heroin.

“More recently, however, fentanyl has increasingly been pressed into counterfeit pills resembling oxycodone, benzodiazepines, and other prescription-drug tablets, which are far more likely to be used by adolescents for experimentation,” they continued.

The study found that in 2022, 0.3% of 12th graders reported previous-year heroin use, whereas 5% reported nonmedical use of prescription drugs.

“Many adolescents may be unaware of the proliferation of counterfeit pills,” the study warned.

Because of this, the study’s authors recommend that teens receive more education about the risks to empower teens to use safely if they do choose to use drugs.

Friedman noted on X that “abstinence is the best recommendation. But for the fraction of teens that will experiment with pills — despite knowing the risks — we must educate them about safety.”

The study pointed specifically to four steps for teens to follow, if they use drugs: Never use alone, have naloxone or Narcan on hand, start slow and know that the strength of street-sold pills can vary wildly.