Questions for Sally Curtin, Statistician and author of “Drug Overdose Deaths Among Adolescents Aged 15-19 in the United States: 1999-2015”
Q: Do trends in overdose deaths among teens reflect the trends of older adults in the U.S.?
SC: There are some similarities, but also differences. Both teens and older adults experienced the sharp increases from 1999 through the mid-2000s. But unlike older adults, whose rates continued to increase, teenagers actually had a decline in drug overdose death rates through 2014, before an upturn in 2015. All of this decline was for males as the rates for females stabilized from 2004-2013 before increasing again.
Q: Do we know why trends for teens dropped during the first several years of the millennium? And why they increased sharply in 2015?
SC: There are many public health initiatives to combat the rising drug overdose death rates. While we do not know the exact reason for the decline, we know the specific drugs that were involved—opioids, cocaine, and benzodiazepines. For the opioids, it was the frequently prescribed drugs—methadone and natural and semisynthetic (oxycodone, morphine) that had declines for teens since the mid 2000s. Other opioids such as heroin and synthetic opioids (including fentanyl) fluctuated but generally increased over the 1999-2915 study period. The continued rise in drug overdose deaths involving heroin and synthetic opioids from 2014 to 2015 contributed to the uptick between those years.
Q: What are the differences in overdose deaths by gender and race?
SC: We did not examine race in this report because the numbers were too small for some groups. By gender, the drug overdose death rate for males was higher for females for every year of the 1999-2015 period and was 70% higher in 2015. While males had a greater increase in drug overdose death rates than females between 1999 and the mid-2000s, they also declined by about a third between 2007 and 2014 before increasing again. The rate in 2015 was still lower than the 2007 peak. Females had an increase, albeit smaller than for males, and then their rate stabilized between 2004-2013 before increasing again.
Q: What type of drugs are killing these teens?
SC: As for the population at large, the majority of drug overdose deaths involve opioids. When we examined the specific type of opioid involved, heroin is the leading drug involved and rose fairly steadily throughout the study period. Synthetic opioids (including fentanyl) were lower than other opioid drugs through the early years of the period, but then doubled between 2014 and 2015. This large increase for synthetic opioids has also been observed for the population at large.
We did not look at combinations of drugs. Often, there is more than one drug involved so the categories we show are not mutually exclusive.