Monday numbers: A closer look at the mounting toll of fentanyl on the nation’s youth

Last year, Policy Watch delved into the epidemic within the opioid epidemic: the terrifying rise of synthetic opioid fentanyl and staggering number of deaths it has caused in North Carolina and across the country.

This month a new analysis of Centers for Disease Control and Prevention data by the nonprofit Families Against Fentanyl sheds new light on the ongoing crisis, particularly deaths among children 14 and under.

The group’s analysis found fentanyl deaths among that group are rising faster than any other, tripling nationwide in just two years from 2019 to 2021 (the last year for which full CDC data is available). Over the same period, fentanyl deaths among infants increased twice as fast as overall deaths.

“These disturbing new findings should serve as a wake-up call to our nation’s leaders,” said Jim Rauh, founder of Families Against Fentanyl, in a statement accompanying his nonprofit’s analysis. Rauh’s own son Thomas died of a fentanyl overdose.

Though it killed more than 3,000 North Carolinians in 2021, fentanyl isn’t widely understood by the public. The drug’s unique characteristics and ubiquity in illicit drug manufacturing have led to overdose deaths in long-time, habitual drug users as well as young young people experimenting with the many recreational drugs in which fentanyl is increasingly found.

In North Carolina, death certificates don’t have a specific code for fentanyl’s involvement in a drug overdose. There is a code – T40.4 — for “other synthetic narcotic overdose.” The Epidemiology, Surveillance and Informatics unit of the NC Division of Public Health’s Injury and Violence Prevention Branch notes that most of these cases are “due to illicitly manufactured fentanyl and fentanyl analogues,” but can also include prescription fentanyl and other, less potent synthetic narcotics like Tramadol.

An analysis of statistics from the NC Office of Chief Medical Examiner finds overdose deaths with that code went from 442 in 2016 (the first year for which the office had such statistics) to 3,163 in 2021 — an increase of 616%.

Cheaper and easier to produce than heroin — and up to 50 times more potent — fentanyl allows illicit drug manufacturers and traffickers to adulterate drugs like heroin, cocaine and methamphetamine, reaping greater profits from products that could be far less pure but dramatically more powerful. Pills sold as Molly (MDMA), or even Vicodin are increasingly found to be substantially or entirely fentanyl.

But accidental fentanyl poisoning among children, including infants under 1 year old, is also seeing a dramatic rise, largely connected to use in their homes by parents or caregivers.

“This is the number one killer of our nation’s young adults,” Rauh said. “It is killing more and more children each year. It’s time to treat this threat with the urgency it deserves.”

As communities across North Carolina continue to plan how they will spend $758 million from the historic national opioid settlement, we take a by-the-numbers look this week at the mounting toll of fentanyl on the nation’s youth.

(Sources: CDC provisional mortality statistics, 2018-2022, Families Against Fentanyl analysis “The Changing Face of Fentanyl Deaths”)

106,699 – Total number of confirmed drug overdose deaths in the U.S. in 2021 (the last year for which there is complete CDC data)

71,000 – Number of those deaths attributable to fentanyl — that’s a year-over-year increase of 23% compared to 2020

700 – Percentage increase in synthetic opioid deaths in the U.S. from 2015 to 2021, among all age groups

1,000 – Percentage increase in synthetic opioid deaths among infants in the U.S. from 2015 to 2021

1,500 – Percentage increase in synthetic opioid deaths among U.S. children ages 1 to 14 from 2015 to 2021.

300 – Percentage increase in synthetic opioid deaths among infants (under 1 year old).

221 – Percentage increase in synthetic opioid deaths in children 1 to 4 years old.

Overdoses in this age group — fatal and non-fatal — are on the rise nationwide, as illustrated by the case of a one-year-old who suffered a fentanyl overdose in Mooresville in November. The child’s parents are now facing a raft of felony charges.

275 – Percentage increase in synthetic opioid deaths in children 5 to 14 years old.

95 – Percentage of fentanyl deaths in 2021 that were found to be unintentional

4 – Percentage found to be undetermined

Less than 1 – Percentage found to have been suicides

These numbers represent dramatic increases over the figures in 2000, when 60% of fentanyl deaths were found to be unintentional, 26.5% suicide and 14% undetermined.