The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2025
Trends in U.S. Adolescent and Young Adult Overdose Fatalities, 1999-2023.
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Chen Yinan, Seiters Hanna, Wang Zhu, Bell Lauren A
Аннотация
PURPOSE: To stratify long-term overdose fatality trends among US (United States) adolescents and young adults (AYA) aged 10-24 years by mechanism of overdose fatality, substance, age, and racial/ethnic group, including understudied groups (10-14-year-olds; Asian/Pacific Islanders), and provide an interactive data visualization application.
METHODS: We developed an R-shiny web application, allowing visualization/stratification of 1999-2023 Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research overdose fatality data. Given illicitly manufactured fentanyl (IMF)-related overdose fatality predominance, we used R for linear regression, Z-tests, and nonparametric bootstrapping to compare IMF-related overdose fatality rates between youth age (10-14, 15-19, and 20-24 years) and racial/ethnic subgroups during peak years of rate increase, 2013-2021.
RESULTS: Most overdose fatalities among AYA are unintentional. Since 2019, 85% have been associated with IMF. The 2023 AYA IMF-related overdose fatality rate (7.5/100,000) remains 124 times higher than in 1999 (0.06/100,000), despite decreasing after the 2021 peak (9.28/100,000). Recent decreases are not shared across subgroups. American Indian/Alaska Native AYA experience the highest rates of IMF-related fatal overdose. Rates among Black AYA are increasing.
DISCUSSION: This study extends previous research regarding long-term US AYA overdose fatality trends by demonstrating trends through 2023 and including understudied subgroups, underscoring IMF-related overdose burden in US AYA and inequities between subgroups, and debuting a data visualization application.
METHODS: We developed an R-shiny web application, allowing visualization/stratification of 1999-2023 Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research overdose fatality data. Given illicitly manufactured fentanyl (IMF)-related overdose fatality predominance, we used R for linear regression, Z-tests, and nonparametric bootstrapping to compare IMF-related overdose fatality rates between youth age (10-14, 15-19, and 20-24 years) and racial/ethnic subgroups during peak years of rate increase, 2013-2021.
RESULTS: Most overdose fatalities among AYA are unintentional. Since 2019, 85% have been associated with IMF. The 2023 AYA IMF-related overdose fatality rate (7.5/100,000) remains 124 times higher than in 1999 (0.06/100,000), despite decreasing after the 2021 peak (9.28/100,000). Recent decreases are not shared across subgroups. American Indian/Alaska Native AYA experience the highest rates of IMF-related fatal overdose. Rates among Black AYA are increasing.
DISCUSSION: This study extends previous research regarding long-term US AYA overdose fatality trends by demonstrating trends through 2023 and including understudied subgroups, underscoring IMF-related overdose burden in US AYA and inequities between subgroups, and debuting a data visualization application.