Help Start The Conversation

What Is Fentanyl?

Pharmaceutical fentanyl is a powerful synthetic opioid. It’s only available with a prescription, and its manufacture and distribution are tightly controlled. It has been safely used in medical settings for over 50 years for pain management and as a surgical anesthetic.

Illicit fentanyl is made in unregulated facilities, and sold through drug trafficking networks. Because fentanyl is an odorless white powder, it can easily be mixed with any drug that is consumed in the form of a pill, powder, or crystals.

How Is Fentanyl Reaching Young People?

Illicit fentanyl is easy and inexpensive to produce. Disguising fentanyl as common prescription medications like Percocet, Xanax, or Oxycontin provides a simple way for drug traffickers to increase their profits.

These pressed pills are stamped and colored to look exactly like brand-name prescription medications, and they frequently make it into the hands of young people, who don’t realize the pills they are taking are counterfeit.

In addition, fentanyl has been found in many illicit stimulant drugs, including methamphetamine, cocaine, and MDMA (Ecstasy/Molly).


How Has Drug Production Changed?

Historically, most illicit drugs, like cocaine and heroin, have been plant-based, which means they are derived from crops that need to be farmed, processed, then shipped across the globe. In recent years, the illicit drug market has moved to fully synthetic drugs, such as fentanyl, which can be cooked from scratch in a chemical kitchen.

With no need for farming and far fewer legs of international narcotics trafficking involved, supply costs have dropped and profits are higher than ever for those selling illicit drugs.

To learn more about the economics of fentanyl, check out the Ad Council’s Economics Lesson, which is taught by a former drug dealer.

Why Is Fentanyl Found In So Many Drugs Now?

Because fentanyl is so strong, a tiny amount in a pill or a powder can have a huge effect on a user. Since it’s inexpensive to produce, by pressing it into counterfeit pills, people making and selling drugs can increase their profit margin.

In opioid-like drugs, fentanyl may be added as a cheap substitute for heroin or oxycodone. Adding a little fentanyl into a batch allows illicit manufacturers to reduce the amount of heroin or oxycodone needed to produce a high.

Other drugs sold as pills or powders, like cocaine and MDMA, may be mixed with fentanyl intentionally or through cross-contamination via shared surfaces like scales while drugs are being processed and packed.

How Much Of A Problem Is This?

In 2021, a record 107,000 Americans died of drug overdoses and poisonings, mostly driven by fentanyl. Counterfeit pills are a big part of this problem, especially among young people who may be trying to deal with stress or health issues, or may be experimenting with recreational use.

For more statistics and charts exploring fentanyl’s impact on youth, visit the Song For Charlie Current Data Page.

How Is Fentanyl Increasing Teen Death Rates?

Most American teens don’t use drugs — in fact, the use of illicit drugs by teens has been decreasing for more than two decades. But despite that decline, drug-related deaths in teens have increased dramatically since 2019. And most of those drug-related deaths now involve fentanyl.

The DEA Laboratory found that six out of ten of the fentanyl-laced counterfeit prescription pills it analyzed in 2022 contained a potentially lethal dose of fentanyl. It’s a new risk that young people need to hear about.

What Leads Youth to Try Drugs?

Understanding why young people might use drugs is an important step towards having effective conversations with them.

There is no one-size-fits-all explanation, but there are several common reasons that teenagers and young adults might experiment with using drugs:

Many teens begin experimenting with drugs simply because they are curious and want to know what it feels like. Even if they’ve heard that “drugs are bad,” they don’t believe that anything bad can actually happen to them. They often feel that they are invincible. The part of the brain that controls rational decision-making, self-control, and judgment isn’t fully developed in teens, making them more prone to take risks without the fear of consequences.

Young people may begin experimenting with substances because they see their friends doing it. They may also feel pressured if they think “everyone else is doing it”. To them, experimenting with substances may seem like an expected part of the teenage experience.

Making friends and establishing themselves at school can be difficult for young people. The teenage years often come with many insecurities, low self-esteem, and fear of not being accepted. Their desire to “fit in” is human nature. Many teens see drugs as a way to cope or to feel more comfortable in their own skin.

It’s critical to educate and model self-love, acceptance and healthy relationships for our youth. Encouraging young people to join clubs and sports can help them make friends and be a part of groups that focus on healthy behaviors.

There is the desire to feel good and there is the desire to feel better. Teens trying to “feel better” through drug use are often self-medicating. They might be battling something deeper than peer pressure or a failed homework assignment. Some young people are suffering from conditions like depression, social anxiety, and stress-related disorders. They may use drugs to forget or replace their negative feelings with substance-induced pleasure.

Some teens turn to drugs as a form of escapism. When they are sad or depressed, they seek alternative methods as a way to forget and feel happier. Some teens might misuse prescription pills to manage their depression and anxiety. Many teenagers are overly stressed with a packed schedule of advanced classes and extracurricular activities or difficult home lives. A lack of coping skills can lead them to seek out an artificial method of coping with stress.

In teenagers, low self-esteem due to how they feel about their appearance or their relationships can lead to a lack of self-confidence. The media, friends, and family members often put pressure on teenagers to act and look a certain way, and they may lose confidence in themselves if they don’t meet those high standards. Teenagers who lack self-confidence will often seek drugs to feel more confident in social settings or to loosen inhibitions and lower their social anxiety.

Some young people grow up thinking drug and alcohol use is normal. Their favorite musicians are singing about it, the movies are glamorizing it, the TV and social media ads are selling it. Our culture has adopted a “pill cures all” mentality – whether you are sad, can’t sleep, or have a headache, there is a drug that can fix your problems. Many young people do not understand the potential consequences of drug use, and how it could harm their minds, bodies, and relationships.

If there is a family history of drug addiction or alcoholism, teenagers may be genetically predisposed to experiment with drugs and alcohol and become addicted. If you have a family history of addiction, be honest and open a dialogue about the real risks of substance use.


How Risky is Teen Drug Use?

Fentanyl has turned drug experimentation into a minefield. Prior to fentanyl, it was fairly uncommon for teens to die from an overdose. Now, overdoses can happen the first, second, or third time a teen uses, if the drug contains fentanyl. They don’t have to have a substance use disorder or a history of using other drugs. Many of the counterfeit pills being sold contain a potentially lethal dose of fentanyl, which means that any experimentation can be deadly. And the threat is not isolated to counterfeit pills; fentanyl is also being found in other substances, such as cocaine, heroin, and methamphetamine.

Remember, the threat posed by fentanyl and the risk of overdose is just one aspect of our concerns regarding teens and drug use. While teenagers are disproportionately affected by fentanyl overdoses, this age group has consistently faced heightened vulnerabilities to drug-related risks, such as altered brain development and the potential for addiction.

The teenage brain is especially receptive to change, a quality that aids in learning. Drugs modify pathways in the brain, leading to altered mental states. Drug-induced altered states can also manifest as lasting changes in behavior and personality traits. Persistent drug use during the teenage years can affect areas of the brain responsible for learning, emotional regulation, memory, and executive functioning.

Psychological dependency can arises when individuals turn to drugs to satisfy an emotional need, especially if they don’t have other means to fulfill that need. Given that much of adolescence revolves around learning skills to address our emotional and psychological requirements, teens are at a higher risk of becoming dependent on drugs. This is encapsulated perfectly in the adage, “grow your brain before you start changing it.”

The teenage years are crucial for both physical and psychological growth. Introducing drugs during this pivotal developmental phase can profoundly influence an individual’s life trajectory, often making it challenging to redirect later in life.


Effective Strategies for Delaying Teen Drug Use

Research shows us that delaying the onset of first use is critical in preventing substance use disorder. 90% of Americans with substance use disorder began using before age 18. Some strategies that research shows will help young people delay or avoid drug use include:

Practicing social skills like decision-making, communication, assertiveness, and refusal skills is crucial to preventing or delaying the onset of substance use.

Understanding how peers, media, and role models at home, in the community, and at school influence young people’s ability to make decisions.

Fostering interest in positive recreation and nurturing protective factors such as peer groups, community, and sporting activities can help to prevent and delay substance use in youth.

Supporting Youth Mental Health

It is normal for teens and young adults to feel overwhelmed at times. There is no shortage of pressures weighing on them – fitting in with peers, school work, sports, family responsibilities, preparing for college/life after high school, body image, sexuality, and the lingering effects of social isolation during the pandemic. Families can help young people manage stress, build up self-esteem, and learn to be resilient in the face of challenges.

The goal is not to make sure that your kids are happy at all times, but rather to make sure kids have the tools to weather the storms of life. As Dr. Lisa Damour writes, “Mental health is not about feeling good. It’s about having the right feelings at the right time and being able to manage those feelings effectively.” Here are some ways families can help:

Life is going to be stressful at times. It is important for teens to know how to manage that stress in healthy ways to minimize the risk of them reaching for an illicit substance to self-medicate. Here are some helpful resources for families:

Physical and mental health are closely linked. It is important for teens and young adults to get sufficient sleep, fuel their bodies with healthy foods, exercise, and be mindful of screen time in order to be healthy in body and mind.

Teens need at least 9 hours of sleep. Most are not getting enough and it can take a toll on their mental health.

Exercise is proven to decrease anxiety and help elevate mood.

Good nutrition is critical to both mental and physical health. Teens and young adults tend to gravitate towards processed snack foods and sugar-filled treats which can lead to sugar spikes and changes in mood.

Screen time, particularly time spent on social media can have a detrimental impact on well-being. Helping your child find balance is critical.

It is normal for teens and young adults to pull away from their parents and families. It can be challenging to maintain a close relationship during these years and ensure that your child feels comfortable turning to you for advice or support. But there are some things that families can do to help sustain open lines of communication including:

  • Listen, don’t lecture
  • Praise them for positive actions
  • Keep your own emotions in check
  • Look for ways to spend time together
  • Validate their feelings rather than jumping to problem-solving.

The Child Mind Institute has more tips for communicating with teens.

Half of all mental health conditions begin by age 14, so families should understand the signs of common mental health issues and how to raise concerns with a teen who is struggling.

Talk about mental health in your home, help to de-stigmatize mental health with your children and let them know help and support are always available. Here is a great primer on what to know and what to say:

Why Is It Important For Families To Talk About Substance Use?

Sometimes it’s difficult to distinguish normal teenage behaviors or anxiety from substance use. Family members can help reduce risk by educating themselves and sharing what they learn with youth, and intervening right away if they sense problems are developing.

Recognizing the difference between casual experimentation, unhealthy substance use, and a full-blown substance use disorder can be challenging for parents. The essence of preventing escalation lies in delaying the onset of a teen’s first drug use.

Understanding the risk and protective factors can guide parents in fostering an environment that diminishes the allure of substance experimentation and prioritizes mental well-being


Play the Opioid Misuse Prevention Game. This video game intervention, designed for high school students, targets opioid misuse prevention and promotes positive mental health. It can help to effectively engage your teens in the conversation.

Concerning Behaviors And Signals

While some behavioral changes are a natural part of adolescence, consistent, extreme, or sudden shifts in mood, behavior, or academic performance, especially if combined with physical symptoms, might point toward substance misuse. It’s imperative for adults to remain observant, understanding, and proactive in addressing potential issues.


  • The Jed Foundation explores the nexus between substance use and mental health, emphasizing that substance misuse can often be an unhealthy coping mechanism for underlying emotional or psychological distress.
  • The website highlights the importance of being alert to behavioral changes that may be indicative of adolescent substance misuse. Symptoms can include fatigue, red or glassy eyes, lasting cough, and emotional signs like irritability, mood swings, or personality changes.
  • The Hazelden Betty Ford Foundation pinpoints certain warning signs in teens that might indicate substance use. These can range from noticeable changes in friends, frequent isolation from the family, and decline in academic performance, to more subtle clues like changes in mood, loss of interest in previous hobbies, or secretive behavior.
  • The American Psychiatric Association provides diagnostic criteria for Substance Use Disorder. Within this context, behaviors like excessive substance use, neglecting responsibilities, and increasing tolerance to the substance can be indicative of misuse or the onset of a disorder.

How Can Families Show Support To Someone Using Substances?

When someone develops a substance use disorder, everyone around them is affected. If this happens to someone in your family, understanding proven principles, effective strategies, and skills for helping a loved one can be critical to their recovery.

There is a tendency for families to pull away from the community when their child is using substances, usually because of shame or fear. Instead, they should try to pull in the community to support them through this process. The young person should be exposed to different adults and community members, as each of them could be a key protective factor in helping them correct risky behaviors and meet their needs in healthier ways. Just as we encourage teens to ask for help and support, parents should be vulnerable in asking for help, too.


What Is Harm Reduction?

Harm reduction is an evidence-based public health approach that acknowledges certain risky behaviors, like drug use, may persist despite their known dangers. Rather than focusing solely on abstinence, harm reduction aims to minimize the negative consequences of such behaviors.

This includes educating the public about tools to prevent overdoses, like fentanyl test strips, and naloxone, a life-saving medication used to reverse opioid overdoses, More details on both of these tools are provided in the “What To Do” section of this site.

What Are The Signs Of An Overdose?

Everyone can learn the three main signs of an opioid overdose. Opioids, including fentanyl, can cause death by affecting the part of the brain that regulates breathing. An opioid overdose can be identified by a combination of three signs and symptoms:

  • Pinpoint pupils
  • Falling asleep or loss of consciousness
  • Slow, shallow breathing

Opioids suppress pain signaling and can cause profound sedation. If this sedation becomes too intense, breathing can slow or stop. This leads to a lack of oxygen, which can cause heart rhythm abnormalities and loss of consciousness.

If you suspect that a person has overdosed on an opioid, call 911, administer Narcan whenever available, and place the person in the recovery position (if they are still breathing) to prevent asphyxiation on vomit. If a person is not breathing, perform CPR.

It is rare for someone to die immediately from an overdose – it is usually a process that takes anywhere from a few minutes to a few hours. When people survive, it’s because someone is there to respond.

Note: People cannot overdose on fentanyl from touching it or touching someone who’s overdosed. Fentanyl is absorbed through mucous membranes. Never hesitate to help someone who is overdosing.

Test Your Knowledge on What to Know

Ready for The New Drug Talk?

    Quiz - FF Chapter 1
    What is the #1 cause of accidental deaths for ages 15-24?

    How Can I Start Talking To My Child About Fentanyl?

    Because fentanyl is now present in so many illicit drugs, it’s imperative that families talk about it together. Educating youth about fentanyl empowers them to make safer choices, and having continued conversations gives parents and caregivers a chance to share updates and correct any misinformation. We are here to help, with tips and resources to assist you as you have these crucial conversations.


    • Let your child know in advance that you want to have this conversation.
    • Acknowledge that it can be hard or awkward to talk about these issues.
    • Share with them that even if they don’t feel like the information relates to their own lives or choices, you want them to be prepared in the future and be able to help a friend.


    • Educate yourself first. Before you talk, get comfortable with the facts about fentanyl and counterfeit pills by reading our “What To Know” section. You don’t have to become an expert – identify the top three concepts that you want to get across to your child – this is about as much as they can absorb in one conversation.


    • Start by asking what they know or have heard about fentanyl.
    • It’s also okay to not be the expert – a fun way to have this conversation is by suggesting that you and your child learn together. Explain that you don’t know everything, and you want to learn. That way they can have ownership over educating you and themselves about the risks of the new drug landscape and you both can continue to share new information with each other.
    • Think about some things you want to learn about, and how you could ask your child in a way that conveys curiosity and compassion.


    • For important and potentially awkward conversations like these, it’s helpful to know what you’d like to say before you say it. Take time, in front of the mirror or with a partner, to run through the points that you feel are most important.
    • Consider how your child will react to the information. They might say things like “I know what I’m doing – don’t worry about me” or “Don’t you trust me?” Try to anticipate how the conversation may go and come prepared to respond calmly to any situation.


    How Can I Make These Conversations Feel Safe?

    Whether we are talking about drugs, dating, mental health, or any other sensitive subject, we want young people to feel safe to honestly share their feelings, ask questions, and voice their concerns. Don’t assume this will be a one-time talk. Instead, work to establish open lines of communication so this conversation can continue as a dialogue.


    • As you talk to your child, try to avoid judgment, anger, or fear. Young people may pick up on your tone and tune out or react defensively. Be sure to make this a conversation and not a lecture.
    • Think of this first conversation as just opening the door – you don’t need to say it all in one go. Focus on setting the tone for open and ongoing dialogue, an environment conducive to mutual understanding and honesty. It is not about being right or having your stance immediately embraced.
    • It may be more effective to have 60 one-minute conversations than one 60-minute conversation. Bite-size conversations and information sharing can be very effective.
    • An open conversation will disarm the notion that this is a lecture. It will also provide a relaxed environment to discuss ideas without making them feel like they are being blamed or are in trouble.


    • If you have a partner, try to have a conversation with them and your child together so they see that you are on the same page and equally invested in sharing this knowledge and keeping them safe.
    • If you don’t have a partner, think about inviting another family over and having a conversation over dinner so they can understand this is a norm that other households share and will reinforce together.


    • Share your values and expectations clearly.
    • Plan in advance for how you might react to concerning information that the young person might share to make sure they still feel safe and welcome to open up.

    What's The Right Time To Talk?

    Pick a calm moment that is distraction-free. Young people sometimes prefer having conversations where they don’t have to sit face-to-face. Try talking while walking, driving, or doing other activities together.

    You might want to talk after seeing drug use depicted in a TV show or before your child goes to a concert with friends.

    Ask open-ended questions about what their peers are doing. Avoid lectures, and instead listen and share what you are learning. Remember your child may be reluctant to talk about this sensitive topic. Just keep trying!

    What's The Best Opening Line?

    It’s smart to start with a question like, “What have you heard about fentanyl?” This will help you understand what they know already, and also give you an opportunity to correct any misinformation. Then you have an opening to share what you know: “I’ve been reading up on fentanyl, and think it’s an important issue to talk about together”.

    Acknowledge that there is a lot to learn and you want to share your knowledge and continue to learn together – things change quickly and together you can share the most up-to-date information with each other.

    What Information Do I Need To Share?

    Try saying “I care about you, and I want you to live a long, healthy life. That’s why I think we need to talk about fentanyl. It’s a VERY powerful drug that is getting mixed into a lot of pills and powders. Often people don’t realize they are even taking fentanyl, but taking it can lead to an overdose and even death.”


    • Explain that because so many drugs now contain fentanyl, experimenting with drug use has become a lot more risky. People can’t see, smell, or taste fentanyl, and unlike some other drugs, when it comes to fentanyl, one pill can kill.
    • Consider sharing the story of Charlie, who lost his life when he took what he thought was a legitimate prescription pill that turned out to be laced with fentanyl.
    • Review the Ad Council’s “Chemistry Lesson,” together – it’s a high school science class taught by someone who used to sell drugs and understands the risks these substances pose.
    • Explain to your child that you know abstaining from all drug and alcohol use may not be realistic, so you want them to understand how to reduce the risks if they do take something.
    Play the Opioid Misuse Prevention Game. This video game intervention, designed for high school students, targets opioid misuse prevention and promotes positive mental health. It can help to effectively engage your teens in the conversation.

    What Do Youth Need to Know About Fake Pills?

    Teens and young adults sometimes try to get medications like Xanax or Percocet through social media or from their friends. Unfortunately, these pills frequently contain fentanyl. Fentanyl is so strong that many people have died from taking just one pill, including numerous teenage victims.

    Fentanyl can be lethal in microgram quantities. It’s so powerful that a dose that’s a tenth of the size of a grain of sand can have an effect. It’s impossible to detect fentanyl with the naked eye,

    Here’s a simple and clear message to share with youth: “Please do not take pills unless they are prescribed to you and you get them directly from a pharmacy. It’s just too risky.”

    Why Is It Important To Talk About Your Family History Around Substance Use?

    Because addiction has such a strong genetic component, you may want to share any family history of substance use issues. This may help a young person make more informed decisions about their own use.

    Young people are often interested in learning more about how their brains and bodies are developing. It can be powerful to share information about how much brains grow and change between ages 10-25. This stage of development makes it possible for young people to learn new information and new skills rapidly, but also makes them more vulnerable to the effects of substance use than older adults.

    For families that want more in-depth guidance, Jessica Lahey’s book, The Addiction Inoculation: Raising Healthy Kids in a Culture of Dependence, gives lots of practical tips. Lahey recommends parents and caregivers be clear about their expectations around substance use, talk about the health consequences of drug use early and often, and discuss brain development and why teenagers are especially vulnerable to addiction.

    What If A Young Person Asks About Your Experiences With Drugs?

    Sometimes young people ask questions like “Have you ever used drugs?” How you answer is a personal decision. It’s ok to say “I’d rather not talk about that” or “I don’t think today is the right day to get into my life history.”

    You might say “I promise to tell you one day, I just don’t feel ready to right now”. That way it doesn’t feel like you are shutting down the conversation, but also gives you time to consider your answer. If you do choose to share, think about how what you say can help you connect with your child and deepen their understanding of the issues involved.

    You may want to talk about how the fact that fentanyl is present in so many illicit drugs today makes it more risky to experiment with drugs than it was in the past. You can talk about other things that have changed as well, saying something like “When I was growing up, we did not have the brain scanning technology that we do today. We didn’t understand how risky drug use during your teen years is. We were told not to use, but were not given science-based explanations about how it might affect us.”

    Parents with a history of substance use sometimes say that they regret some of the choices that they made and they are trying to help their child avoid making similar mistakes.

    How Can a Game Help With This Conversation?

    The PlaySmart video game is a great way for families to connect, have deeper conversations, and learn from an accurate source in a fun and engaging way. PlaySmart was designed for older adolescents (age 16-19), with the goal of teaching players critical skills and knowledge through an engaging, interactive video game targeting their perception of risk surrounding opioid misuse.

    Video games have demonstrated significant engagement and impact with people of all ages, but particularly youth. 66% of Americans—more than 215 million people of all ages and backgrounds, play video games regularly.

    The PlaySmart game was designed, developed, and evaluated with the input of hundreds of teens, in collaboration with behavioral scientists with expertise in both substance misuse and mental health, content experts, and commercial and serious games developers. The game was recently added as an important resource around mental health by the Office of the US Surgeon General, and was featured in an impactful article in the Washington Post as a tool to fight the opioid crisis.

    Recommended resources

    Request access to the PlaySmart game.

    The development and evaluation of PlaySmart is part of a large national multi-site study funded by the National Institutes of Health (NIH)/National Institute on Drug Abuse (NIDA) Helping to End Addiction Long-term (HEAL) Initiative.

    How Can I Keep This Conversation Going?

    You’ve taken a brave step by starting this conversation with your family. It’s so important. Now that you’ve started to talk, here are some things you could say to let your young person know that you’d like to keep the communication going.

    • “Thank you for having this important conversation with me, I want to continue talking and sharing new information as we learn more. Can we agree to come together and discuss this again when either of us learns something new about this topic?”
    • “Can you let me know if you or a friend might need support? I’m here for you and safety is my #1 priority.”
    • “If you are ever somewhere where people are being unsafe and you feel uncomfortable, you can call home for a ride with no questions asked.” Consider formalizing this by making an “X Plan.
    • “Can I help you get naloxone? We can research this and get some for both of us to have on hand.”
    • “How should I bring this topic up to you again in the future? Did this way of discussing fentanyl work for you? Is there a different approach that might work better?”


    What If I'm Concerned About a Young Person's Drug Use?

    Sharing your concerns with a young person you suspect is using drugs is challenging, but it could save their life. Fentanyl is killing some young people the first or second time they experiment with drugs. It is more important than ever that everyone knows these risks. Coming from a place of love and support, you can start a constructive conversation.


    Some useful phrases:

    • “I am here for you and love you no matter what. I want to have open and honest conversations with you about drugs and alcohol so I can best support you.”
    • “Where do you fall on the line when it comes to drugs? I am curious if you’ve checked in with yourself about this and how I might support you. (Use this guide as a resource)”
    • “If you tell me that you are using drugs, I will try to stay calm, open and be here for you. My #1 priority is your safety. If there is anything you want to tell me, I’m here.”
    • “I know that a lot of young people use drugs and alcohol and I wouldn’t be surprised if you are. I just want to be here for you to help you make the safest decisions possible.”
    • “Do you need support? How can I help you? Are you open to looking at your use?”

    How Can I Learn More About Harm Reduction?

    In the “What To Know” section of this site, we explain that harm reduction is an evidence-based public health approach that acknowledges certain risky behaviors, like drug use, may persist despite their known dangers. Rather than focusing solely on abstinence, harm reduction aims to minimize the negative consequences of such behaviors.

    This includes educating the public about tools to prevent overdoses, like fentanyl test strips, and naloxone, a life-saving medication used to reverse opioid overdoses, More details on both of these tools are provided in the “What To Do” section of this site.

    What Are Some Good Resources For Dealing with Addiction?

    Test Your Knowledge on What to Say

    Ready for The New Drug Talk?

      Quiz - FF Chapter 2
      Can most families say everything they need to say in one “drug talk”?

      After We Talk, What’s The Next Step?

      Check-in with your young person and thank them for participating. See how they are feeling about the conversation, and consider ways to keep the dialogue open for them to access your support if they need it in the future.


      Some useful phrases:

      • “Thank you for trusting me to have an honest and open conversation about an uncomfortable topic with you.”
      • “Thank you for allowing me to learn with you about how we can safely navigate substance use.”

      Intentionally giving your child positive reinforcement for participating in this conversation makes it more likely that they will remain open to discussing this in the future..


      Consider opportunities in your day-to-day life where you can model healthy behaviors and decisions around substance use for your children to see. Developing brains learn first through mimicry, so there are many chances for you to provide a positive influence in these areas outside of when you sit down to discuss it directly.


      • With other adult family members and friends, model healthy conversations about substance use (including alcohol) and making safe choices in front of your children to show them a variety of positive examples.
      • Next time you or your child has a prescription, review the label with them. Point out where the name of the person to whom the medicine belongs is printed, where the name of the medication is written, and where they can find the dosage instructions. Discuss why it is only safe for people to take pills that are prescribed for them.

      How Can I Understand Harm Reduction Strategies?

      Harm reduction is an evidence-based public health approach that acknowledges certain risky behaviors, like drug use, may persist despite their known dangers.

      Rather than focusing solely on abstinence, harm reduction aims to minimize the negative consequences of such behaviors.

      This includes educating the public about tools to prevent overdoses, like fentanyl test strips, and naloxone, a life-saving medication used to reverse opioid overdoses


      • Young people are often in a position to influence the behavior of their friends and peers, so it’s important for them to know about harm reduction techniques.
      • Try saying something like “There are many everyday ways we work to reduce harm in our lives (in addition to drug use) such as using seatbelts, wearing helmets, and obeying traffic lights. This is a sensible way to think about drugs too – let’s discuss a few ways people can reduce the risk of harm when it comes to drug use.”
      • You might discuss things like not driving under the influence before talking about fentanyl test strips or naloxone.

      What Does A Fentanyl Overdose Look Like?

      Overdoses on opioids, including fentanyl, can be identified by a combination of three signs and symptoms:

      • Pinpoint pupils
      • Falling asleep or loss of consciousness
      • Slow, shallow breathing

      If you suspect that a person has overdosed on an opioid, call 911, administer naloxone, and place the person in the recovery position (if they are still breathing) to prevent asphyxiation on vomit. If a person is not breathing, perform CPR.

      How Can Fentanyl Test Strips Help Prevent Overdoses?

      Fentanyl test strips are designed to reduce the risk of overdoses from drug use.. Anyone can purchase and use fentanyl test strips to test for the presence of fentanyl in a drug. They use the same technology as an at-home pregnancy test and were originally developed to detect the presence of fentanyl in urine.

      Studies have shown that fentanyl test strips not only decrease overdose deaths, but in many cases prevent drug use altogether. When young people use fentanyl test strips and see for themself that their drug has fentanyl inside, they typically do not consume the drug and instead throw it away.


      Fentanyl test strips are highly effective at detecting microscopic amounts of fentanyl in drugs. That’s important, because doses of fentanyl as low as 2mg – the size of a few grains of sand – can be lethal.

      Like most things, the test strips are not 100% accurate in all cases. The test strips sometimes show a “false positive” when there is no fentanyl. There is little to no documented evidence of a “false negatives” occurring, where the results would incorrectly state that the substance contained no fentanyl when it truly did.

      A redesigned type of fentanyl test strip, available from DanceSafe, may be less likely to produce false positives when used according to the instructions.


      • This fact sheet from the California Department of Public Health explains how the strips can be used effectively. For accurate results, it is critical to follow the instructions precisely.


      • If someone is using drugs without a fentanyl test strip, they can make sure to have Naloxone on hand and use “one person at a time” to make sure someone is sober and able to respond in case of overdose.


      What is Naloxone And How Does It Work?

      Naloxone is a life-saving medication used to reverse an opioid overdose, including heroin, fentanyl, and prescription opioid medications. Naloxone is safe and easy to use, works almost immediately, and is not addictive. Naloxone has very few negative effects and has no effect if opioids are not in a person’s system.

      By learning where you can get naloxone and when you should administer it, you can be ready to save a life. Naloxone comes in several forms, but the most common is a single-use nose spray called Narcan:

      • NARCAN Information And Instructions For Use
      • Narcan may take several minutes to kick in – up to 2 to 3 minutes when administered nasally.
      • It may take two or more doses of Narcan to revive someone if they have ingested a large quantity of fentanyl.
      • Naloxone only works if there are opioids involved with the overdose. It will not reverse an overdose of cocaine, methamphetamine, benzos, alcohol, or other non-opioid drugs, however, administering it will not harm someone who is overdosing on a non-opioid drug.


      As of this year, nasal Naloxone is now considered an over-the-counter drug nationwide, so you can get your own nasal Naloxone from any pharmacy without a prescription. Depending on individual insurance coverage, nasal Naloxone may cost between $45-145 at the pharmacy.

      To make nasal Naloxone more widely accessible, many states and non-profit organizations subsidize nasal Naloxone to make this life-saving drug available for free. If you do not have the financial resources to purchase nasal Naloxone, you can still access it at reduced or no cost thanks to these organizations.


      What Are Good Samaritan Laws And How Do They Apply?

      If someone has overdosed, always call 911! Fentanyl can make breathing slow and then stop. Medically, this is called “respiratory arrest” and is a life-threatening emergency. You need to call 911 to save a life – even if you have naloxone.

      Worried about calling 911? Since most recreational drug use is illegal in the United States, do you have to choose between saving a life and getting arrested? Thankfully, most states have “Good Samaritan” laws that protect drug users from being arrested for having limited quantities of illicit drugs in their possession.


      Why Do People Say “Never Use Alone”?

      If someone is going to use drugs, they should never be alone. Someone needs to be able to call 911 or administer Naloxone in case of emergency. Unfortunately, sometimes people may not have someone to be a sober buddy and still choose to consume illicit substances. In these cases, people can call a hotline like Never Use Alone and have them remain on the line during the critical window where an overdose could occur.

      How Can Scenarios Help Youth Prepare?

      Using scenarios provides a way to discuss challenging situations with your child in a low-stress environment. You can brainstorm solutions together to help them prepare for similar situations they may face in the future. These exercises support young minds in:

      • Developing their long-term, goal-oriented thinking skills.
      • Allowing them to apply their new knowledge to support retention.

      It’s recommended to pose 1-2 scenarios to your child at a time, so long as they remain actively engaged in responding.


      • “You walk into a public bathroom where some of your classmates are drinking and using drugs. You see one of them is passed out, unconscious. You have a sinking feeling that they need help, but don’t want them to get in trouble. What do you do?”
      • “You are at a party hosted by the coolest person you know. You’re talking and laughing with some people you meet there. One of them offers you a drug – you’ve seen it on TV before, but don’t know what class of drug it is or what it might do to you in real life. So you say that you don’t know enough about the drug to try it, “I’ll pass for now.” They tell you they started doing it recently and that it’s more fun every time. What do you do?”
        • If they are unsure, try asking “What would you want for yourself the day and the week after that night?” to encourage goal-oriented thinking.
        • Discuss how if they feel uncertain about a drug, how might taking it be risky to their safety?
      • “Two of your friends have decided to try a drug and are now asking you to be their sober safety sitter. They tell you that even if you say no, they will try the drug anyway. How can you help them stay safe?”
      • Some suggestions:
        • Test for fentanyl – If they are going to take this drug, encourage them or help them to check that it most likely won’t kill them.
        • Start small and go slow – If they are going to take it, encourage them to make a plan for how much they are going to consume and when. For both their comfort and their safety, remind them that it is always possible to take more but it is not possible to remove excess or take less of a drug once it enters the body.
        • Carry naloxone nasal spray – If they are going to take it, help ensure they survive their experience by having your own doses of nasal naloxone (such as Narcan) on hand and knowing what the signs are for when you need to use it to save a friend’s life.

      How Can I Learn More About Fentanyl?

      There are many materials available to help you and your family learn more about fentanyl. Here are a few trustworthy sources:

      How Can You Help Your Community Understand Fentanyl's Risks?

      The first thing families can do is educate themselves on fentanyl: What it is, how young people are accidentally dying from it, how to talk to teens about it, and how to respond if someone is overdosing. By visiting this website, you’ve taken an important step towards preparedness. Now you can share what you’re learning with others.


      Because many adults are just learning about fentanyl and the risks it poses to young people, you can support them by sharing and the resources that have been helpful to you.

      How Can I Take Action Around This Issue?

      Today’s drug landscape with fentanyl is scary. But the harms of fentanyl are preventable, so there are simple steps that you can take to keep yourself and those you love safe.

      Now that you are taking the first step to educate yourself, you can engage and educate your family, friends, and community. Help others understand the growing risks of using drugs today so they can make well-informed choices.

      Play the Opioid Misuse Prevention Game. This video game intervention, designed for high school students, targets opioid misuse prevention and promotes positive mental health. It can help to effectively engage your teens in the conversation.

      Why Is Finding Your Local Resources Important?

      One important way to learn more about fentanyl and its risks is to connect with people in your community who are leading local education and outreach efforts. They may be hosting educational outreach events, distributing harm-reduction supplies such as fentanyl stips or naloxone, or connecting with schools. Find out what’s going on in your area and how you can participate.

      How Can I Keep Up-To-Date On This Issue?

      Keep up with the latest information and get tips, scripts, and tools for continuing this conversation.

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      Test Your Knowledge on What to Do

      Ready for The New Drug Talk?

        Quiz - FF Chapter 3
        What are two examples of harm-reductions tools used to reduce the risk of fentanyl overdoses?