Fentanyl Awareness Is Up. Here’s Where Youth Drug Prevention Needs to Go Next

Five years of national research show substantial progress in young people’s understanding of fentanyl and counterfeit prescription pills. The latest data also shows where we need to go next: reach young people earlier, help them make sense of risk and give them healthier ways to handle stress and pressure.

Here are five findings that can help guide the next phase of prevention.

1. Awareness is increasing — but prevention should begin earlier.

In 2021, just 27% of teens had heard that fentanyl could be found in counterfeit prescription pills. Today, that figure is 65%. Among teens who have seen information about fentanyl-laced counterfeit prescription pills, 72% say it makes them less likely to consider misusing prescription pills without a prescription.

That’s a promising sign that education is reaching young people and influencing how they think about pill misuse.

This progress comes alongside encouraging national mortality trends: from 2023 to 2024, the overdose death rate among 15–24-year-olds fell 37% — the largest decline of any age group.

But the findings also reinforce the importance of starting education earlier. Awareness that fentanyl can be found in counterfeit prescription pills rises from 57% among 13–14-year-olds to 70% among 15–17-year-olds, even as nearly one-third of younger teens have already heard of people their age misusing prescription pills. That progress matters. But the risk hasn’t gone away. Fentanyl is still showing up in counterfeit prescription pills, powdered drugs and other substances. The opportunity now is to build on what’s working while reaching young people sooner.

2. Young people need better tools to evaluate risk.

Knowing fentanyl is dangerous doesn’t always mean young people recognize the risk when they’re actually faced with a decision. The clearest example is where a pill comes from.

A large majority of young people consider a prescription pill obtained from a stranger online highly dangerous: 88% of teens and 81% of young adults. But when the pill comes from a close friend, just 33% of teens and 40% of young adults place it in that same high-danger category.

There’s another important gap: 13% of teens and 22% of young adults say they’re confident they could identify a counterfeit prescription pill by looking at or holding it. But the DEA warns that counterfeit prescription pills can look nearly identical to legitimate medications and can’t be reliably identified by appearance alone.

Newer substances add another layer of uncertainty. Kratom and 7-OH ranked last in familiarity among every audience tested, and roughly half of young people either believe or are unsure whether these “natural” products are non-addictive.

We can’t prepare young people by giving them an endless list of substances to avoid. We need to help them recognize risk—even when something looks familiar, comes from a friend or is marketed as “natural.”

3. The next drug talk needs to be about coping and connection.

Young people connect prescription pill misuse with stress and anxiety, not just getting high or having fun. Seventy-three percent of teens and 81% of young adults say coping with stress and anxiety is a common reason people their age misuse prescription pills. More than four in five young people also say people their age generally feel overwhelmed.

That means the drug talk can’t only be about drugs. Young people also need practical ways to handle stress, get through difficult moments and ask for help when they need it.

The research also points to a challenge in how families have these conversations. Young people say fear of judgment or a negative reaction is the leading barrier to raising difficult subjects with parents. Parents, meanwhile, most often worry about pushing their child away or damaging the relationship.

And there’s a big disconnect. Seventy-three percent of parents say they’ve talked with their children about prescription pill misuse, yet only 27% of teens and 34% of young adults report having had that conversation. Young people say those conversations would be easier if parents stayed calm, asked questions instead of lecturing, helped solve problems rather than simply punish and listened without judgment.

Parent education shouldn’t focus only on what to say. It should also help parents have conversations young people are willing to be part of.

4. Put trusted voices into the channels young people already use.

Social media is the most common source of fentanyl and counterfeit prescription pill information among young people. Among those who encountered this information, 60% of young adults and 40% of teens saw it in social media posts. Only 15% said they had received this information from a doctor.

But when young people were asked whose information they would be receptive to, doctors ranked first: 76% of young adults and 71% of teens.

Here’s the opportunity: young people are on social media, but that doesn’t mean influencers are the voices they trust most. A short video on Instagram or TikTok may land differently when the information comes from a doctor, clinician or another credible messenger.

Put trusted voices where young people already are. The platform provides the reach; the messenger provides the credibility.

5. Parents want practical tools — and they’re open to many ways of receiving them.

More than 80% of parents rated every resource tested as helpful. At the top were resources explaining how to identify and respond to an overdose, at 91%; information about supporting a child’s mental health, at 90%; resources on recognizing fake or counterfeit pill use, at 89%; and conversation tips, at 87%.

Parents were also open to a wide range of delivery methods, including online articles, school-based parent education events, TV news, on-demand videos and interactive online learning. 

Parents are telling us they want help. The job now is to give them practical tools they can actually use. Those tools should include facts about fentanyl, overdose and emerging substances, but also help parents answer questions like: How do I bring this up? How do I stay calm if my child tells me something concerning? What do I say without lecturing? How do I make sure my child knows they can come to me for help?

Where prevention goes next

Five years of tracking show real progress. Teens are much more familiar with the risks of fentanyl and counterfeit prescription pills than they were in 2021, and most now recognize that using prescription pills without a prescription is risky. At the same time, self-reported intent to misuse pills and reported use have remained flat or declined rather than rising alongside awareness. 

But prevention can’t stand still because the environment around young people isn’t standing still. So where do we go from here?

Start earlier. Talk about stress and healthy coping, not just substances. Help young people recognize risk when it doesn’t look obvious. Give parents tools for conversations that keep the door open. And put trusted voices in the places young people already spend their time.

The drug landscape has changed. The drug talk has to keep changing with it.

About the Research

We worked with Breakwater Strategy to survey 2,505 people nationally, including teens ages 13–17, young adults ages 18–24 and parents. Fieldwork was conducted from June 24 to July 21, 2026. Many questions have been repeated since 2021, allowing researchers to track how knowledge, attitudes and behaviors around fentanyl, counterfeit pills and other drug risks have changed over time.