Awareness and Behaviors Related to Pill Use and Fentanyl: Perspectives from Youth and Young Adults in Oregon

Overdose deaths in the United States and Oregon have increasingly impacted young people ages 15 to 24. This study aimed to understand awareness and experiences related to fentanyl and counterfeit pills among young people to inform messaging and strategies to reduce the risk of overdose. We conducted a cross-sectional correlational survey study. Social media posts recruited participants ages 15 to 25 for a web-based survey about fentanyl from May to June 2023. We conducted descriptive analyses and fit a univariate logistic regression model to estimate group differences by age group and past use of non-prescribed pills. Of the 897 participants, one third reported that they had heard about fentanyl not at all or a little. The most common sources of information were the internet and friends, but more participants reported they would trust information provided by health care providers and the state health authority. Youth (ages 15-17) were more likely to have heard about fentanyl than young adults (ages 18-25). Compared with participants who reported no lifetime non-prescribed pill use, participants who reported lifetime non-prescribed pill use were more likely to report food insecurity, mental health concerns, having a family member who had experienced an overdose, having witnessed an overdose, and having received information about fentanyl; but were less willing to call 911 or seek help. These findings highlight limited awareness about fentanyl, misperceptions of the risk of counterfeit pills, and challenges identifying trusted sources of information. These findings support the need to expand overdose prevention strategies and practices among young people.