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The Fourth Wave of the Opioid Overdose Epidemic

Authored by Ella Yitzhaki, Government Major & Public Policy '24

The Opioid Overdose Epidemic in the states has led to the deaths of over half a million people between just 1999 and 2020. This two-decade time span has been split up into three waves: over-prescription of opioids, heroin-related deaths, and, finally, synthetic opioids, particularly fentanyl, deaths [1]. Due to its chemical composition, synthetic opioids like fentanyl are far more lethal causing the “3rd wave” to now reach over 100k deaths annually in 2021 [2].

With such a lethal substance, it is absolutely shameful that evidence now shows young people (<24 years) as a growing victim population of fentanyl. Families Against Fentanyl, a nonprofit that spreads awareness about the deadly drug, reports that between 2015 and 2021, children under one-year-old grew 10x more likely to overdose and die on fentanyl, while children between 1 and 14 grew 15x more likely to overdose and die [3]. While this data is in alignment with other age groups [4] seeing a seven-fold increase in chances of overdose death from fentanyl in this time period, it is bewildering to scientists, public health officials, and now politicians how these children even got their hands on these deadly drugs.

Congressional testimony has shown time and time again that these children are not only overdosing accidentally but also ingesting fentanyl accidentally as well via the cartels and their networks mislabeling or “cutting” fentanyl into other illicit substances (i.e., Adderall, cocaine, Percocet, etc.). Thus, our metric of success should be disrupting the drug networks themselves and their methods of delivering drugs into the hands of young people.

Returning to the original question as to how young children are getting access to these substances, the rise in overdose deaths between 2019 (non-pandemic-year) and 2021 (pandemic-year) hints at how the drug market/ “drug business” shifted given lockdown measures. According to the Drug Enforcement Agency (DEA), “With the growth of social media and the proliferation of smartphones, a dangerous and deadly new drug threat has emerged: criminal drug networks are abusing social media to expand their reach, create new markets, and target new clientele. This includes selling deadly fake fentanyl and methamphetamine pills, often to unsuspecting teenagers…[5]”

Teenagers and young adults infamously use social media platforms but data also suggests a substantial rise in response to pandemic lockdown orders and public safety measures. According to Pew Research, social media use by those 18-29 has increased to 84% of people by 2021 with a whopping 65% of them using Snapchat (Snap) by 2021 [6]. Snap’s message and postings deletion service, the main appeal of the application, provides an inviting environment for the illicit activity to occur as law enforcement cannot trace the steps and actions criminal organizations utilize.

In a recent House Energy and Commerce hearing on Big Tech’s role in the fentanyl crisis, a sheriff from Spokane, Washington, a region that has seen a 1,200% increase in fentanyl overdose deaths between just 2017 and 2021, said, “Our drug dealers are all too often allowed to operate in secrecy. This is a significant issue in every community in this country. We need help to hold people accountable who are poisoning our children [7].” The DEA asserts that social media sites are not taking sufficient actions to enforce their terms of service, including prohibitions on drug dealing. Administrator Milgram stated that these companies have the means to stop illicit drug transactions via their platforms but choose not to [8].

While dozens of parents of victims, law firms, and nonprofits have attempted to sue platforms like Snap for not doing enough to assist law enforcement in investigations nor enough in prevention measures when drug deals are arranged, all tech platforms are protected by Section 230: a 1996 piece of legislation that offers platforms near total immunity from liability. Section 230 has been continuously challenged on both sides of the aisle for decades for various reasons, including but not limited to spreading misinformation and hate speech, sexual exploitation of children, limiting free speech, and facilitating eating disorders & other mental illnesses [9].

In the 117th Congress, 95 bills were introduced regarding reform to Section 230. Whether it be President Trump venting about Section 230 via Twitter or President Biden calling on more regulation of hate speech and extremism, political leaders have taken note of Section 230 for various reasons and made it clear that there is brewing anger at tech platforms [10, 11].

With rising fentanyl overdoses comes a rising death toll: the main effect. That said, addiction and substance abuse are still in play as the public health crisis of the opioid overdose epidemic has now spread to young people. Now anything related to or involving children and young people can and will be impacted by it: the financial side, as their families’ money is funneled into drug networks at a younger and younger age; the medicinal side, as young people fear medication being “cut with” fentanyl; the educational side, as children are taught drug education; prevention; and treatment at an even younger age, or the social side as friends see one another overdose. Meanwhile, drug trafficking networks, Mexican drug cartels, and the PRC can continue to thrive and grow their multi-billion-dollar operations at the expense of teenagers.

Works Cited

  1. Understanding the Opioid Overdose Epidemic. (2022, June 1). CDC.

  2. Drug Overdose Death Rates. (2023, February 9). The National Institute on Drug Abuse.

  3. The Changing Faces of Fentanyl Deaths. (2023, January 12). Families Against Fentanyl.

  4. SUDORS Dashboard: Fatal Overdose Data. (2022, December 8). CDC.

  5. Social Media - Drug Trafficking Threat.(2022, January 1). Drug Enforcement Administration.

  6. Social Media Fact Sheet. (2021, April 7). Pew Research Center.

  7. E&C Republicans Hold Roundtable on the Dangers of Big Tech and the Fentanyl Poisoning Crisis.

  8. (2023, January 27). Energy 7 Commerce Chair Rodgers.

  9. Policing Drug Trafficking on Social Media. (2022, December 15). CRS Reports.

  10. It's Time to Update Section 230. (2021, August 12). Harvard Business Review.

  11. Trump battles to strip social media of legal protections. (2020, May 29). Financial Times.

  12. Trump and Biden vs. Facebook: Why Section 230 could get repealed. (2021, January 4). USA Today.

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