Suggested Actions to Reduce Overdose Deaths

To:      State, territorial, tribal, and local policymakers and administrators of agencies and programs focused on child, youth, and family health and well-being

Dear Colleagues,

Thank you for your work to support children, youth, and families. Populations served by Administration for Children and Families (ACF)-funded programs — including victims of trafficking or violence, those who are unhoused, and young people and families involved in the child welfare system — are often at particularly high risk for substance use and overdose. A variety of efforts are underway at the federal, state, and local levels to reduce overdose deaths. These efforts focus on stopping drugs from entering communities, providing life-saving resources, and preventing drug use before it starts. Initiatives across the country are already saving lives: the overdose death rate has declined over the past year but remains too high at 32.6 per 100,000 individuals. 

Fentanyl, a powerful synthetic opioid, raises the risk of overdose deaths because even a tiny amount can be deadly. Young people are particularly at risk for fentanyl exposure, driven in part by widespread availability of counterfeit pills containing fentanyl that are marketed to youth through social media. While overdose deaths among teens have recently begun to decline, there were 6,696 deaths among adolescents and young adults in 2022 (the latest year with data available)[1], making unintentional drug overdose the second leading cause of death for youth ages 15—19 and the first leading cause of death among young adults ages 20-24.[2] 

Often these deaths happen with others nearby and can be prevented when opioid overdose reversal medications, like naloxone, are administered in time. CDC’s State Unintentional Drug Overdose Reporting System dashboard shows that in all 30 jurisdictions with available data, 64.7% of drug overdose deaths had at least one potential opportunity for intervention.[3] Naloxone rapidly reverses an overdose and should be given to any person who shows signs of an opioid overdose or when an overdose is suspected. It can be given as a nasal spray. Studies show that naloxone administration reduces death rates and does not cause harm if used on a person who is not overdosing on opioids. States have different policies and regulations regarding naloxone distribution and administration. Forty-nine states and the District of Columbia have Good Samaritan laws protecting bystanders who aid at the scene of an overdose.[4]

ACF grant recipients and partners can play a critical role in reducing overdose deaths by taking the following actions:

• Focus on measures to prevent drug use. Many ACF grants can be used to support work broadly in behavioral health, including training for staff to respond to overdose crises. ACF recently published a guide (PDF) that provides information on the ACF grants that can be used to fund efforts focused on behavioral health. 
• Ensure that community facilities, in particular those that shelter youth and families, have naloxone on site and are prepared to administer it as needed. Reach out to your local public health department or state behavioral health agency to understand the status of naloxone policies and regulations in your state. These entities can also be helpful in working with you to access naloxone. 
• Direct staff and community members to trainings and other resources about overdose risk and naloxone. Some resources to consider are included in the table below.

Thank you for your dedication and partnership. If you have any questions, please contact your local public health department or state behavioral health agency. Together, we can meaningfully reduce overdose deaths in every community. 

/s/

Meg Sullivan

Principal Deputy Assistant Secretary