Study: Perceived Risk of Fentanyl Use among U.S. Adolescents (DOI: 10.1001/jamanetworkopen.2026.22039)
Most U.S. eighth graders underestimate the dangers of fentanyl use, according to a new University of Michigan study.
More than half, about 52%, did not believe that experimental use of fentanyl-a man-made opioid that can be more than 50 times stronger than heroin-carried a high level of danger, highlighting a critical gap in awareness that could increase overdose deaths among adolescents.
Each week in the United States, about 22 high school students die from a fentanyl overdose-roughly the size of a typical high school classroom.
The study, funded by the National Institute on Drug Abuse, also found that around one-third did not believe regular fentanyl use carries a great risk.
The findings, published in JAMA Network Open, come from the long-running Monitoring the Future survey and highlight a gap in awareness-not a lack of fear-that researchers say prevention efforts must address.
"Our biggest finding is that most eighth graders simply don't know that fentanyl can be lethal-and that gap, not a lack of fear, is the real issue," said Richard Miech, principal investigator of the MTF study at U-M's Institute for Social Research. "These findings point to the importance of efforts to strengthen and augment current messaging about the potential effects of fentanyl use."
The study analyzed responses from more than 3,800 eighth, 10th and 12th graders about how they perceive the risks of fentanyl use.
"Raising awareness of the lethal dangers of fentanyl use among this age group is a key strategy to reduce these deaths," Miech said. "For example, warnings that students shouldn't take counterfeit drugs because they may be laced with fentanyl won't have much effect if students don't know how dangerous fentanyl is."
Miech and colleagues also found differences across demographic groups.
"It was interesting that students in rural areas were more likely than those in suburban and urban areas to perceive fentanyl use as dangerous," Miech said. "A deeper dive into the underlying reasons for this finding could help campaigns that aim to raise awareness of fentanyl to be more effective."
Researchers say schools, parents, clinicians and public health leaders should strengthen education about fentanyl before students reach high school. They recommend messages that emphasize fentanyl can be deadly even the first time it is used and that it is often found in counterfeit pills or mixed into other drugs without a person's knowledge.
Research reported in this publication was supported by the National Institute On Drug Abuse of the National Institutes of Health under Award Number R01DA001411. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
