Why Are Teens More Vulnerable to Prescription Opioids and Heroin?
Teens face a high risk of opioid and heroin addiction due to brain development, peer pressure, and accessibility. Learn the warning signs and prevention strategies.
Research from the University of Southern California showed that teens who use prescription opioids to get high are more likely to use heroin by high school graduation [1]. Shocking perhaps?
Read on to learn more about these drugs and factors that explain why teens are more vulnerable to substance abuse and addiction.
Understanding the Opioid Crisis Among Teenagers
In recent years, the trends in opioid and heroin misuse by teens are complex. There are some encouraging developments but also ongoing concerns.
Since the pandemic, there has been an overall decline in substance use [2]. Specifically, opioid misuse decreased from 14% in 2017 to 12% in 2022, among high school students [3]. However, of great concern is the dramatic rise in overdose deaths between 2010 and 2021 and which remained elevated in 2022.
This increase is largely due to illicit fentanyl contaminating the supply of counterfeit pills made to resemble prescription medications. Fentanyl-related overdose deaths among teens increased by 2% from 2022 to 2023, the smallest annual increase since the pandemic began.
But fentanyl was involved in 76% of adolescent drug fatalities in 2022. Teens frequently obtain drugs through social media and they are often contaminated. In 2023, 7 out of 10 counterfeit opioid pills contained a potentially deadly dose of fentanyl [3].
But the dangers of opioid and heroin misuse are not limited to overdose. There are also devastating health impacts with severe addiction, hepatitis C, HIV and other infections from sharing needles.
Opioid misuse tends to be with older teens. And despite the surge in opioid-related deaths, treatment rates among teens and young adults (ages 15-24) have been decreasing.
Why Teens are More Susceptible to Opioids and Heroin Addiction
There are a number of factors which explain why teens are more susceptible to prescription opioids and heroin addiction.
Brain Development
The teen years are a critical time in the development of the brain. The pre-frontal cortex, responsible for decision-making and impulse control, is still developing. So teens are more prone to risk-taking and with greater impulsiveness than adults. Teens hold beliefs about their own invincibility, also known as optimistic bias. In the case of fentanyl, if a teen believes an overdose “would never happen to me” it’s particularly dangerous as small amounts can be deadly [4].
With heightened sensitivity to rewards and lower sensitivity to the sedative qualities of these substances, a teen brain’s reward system is particularly vulnerable to the euphoric effects of opioids. This makes it more likely they will seek out and become dependent on these drugs.
Peer Influence
Peer pressure and approval can drive teens to risky behaviors, including experimenting with drugs. Not only can this lead to initial drug use, it can promote continued drug abuse, possibly leading to addiction.
Lack of Awareness
Most teens have a limited awareness and understanding of the dangers of opioids. This may lead to curiosity and experimentation, increasing their vulnerability to the potential for addiction, overdose or death.
Gateway Effect
While teens may begin by experimenting with illegally obtained prescription opioids, this may act as a gateway to trying heroin. In fact studies have shown that those teens who have used prescription opioids are 13 times more likely to try heroin.
Access
Teens generally have easier access to prescription opioids from friends, family members and social media. Of course this increases the likelihood of misuse and addiction.
Mental Health
Teens with a history of depression have a 1.5 times increased risk of misuse of prescription opioids. Anxiety and conduct disorders are also linked to increased opioid misuse.
Childhood Trauma
A teen’s history of childhood emotional or physical abuse is linked to opioid misuse in early adulthood.Warning Signs of Opioid Abuse in TeensThere is a wide range of warning signs of opioid or heroin abuse in teens, including:

Effective Strategies for Prevention and Support
There are a number of things parents can do to help their teen choose to not use opioids or heroin, including:
- Open Communication: Have open, honest and informative conversations with your teen about substance abuse and its risks. Set aside a safe space where your teen feels comfortable to share their concerns and experiences. Withhold judgment.
- Set Clear Expectations and Rules: Create and share clear guidelines and stick to them. Teens who feel there is strong parental disapproval of substance abuse are less likely to engage in these behaviors.
- Parental Involvement: Maintain active engagement in your teen’s lif by knowing their friends, activities and whereabouts. This can reduce the possibility of drug use.
- Family Activities: Have regular family activities that foster emotional connections and healthy outlets for your teen.
- Education and awareness: Provide accurate information about the risks of drug use. Don’t use scare tactics as they can lessen trust.
- Positive role modeling: Show your teen healthy behaviors and coping strategies that you have used, as teens may often mimic behaviors they see at home.
- Encourage healthy activities: Provide support to your teen’s participation in hobbies, sports and clubs that interest them. This can promote positive interactions and self-esteem.
- Help your teen refuse drugs: Teach them ways to turn down drugs if offered. Let them know they can always turn to you.
- Offer empathy and support: Maintain an open attitude, with an empathetic supportive tone. You are there to help, not judge.
Professional Help for Teen Addictions
Lotus Behavioral Health helps teens recovering from substance abuse & co-occurring disorders break addictive tendencies and develop healthy habits that support their long-term recovery. Our residential, PHP, and IOP treatment programs take a family-first approach to help teens build a sustainable lifestyle that encourages sobriety & success.
If you are concerned that your teen is struggling with an addiction to e-cigarettes, reach out to our admissions team today for support.

Sources
[1] Hopper, L. Teens who abuse opioids are more likely to later use heroin, USC study shows. USC Today.
[2] NIDA. 2023, December 13. Reported drug use among adolescents continued to hold below pre-pandemic levels in 2023.
[3] Panchai, N and S. Zitter. 2024. Teens, Drugs, and Overdose: Contrasting Pre-Pandemic and Current Trends. KFF.
[4] Peavy, M. and C. Green. Understanding and Supporting Adolescents with an Opioid Use Disorder. University of Washington. Addictions Drug and Alcohol Institute.Yule AM, Lyons RM, Wilens TE. Opioid Use Disorders in Adolescents-Updates in Assessment and Management. Curr Pediatr Rep. 2018 Jun;6(2):99-106.
Why Are Teens More Vulnerable to Prescription Opioids and Heroin?
Teens face a high risk of opioid and heroin addiction due to brain development, peer pressure, and accessibility. Learn the warning signs and prevention strategies.

Research from the University of Southern California showed that teens who use prescription opioids to get high are more likely to use heroin by high school graduation [1]. Shocking perhaps?
Read on to learn more about these drugs and factors that explain why teens are more vulnerable to substance abuse and addiction.
Understanding the Opioid Crisis Among Teenagers
In recent years, the trends in opioid and heroin misuse by teens are complex. There are some encouraging developments but also ongoing concerns.
Since the pandemic, there has been an overall decline in substance use [2]. Specifically, opioid misuse decreased from 14% in 2017 to 12% in 2022, among high school students [3]. However, of great concern is the dramatic rise in overdose deaths between 2010 and 2021 and which remained elevated in 2022.
This increase is largely due to illicit fentanyl contaminating the supply of counterfeit pills made to resemble prescription medications. Fentanyl-related overdose deaths among teens increased by 2% from 2022 to 2023, the smallest annual increase since the pandemic began.
But fentanyl was involved in 76% of adolescent drug fatalities in 2022. Teens frequently obtain drugs through social media and they are often contaminated. In 2023, 7 out of 10 counterfeit opioid pills contained a potentially deadly dose of fentanyl [3].
But the dangers of opioid and heroin misuse are not limited to overdose. There are also devastating health impacts with severe addiction, hepatitis C, HIV and other infections from sharing needles.
Opioid misuse tends to be with older teens. And despite the surge in opioid-related deaths, treatment rates among teens and young adults (ages 15-24) have been decreasing.
Why Teens are More Susceptible to Opioids and Heroin Addiction
There are a number of factors which explain why teens are more susceptible to prescription opioids and heroin addiction.
Brain Development
The teen years are a critical time in the development of the brain. The pre-frontal cortex, responsible for decision-making and impulse control, is still developing. So teens are more prone to risk-taking and with greater impulsiveness than adults. Teens hold beliefs about their own invincibility, also known as optimistic bias. In the case of fentanyl, if a teen believes an overdose “would never happen to me” it’s particularly dangerous as small amounts can be deadly [4].
With heightened sensitivity to rewards and lower sensitivity to the sedative qualities of these substances, a teen brain’s reward system is particularly vulnerable to the euphoric effects of opioids. This makes it more likely they will seek out and become dependent on these drugs.
Peer Influence
Peer pressure and approval can drive teens to risky behaviors, including experimenting with drugs. Not only can this lead to initial drug use, it can promote continued drug abuse, possibly leading to addiction.
Lack of Awareness
Most teens have a limited awareness and understanding of the dangers of opioids. This may lead to curiosity and experimentation, increasing their vulnerability to the potential for addiction, overdose or death.
Gateway Effect
While teens may begin by experimenting with illegally obtained prescription opioids, this may act as a gateway to trying heroin. In fact studies have shown that those teens who have used prescription opioids are 13 times more likely to try heroin.
Access
Teens generally have easier access to prescription opioids from friends, family members and social media. Of course this increases the likelihood of misuse and addiction.
Mental Health
Teens with a history of depression have a 1.5 times increased risk of misuse of prescription opioids. Anxiety and conduct disorders are also linked to increased opioid misuse.
Childhood Trauma
A teen’s history of childhood emotional or physical abuse is linked to opioid misuse in early adulthood.Warning Signs of Opioid Abuse in TeensThere is a wide range of warning signs of opioid or heroin abuse in teens, including:

Effective Strategies for Prevention and Support
There are a number of things parents can do to help their teen choose to not use opioids or heroin, including:
- Open Communication: Have open, honest and informative conversations with your teen about substance abuse and its risks. Set aside a safe space where your teen feels comfortable to share their concerns and experiences. Withhold judgment.
- Set Clear Expectations and Rules: Create and share clear guidelines and stick to them. Teens who feel there is strong parental disapproval of substance abuse are less likely to engage in these behaviors.
- Parental Involvement: Maintain active engagement in your teen’s lif by knowing their friends, activities and whereabouts. This can reduce the possibility of drug use.
- Family Activities: Have regular family activities that foster emotional connections and healthy outlets for your teen.
- Education and awareness: Provide accurate information about the risks of drug use. Don’t use scare tactics as they can lessen trust.
- Positive role modeling: Show your teen healthy behaviors and coping strategies that you have used, as teens may often mimic behaviors they see at home.
- Encourage healthy activities: Provide support to your teen’s participation in hobbies, sports and clubs that interest them. This can promote positive interactions and self-esteem.
- Help your teen refuse drugs: Teach them ways to turn down drugs if offered. Let them know they can always turn to you.
- Offer empathy and support: Maintain an open attitude, with an empathetic supportive tone. You are there to help, not judge.
Professional Help for Teen Addictions
Lotus Behavioral Health helps teens recovering from substance abuse & co-occurring disorders break addictive tendencies and develop healthy habits that support their long-term recovery. Our residential, PHP, and IOP treatment programs take a family-first approach to help teens build a sustainable lifestyle that encourages sobriety & success.
If you are concerned that your teen is struggling with an addiction to e-cigarettes, reach out to our admissions team today for support.

Sources
[1] Hopper, L. Teens who abuse opioids are more likely to later use heroin, USC study shows. USC Today.
[2] NIDA. 2023, December 13. Reported drug use among adolescents continued to hold below pre-pandemic levels in 2023.
[3] Panchai, N and S. Zitter. 2024. Teens, Drugs, and Overdose: Contrasting Pre-Pandemic and Current Trends. KFF.
[4] Peavy, M. and C. Green. Understanding and Supporting Adolescents with an Opioid Use Disorder. University of Washington. Addictions Drug and Alcohol Institute.Yule AM, Lyons RM, Wilens TE. Opioid Use Disorders in Adolescents-Updates in Assessment and Management. Curr Pediatr Rep. 2018 Jun;6(2):99-106.
