The most important question about addiction

By Maia Szalavitz / New York Times

Despite rising overdose deaths, there’s some important good news regarding opioid misuse. Rates of nonmedical use by high school seniors have fallen by nearly 83 percent since 2002, when 14 percent reported having ever tried using prescription pain pills to get high. By 2021, that proportion was down to just 2 percent. Heroin use also shows a precipitous drop, with only 0.4 percent of 12th graders reporting trying it as of 2021.

This is especially welcome news because teen use is an excellent predictor of the course of drug epidemics: The vast majority of addictions start in late adolescence or early adulthood. Since the deadliest opioids like fentanyl are most often sold in the guise of prescription pain pills or heroin, this bodes well for reductions in overdose deaths.

But to translate this positive change into lasting reductions in addiction and overdoses, it’s important to understand how drug use patterns change over time and not view them solely as isolated crises related to specific substances.