Supporting the Health of Youth Who Use Fentanyl/Opioids
Staying Connected · Health & Safety

Why connection is important

Many people in recovery say it was crucial they had someone who didn’t give up on them so they would not give up on themselves. People who use drugs often feel shame and guilt. They may try to hide their substance use and withdraw from others.

This is dangerous because a person using opioids alone is more likely to die if they overdose. If a young person lacks connection with family and friends, they might fill that void with new people who might not care as much about them or their health and safety.

“Young people find their way out of fentanyl addiction mostly with support, patience, and having some form of community to be part of.” – Johnny Ohta, SUDP



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Support for family and friends

Family and friends also need their own support. This may come from other family members or friends. If you run into judgment or blame, keep reaching out until you find someone who listens and is helpful.

Another support may be Community Reinforcement and Family Training (CRAFT). This is an evidence-based counseling approach that teaches family and friends how to care for themselves and talk more successfully with a youth who is using drugs. See the Resources section below for links to more information on CRAFT and CRAFT training or support groups in Washington State.

Why isolation is harmful

Why isolation is harmful

People who use drugs often feel shame and guilt. They may try to hide their substance use and withdraw from others. This is dangerous because a person using opioids alone is more likely to die if they overdose. If a young person lacks connection with family and friends, they might fill that void with new people who may not care as much about them or their health and safety.

The definition of opioid use disorder (OUD) includes this sign: continued use despite knowing it is causing harm. People do not need to “hit rock bottom” before they can start to recover from substance use. This is a myth.

Medications are the best treatment for Opioid Use Disorder

Medications are the gold standard treatment for opioid use disorder. They support recovery and reduce the chances of dying from an overdose by more than 50%7,8. Not everyone with OUD may want treatment medications. Each person should make an informed choice if medications are right for them.

This easy-to-read patient flyer (pictured) can help. Medications for Opioid Use Disorder (MOUD) describes the pros and cons of different treatment medications and how to get them.

Are medications working if a person keeps using substances?

Generally, yes. Most people do not stop opioids right away and then never use them during treatment and recovery. Research shows that it takes more than two years on average for people to recover from opioid use disorder10. Many who are on MOUD may keep using fentanyl/opioids or other substances. Over time, most people will decrease or stop using opioids if they stay on their medication. This also lowers their risk of dying from an overdose during this time.

If a person keeps using substances, they might need a different medication, dose, or treatment approach. A health care provider can talk about options or other physical and mental health care that could help.

Recommended Resource

The fact sheet Medications for opioid use disorder for youth has more  information for friends and family of people who are using fentanyl9.

How to get help

1. Find a health care or OUD treatment provider who is experienced with medications for OUD. Even if you or your loved one with OUD isn’t sure about treatment medications, it’s best to talk with a provider who knows about OUD and all treatment options available. 

The Washington State Recovery Helpline can explain care options and help find providers. Their webpage also has search options to find care that is a good fit for your youth. Some medications can be prescribed via an online “virtual” medical visit.

2. High quality counseling and social supports can be invaluable for youth and their loved ones. A mental health or substance use disorder professional can help you understand drug use and how to help. They often start with the youth alone and ask if they want to involve family/friends in their counseling or mental health care. Many youth will say no, which can be painful to family/friends. This is common and should not stop you from getting your own counseling and support.

Community Reinforcement and Family Training (CRAFT) is a proven approach to support caregivers and improve communication with youth who are using drugs. For more information on CRAFT, see the Resources section below.  

The earlier you start help, the better. With help, youth are often able to get back on track faster than adults. Again, staying connected is key.

WA Recovery Help Line website's MOUD Locator
The MOUD locator at the
WA Recovery Help Line
Health & safety: Preventing fatal overdoses and infectious diseases

No one wants to see their loved one overdose, get HIV or hepatitis, or develop painful wounds while they are using drugs. Here are some ways to help prevent serious health risks of using fentanyl/opioids. The Resources section below also has links to online information, training and tools.

Preventing overdose and death

Know how to recognize and respond to an overdose. If response is quick enough, most overdoses can be reversed before a person dies or gets permanent injuries4.

Get naloxone and talk with your youth about how to use it. This can be a signal to a youth that you care and will support them no matter what. It can also help you talk about ways to prevent overdoses in the first place, such as using smaller amounts or in way that leads to slower absorption (e.g. by mouth versus smoking). There is a useful conversation guide in the Resources section.

Opioid treatment medications reduce the chance of dying from an overdose by at least 50%.

Drug checking

Another way to lower risk is to test the drugs to learn what is in them so a person can make informed decisions about using them. Because non-prescription fentanyl/opioids and other drugs are unregulated, they can contain dangerous substances. “Drug checking” can be done at home with fentanyl and other drug test strips or at community drug checking programs5. Test strips and/or onsite testing are available at some health departments, harm reduction programs, and syringe services programs in WA State.

Find more information: Washington DOH Syringe Service Program Directory | WA State Community Drug Checking Network.

How to help youth who have stopped using fentanyl

Recovery is defined as “A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.”  In addition to substance use, recovery also involves positive social relationships and mental and physical wellbeing.

Recovery is an ongoing process that can look different for each person. For example, people may define “recovery” as:

  • No substance use of any kind.
  • No use of the “problem” substance(s).
  • Less or more managed use of a substance that used to be a bigger problem.

Ongoing use or a slip back to use from time to time (i.e., relapse) are normal in recovery. It’s important to remember the health and safety tools described above and to encourage people to use them. Recovery is very personal, and recovery needs and support vary widely. Many youth, as well as family and friends, find benefit from peer support groups.

Improved health and safety are possible with any of these patterns of substance use.

Resources for support
  • Recovery Helpline or 1-866-789-1511. Talk to trained people about opioid use disorder and treatment options. Or use the online search tool to find treatment providers by location, medications offered, insurance, and other services.
  •  Teen Link or 1-866-833-6546. “Our teen volunteers are trained to listen to your concerns and talk with you about whatever’s on your mind – bullying, drug and alcohol concerns, relationships, stress, depression or any other issues you’re facing. Calls and chats are confidential.”
  • Crisis Text Line. Text HOME to 741741 to connect with a volunteer crisis counselor.
  • SMART recovery groups. Their family and friends meetings utilize a CRAFT-aligned approach to help stay connected with a loved with substance use disorder
  • Washington Mental Health Referral Service for Children and Teens or 1-833-303-5437.
  • Seattle-Area Therapists. WA State therapists with expertise in substance use disorder. Some offer individual or group Community Reinforcement and Family Training (CRAFT) an evidence based treatment.
  • Center of Parent Excellence Project. Help and peer support for parents navigating the children’s behavioral health system.
  • Helping Families Help. This website will “introduce you to CRAFT, an evidence-based method for motivating your loved one towards recovery while taking care of yourself in the process & connect you with longer-term CRAFT-based resources and supports to continue to learn and practice these skills and perspectives through time.”
  • Helpline: Get One-on-One Help to Address Your Child’s Substance Use. Text CONNECT to 55753, email, or make an appointment for a call. Talk to a trained and caring specialist about the challenges, setback, obstacles, and difficult emotions that go along with a child’s substance use and addiction. Available in English and Spanish. Confidential and free.
Information about opioids, overdose & treatment
Relevant research
  1. Singh S, Palayew A, Banta-Green CJ. Preliminary Results: Time to Onset of Opioid Use Disorder for People Using Fentanyl Versus Heroin: Results From a Cross-Sectional Study in Seattle, WA. Presented at: College on Problems of Drug Dependence; June 16, 2024; Montreal, Canada.
  2. Coffin PO, Maya S, Kahn JG. Modeling of overdose and naloxone distribution in the setting of fentanyl compared to heroin. Drug and Alcohol Dependence 2022;236:109478. doi:10.1016/j.drugalcdep.2022.109478
  3. Godley MD, Passetti LL, Subramaniam GA, Funk RR, Smith JE, Meyers RJ. Adolescent Community Reinforcement Approach implementation and treatment outcomes for youth with opioid problem use. Drug and Alcohol Dependence 2017;174:9-16. doi:10.1016/j.drugalcdep.2016.12.029
  4. Davidson PJ, Wheeler E, Proudfoot J, Xu R, Wagner KD. Naloxone distribution to drug users in California and opioid-related overdose death rates. Drug and Alcohol Dependence 2015;156:e54. doi:10.1016/J.DRUGALCDEP.2015.07.1064
  5. Maghsoudi N, Tanguay J, Scarfone K, et al. Drug checking services for people who use drugs: a systematic review. Addiction 2022;117(3):532-544. doi:10.1111/add.15734
  6. Bluthenthal RN, Anderson R, Flynn NM, Kral AH. Higher syringe coverage is associated with lower odds of HIV risk and does not increase unsafe syringe disposal among syringe exchange program clients. Drug and Alcohol Dependence 2007;89(2-3):214-222. doi:10.1016/j.drugalcdep.2006.12.035
  7. Pierce M, Bird SM, Hickman M, et al. Impact of treatment for opioid dependence on fatal drug-related poisoning: a national cohort study in England. Addiction 2016;111(2):298-308. doi:10.1111/add.13193
  8. Larochelle MR, Bernson D, Land T, et al. Medication for opioid use disorder after nonfatal opioid overdose and association with mortality. Annals of Internal Medicine. Published online June 19, 2018. doi:10.7326/M17-3107
  9. Washington State Health Care Authority, Addictions, Drug & Alcohol Institute, University of Washington. Fact Sheet: Medications for Opioid Use Disorder for Youth. 2024.
  10. Kelly JF, Greene MC, Bergman BG. Beyond abstinence: Changes in indices of quality of life with time in recovery in a nationally representative sample of U.S. adults. Alcohol: Clinical & Experimental Research 2018;42(4):770-780. doi:10.1111/acer.13604

Acknowledgements: Huge thanks to wonderful care providers who helped inform this guide with their conversations, interviews, and presentations including Johnny Ohta, Lara Okoloko, Dr. Taryn Hansen, Abbie Woods, and Addy Adwell. Thank you also to colleagues involved in qualitative interviews and research that helped inform this document including Samyukta Singh and Drs. Teresa Winstead, Alexis Ball, and Anthony Floyd.

This information is for educational purposes only. It is not a substitute for professional medical advice.