Preventing accidental overdoses among young people

In April 2026, the San Francisco Department of Public Health was informed about an overdose death involving counterfeit pills—pills that looked like ordinary prescription medications but contained dangerous substances that the individual had no way of knowing were present. The overdose involved novel synthetic opioids.

Counterfeit pills are fake versions of real prescription medications. They are designed to look exactly like familiar prescription medications such as Xanax or Adderall but can contain unknown and potentially lethal substances such as fentanyl and other dangerous opioids. There is no way to tell from appearance alone whether a pill is safe. A single counterfeit pill, or a fraction of one, can be fatal.

Opioids affect the respiratory system and can cause fatal overdoses. Fentanyl is the most prevalent human-made opioid in fatal overdoses. It can be up to 50 times stronger than heroin and 100 times stronger than morphine.

New and more dangerous human-made opioids are present in San Francisco's drug supply. The recent case involved a novel human-made opioid not previously detected in San Francisco overdose decedents. The safest choice is to avoid any pill that has not been prescribed to you by a pharmacy.

• Read this SFDPH Health Alert to learn about the novel human made opioid recently  detected
• Learn more about other opioid-like substances such as 7-OH and Kratom

National data shows that overdose fatalities involving counterfeit pills are more likely to occur among young people.

Teens and young adults may take counterfeit pills without knowing what is in them, putting them at the risk of overdose. Educators, parents, and young adults should know how to recognize when someone is overdosing and be equipped with the knowledge and tools to save a life.

Watch this YouTube video from a doctor explaining what Naloxone is.

The California state legislature passed several bills to prevent opioid-related overdoses among young adults, including mandatory access to naloxone and protections for students involved in overdose events. We invite you to learn more about statewide measures that support youth overdose prevention:

• SB 10 Youth Overdose Prevention: Requires school safety plans for schools serving grades 7–12 to include a protocol for responding to a suspected student opioid overdose.
• SB 997 Naloxone Access in K–12 Schools: Allows students at middle schools, high schools, and adult schools to carry naloxone and fentanyl test strips on campus and at school activities.
• AB 1841 Higher Education Campus Housing: Requires California state universities and community college systems to stock naloxone in student housing, train on-campus residents in its use, and prohibit disciplinary action for drug violations occurring near an overdose.
• AB 602 Campus Overdose Prevention Act: Protects public college and university students from suspension, probation, or expulsion when seeking emergency help for an overdose.

Ensure that naloxone is readily available for staff and students along with appropriate training.

• Order online from the Naloxone Distribution Project.
• Request overdose prevention training and resources from SFDPH.

Develop school policies to promote overdose prevention and education among young people.

Equip school staff with educational materials about substance use among young adults.

• Explore a prevention and intervention curriculum from the Stanford Halpern-Felsher REACH Lab.
• View lesson plans for elementary school, middle school, and high school students.
• View lesson plans for grades 9-12 on health literacy, understanding substance use, and the science behind addiction.
• Explore a public education campaign for young adults.

Make sure teens and young adults know that naloxone is a life-saving medication.

Know how to use naloxone and consider keeping it in an accessible location at home (e.g., medicine cabinets).

Talk to young people about substance use, counterfeit pills, and the risk of fatal overdoses.

• View a guide on how to talk to a loved one about substance use.
• Read “10 Questions Teens Ask About Drugs and Health.”
• Download a Parent/Caregiver Toolkit with facts about prescription medication and guidance for starting discussions with young adults.
• Read “Should Your Teen Take That Prescription?”
• Learn about the warning signs of substance use or abuse.
• Explore more substance use resources for parents and caregivers.

Talk to friends and peers about naloxone, fentanyl, and accidental overdoses, even if they don’t think they are taking opioids.

View a guide on talking to a friend about potential substance use.

Know the signs of an opioid overdose and how to use naloxone.

• Take a course on recognizing and responding to an opioid overdose.
• Watch a video about administering intramuscular naloxone.
• Watch a video about how fentanyl test strips work.

Naloxone is available over the counter at retail pharmacies and for free pickup at BHS pharmacy at 1380 Howard St., open 8am-6pm Monday through Friday and 9am-4pm Saturday and Sunday.

Explore more resources for young adults from the California Department of Public Health.

• California Department of Public Health Overdose Prevention Initiative
• National Institute on Drug Abuse (NIDA)