evidence: There were 518 deaths among adolescents (2.40 per 100 000 population) in 2010, with rates remaining stable through 2019 with 492 deaths (2.36 per 100 000). Deaths increased to 954 (4.57 per 100 000) in 2020 and to 1146 (5.49 per 100 000) in 2021. Between 2019 and 2020, overdose mortality increased by 94.03% and from 2020 to 2021 by 20.05%. In the overall population, numbers of overdose deaths were higher and rates increased steadily from 2010 (n = 38 329; 12.4 per 100 000) to 2020 (n = 91 799; 27.86 per 100 000) and 2021 (n = 101 954; 31.06 per 100 000). The percent change was 29.48% from 2019 to 2020 and 11.48% from 2020 to 2021 (Table). Among adolescents, fentanyl-involved fatalities increased from 253 (1.21 per 100 000) in 2019 to 680 (3.26 per 100 000) in 2020 and to 884 (4.23 per 100 000) in 2021 (Figure, A). In 2021, fentanyls were identified in 77.14% of adolescent overdose deaths, compared with 13.26% for benzodiazepines, 9.77% for methamphetamine, 7.33% for cocaine, 5.76% for prescription opioids, and 2.27% for heroin.