This report describes five main findings related to overdose deaths among adolescents (persons aged 10–19 years): 1) deaths have increased substantially since the end of 2019; 2) a majority of deaths involved IMFs; 3) nearly one quarter of deaths included evidence of counterfeit pills; 4) two thirds of decedents had a potential bystander present, although most provided no overdose response; and 5) approximately 41% of decedents had a history of mental health conditions or treatment. Overdose prevention efforts promoting awareness of dangers of IMFs and aiming to treat underlying mental health and substance use disorders might help reduce adolescent overdose deaths.