COLUMBUS, Ohio -- Groups working to prevent substance misuse said immediate action is needed to stem the surge of young people vaping marijuana.

In a 2020 federal drug survey, one in five 10th and 12th graders said they had vaped marijuana in the past-year. While that's about the same as 2019, it's still nearly double the rate from 2017.

Fran Gerbig, executive director of the Prevention Action Alliance and a Certified Prevention Consultant, contended there are legitimate health risks with vaping, including the harmful substances used in vaping fluid, and the risk of vaping-related lung injury.

"Then you add the components of marijuana," Gerbig explained. "Not only are you impacting the lung, you're impacting the cognitive ability of that person, you're impacting the potential risk of developing significant mental-health illnesses and challenges."

She pointed out decision-making, memory and concentration can be affected for days after marijuana use. This is National Prevention Week, with Wednesday specifically focused on preventing illicit drug use and youth marijuana use.

A recent study revealed the more youths are exposed to videos with any electronic cigarettes, the more likely they are to use the product.

Gerbig emphasized the pandemic removed some of the protective factors that kept youths away from vaping and marijuana, while enhancing some risk factors.

"Their abilities to socialize were limited and because of that we saw boredom, we saw increased stress and anxiety and depression," Gerbig outlined. "And a time on their hands where they could be on social media to see vaping being modeled. I really think it took the wind out of some of the prevention work that was happening."

Gerbig noted vaping during the pandemic is especially troubling, since COVID-19 attacks the respiratory system.

She added everyone has a role in prevention, and encouraged parents, teachers and other trusted adults to be proactive in educating youths about the dangers of substance use.

"Young people are smart," Gerbig asserted. "And if they're provided with good data and understand the expectations that their parents and other caring adults have, they're very likely to listen and to follow suit."

Prevention Action Alliance has online substance-misuse resources, including fact sheets with information on vaping marijuana.

The State of Indiana wants to learn more about Hoosiers' experiences with substance-use disorder and addiction-recovery services.

Administered by the state's Division of Mental Health and Addiction (DMHA), the "Recovery Capital Index" will take a holistic look at the addiction-recovery resources available to people across the state, to help determine whether further resources are needed to ensure patients stay on the path to recovery.

Becky Buhner, deputy director of addiction and forensic treatment for the DMHA, said the data will help policymakers craft targeted responses to addiction-recovery needs.

"We can then look at a ZIP code to determine if there is an area of high need within that ZIP code," Buhner explained. "That's going to allow us to make funding decision in the future as to how we can better allocate our resources to meet the needs of that area."

People can complete the survey online or by texting "RECOVERY" to 833-638-3784. Buhner said the state wants to hear from a wide variety of people, including those currently using drugs, those in recovery, and their family and friends.

The state said it has allocated more than $45 million in grant funding over the past four years to combat the opioid epidemic. Buhner pointed out Indiana has spent years expanding its addiction-recovery infrastructure. But she noted there are people who need help who are not connected to the recovery system, and the survey will help state health officials learn about those needs.

"We released it on Friday, and as of Saturday morning, we had 234 people that signed up for the text-message series," reported. "We had 99 individuals that actually completed the Recovery Capital Index, which is a 43% response rate."

She added the data compiled from the survey will be made public after six months. According to provisional data from the Indiana Department of Health, the state saw more than 2,500 drug overdose deaths last year, a five-year high. About 80% of those deaths were due to opioids.

Ohio's overdose crisis has been heavily linked to the use of prescription painkillers or heroin, but it is not the case anymore. Health officials now warn historic levels of overdose deaths are being exacerbated by the availability of counterfeit pills laced with fentanyl, a potent and deadly synthetic drug.

Shabbir Imber Safdar, executive director of the Partnership for Safe Medicines, said fake pills are being sold as prescription painkillers such as OxyContin, the anxiety drug Xanax, and stimulant medications.

"There's a lot of young people who take Adderall, and they're not particularly careful about where they get their pills," Safdar pointed out. "I think we're going to see a rise in deaths in the 16-24 age range from fake Adderall made with fentanyl."

In May, two Ohio State University students died from suspected use of fake Adderall pills laced with fentanyl. Ohio is expected to report more than 5,200 overdose deaths for 2021, compared with just 327 in 1999.

Counterfeit medications are commonly sold through social media, on hidden sites on the "dark web" or in person by someone claiming they are real. Safdar noted an estimated four in 10 pills with fentanyl contains a potentially deadly dose.

"Even the first fake pill you ever take might kill you because if it has too much fentanyl, there's no time to get addicted, that first pill will kill you," Safdar stressed. "So it's really a game of Russian roulette when you take one of these pills that did not come from a pharmacy, which is the only safe source."

The Drug Enforcement Administration recently issued a Public Safety Alert about the rise in the lethality and availability of fake prescription pills containing fentanyl, and is encouraging people to only use prescription medications as directed by a medical professional and dispensed by a licensed pharmacist.

Online sales of counterfeit prescription pills containing fentanyl are on the rise, and experts say social media apps like Snapchat and TikTok are driving the surge, including in Tennessee.

Shabbir Safdar, executive director of the Partnership for Safe Medicines, said an alarming number of counterfeit prescription drug pills containing fentanyl are being bought online by teens and young adults.

"And in fact, just in the last four years, we've tracked fatalities in 19 different states from people who've met a drug trafficker on Snapchat and then bought a fake pill," Safdar reported.

According to the Tennessee Department of Mental Health and Substance Abuse Services, more than 2,000 Tennesseans died of fentanyl-related drug overdoses in 2020, more than double the number in 2019.

Tennessee is one of many states recently passing laws decriminalizing fentanyl test strips in an effort to reduce deaths. The tests work by dipping the strip in water containing dissolved drugs.

Safdar noted he believes strips should be legal, but pointed out they do not always detect fentanyl in large batches.

"In fact, there's a young man in Tennessee that we profiled in the last couple of years, who he and his friends all order Xanax off the dark Web, and they each took a pill," Safdar recounted. "It was only this young man's that had the fatal amount of fentanyl in it."

Safdar pointed out more Americans are turning to online pharmacies for acetaminophen, aspirin, blood thinners and other routine medications, but said there's risk in buying products from any source other than a licensed pharmacy.

"During the pandemic, as many as one in seven Americans went online to purchase medication, and many of them went to these fake Canadian pharmacy websites," Safdar emphasized.

According to a study in the Journal of the American Pharmacies Association, there are more than 11,000 websites based in the U.S. and Canada calling themselves "pharmacies" and selling drugs online.