How To LA

EP #15: Navigating The Teen Fentanyl Crisis

Alberto M. Carvalho  

We are experiencing a devastating epidemic. [somber music] Whether we talk about fentanyl, or the many variations of fentanyl, there is an abundance of drugs that students are having ready access to. But there are solutions.

Brian De Los Santos  

From Laist Studios, this is How To LA, the podcast that helps you, among other things, navigate some complicated issues affecting our city. I'm Brian De Los Santos, and that guy you just heard he's a Superintendent for the Los Angeles Unified School District, Alberto Carvalho. As of last week, nine students had overdosed across the district just recently, including a 15 year old girl who died after consuming a pill laced with fentanyl.

Alberto M. Carvalho  

This is not unique to Los Angeles, it is a national scourge.

Brian De Los Santos  

We've been hearing about fentanyl for a few years now. It's been in the headlines and it's been circling around unhoused people in LA, and led famous people like Mac Miller, Prince and Tom Petty to OD. It's also been in TV plots like Euphoria. But this recent overdose death of a high school teenager here in Hollywood, it really caught my attention. It seems like fentanyl is just everywhere now. But how and and why? [somber music cuts out]

Keegan Hamilton  

Right around 2015/2016, started hearing about this drug fentanyl.

Brian De Los Santos  

That's Keegan Hamilton. He's an organized crime and drug trade reporter at Vice. He's been covering this crisis for years.

Keegan Hamilton  

which is not a new drug. It's a synthetic opioid that has been around for decades and has been used by doctors and surgeries-and is still used all the time-medically.

Brian De Los Santos  

It's prescribed for pain like morphine, but 100 times more powerful. But what we're really talking about here, and what LAUSD is worried about is the stuff that's made illegally: the powders, the liquids that are getting mixed into cocaine, heroin and methamphetamine.

Keegan Hamilton  

Mexican cartels figured out that they could make fentanyl very cheaply, very profitably. And then they could substitute it for heroin, which they were already, you know, making and selling. [suspenseful music in]

Brian De Los Santos  

So fentanyl is basically like a filler, but a deadly one.

Keegan Hamilton  

And what we've seen is over the last three to five years is that fentanyl has really become the most prevalent street drug in the United States.

Brian De Los Santos  

The reason we're talking about this today is because there are more young people overdosing from it, and dying. And a lot of people don't even know that they're using it. High school students might not have any idea that the pill they just bought may contain fentanyl. The person who gave it to them might not even know it had fentanyl in it, either. [suspenseful music out]

Megan Larson  

And that's what's so scary about this.

Brian De Los Santos  

That's our executive producer, Megan Larson.

Megan Larson  

This idea that there's something in a drug that they might be experimenting with, or their friends might be experimenting with. It does change the rules.

Brian De Los Santos  

She has three kids, and the oldest one is in high school.

Megan Larson  

I gave the boys the talk about all of this last weekend in the car, because that's when you have serious talks, right? I'm driving, they're in the backseat. I was surprised they hadn't heard about the girl who died. You know the way kids talk, and Snap and whatever. But they hadn't. And, I think it scared them.

Brian De Los Santos  

How do you think you-think it went? How do you think you did as a parent?

Megan Larson  

Oh, I don't know. I think they heard me. But I don't know if I handled it in the right way. I want them to be aware I want them to be safe. But I also don't want to freak out and make them think that evil is lurking around every corner. [slow 2bit techno music in]

Brian De Los Santos  

Here are the facts. Nationwide overdose deaths among high school kids have spiked in the last few years. According to the journal JAMA, these deaths have stayed steady from 2010 to 2019, at around 500 young people a year. But in 2020, that number nearly doubled, which had never happened before. So in the midst of this crisis, we want to understand what parents like Megan, and schools and kids themselves can do to protect young people in the community. To help us out. We're bringing UCLA researcher Joseph Friedman into the studio today. He's the author of that JAMA study we mentioned earlier, it looks at trends and overdoses among young people. [slow 2bit techno music out]

Joseph Friedman  

The problem is we don't really know how many kids are coming into contact with this. The nature of the drug supply right now is it's very unpredictable. What we showed in our study was that among only high school aged adolescents, so 14 to 18. We showed that 518 adolescents passed in 2010. That was really stable all the way through 2019 when it was 492 teenagers, but all of a sudden in 2020, that jumped up to 954, right? So it's almost doubling in a single year, which is totally unprecedented. And then it rose further in 2021, rising up to the equivalent of about 1,150 teen deaths.

Brian De Los Santos  

This was across the US, right? But what about California?

Joseph Friedman  

So in the past two years of data that we have, it's about 400 teenagers have unfortunately passed away due to drug overdose in the state of California, which I think is really a tragedy. But you know, it's important to note that over the past few years, teen drug use rates have actually fallen precipitously, even as overdose deaths have gone up. So teen drug use is actually less common, but more dangerous.

Brian De Los Santos  

I want to go back a little bit to you mentioning 2020. How has that number spiked and overdose deaths and among teens, that the height of the pandemic have to do anything with that?

Joseph Friedman  

So that's a really good question. I think indirectly probably, yes, it would be easy to think that because of the stress of the pandemic and lock downs, teens were maybe using more drugs, right, and this was leading to more overdoses. Actually, the opposite is true. Because teen drug use is such a social phenomenon, we actually saw that drug use rates among teens have come way down during the pandemic, most likely, there is evidence to suggest that the drug supply became more toxic during the pandemic. So because the drug supply was disrupted, right borders were closed, it became more difficult to perhaps move drugs around. And we know as a general rule, whenever that happens, it promotes the drug supply becoming more potent and more toxic. I will say though, the key driver of the teen overdose crisis is the spread of counterfeit pills that looked like prescription pills would actually contain fentanyl, that was already happening before COVID. So most likely, the pandemic just kind of exacerbated these underlying trends that were already getting worse.

Brian De Los Santos  

So this conversation takes me back to the DARE program where I remember police officers were coming in their uniform, and they would tell the classroom: “hey, drugs are bad for you.” And after a few weeks of being that program, you get a shirt right. But, at the core of that program was-the message was abstinence. So, does that work?

Joseph Friedman  

So even with teen drug use rates falling, it's still about a third of 12th graders report having experimented with an illicit drug before they graduated from high school. So unfortunately, despite our best efforts, of course, we would love to be able to prevent teenagers from using drugs, right? But we know that it's simply not possible to achieve that across the board. And so I think the best drug education options show abstinence as the best option, but alongside a host of other strategies and understandings for teens to keep themselves safe. Should they experiment with drugs, or should their friends experiment with drugs.

Brian De Los Santos  

I don't have kids (uncomfortable laugh). But, how would you kind of advise a parent to talk to their kids about this because it may be uncool-you know, as a mom or a dad like: "Hey, kids, y'all doing drugs? Let me teach you some things." Do you have any tips as an expert of how to approach this?

Joseph Friedman  

So I think we have to start by not being naive and understanding that these young teenagers that you're referring to have probably already heard all kinds of messages from social media, right-on Instagram on Tik Tok on Facebook-there's information about drugs all over the place. So this is already something that they're aware of, in some capacity. And it is important to tell teens that abstinence from these drugs is definitely the best thing they can do for their health, right. And then the other thing we can say is listen, let's say that your friends are experimenting with drugs for whatever reason, they're not going to wait, then it's important understand that not all drugs are equally dangerous. So cannabis, alcohol, these are not risk free substances. But they have never been shown to be contaminated with fentanyl, right? Whereas any pill or any powder is absolutely the highest risk category. So if you are going to experiment with a pill or a powder, it's essential to have Narcan on hand and know how to use it. If you can try and test it for the presence of fentanyl. Then also make sure that there's always someone there who's not using, who knows where the Narcan is who can help out, who can call 911 should there be an emergency. [drab music in]

Brian De Los Santos  

Okay, I want to stop right here for a second. This might seem a little weird, this idea of carrying Narcan around, but let me explain Naloxone, more commonly known as Narcan. It's a potentially life saving medication that can reverse the effects of opioids. It's administered as a nasal spray, but for someone who's OD'ing, they need it really fast, like within three minutes after symptoms start. After that recent fatal teen overdose, the LAUSD superintendent made an important announcement:

Alberto M. Carvalho  

Effective the second week of October, every one of our schools at LA Unified will be outfitted with the appropriate tools, including Narcan available for students who may experience a condition of overdose.

Brian De Los Santos  

So I asked Joe Friedman, well, he thought about that. [drab music out]

Joseph Friedman  

Well, so if they do it well is a great step. I was really happy to see this announcement. You know, they have historically resisted offers from certain harm reductionist and harm reduction groups to actually bring Naloxone into schools over concerns of liability, right. And so, it's great that they finally changed their mind and are doing the right thing. Now, the devil's in the details, right? Because if they're just bringing in Narcan, and, you know, putting it in the closet and locking it up-and you know, that-maybe the teacher can access it in an emergency, hopefully. But we know that most overdoses are not occurring in the classroom. Right, most overdoses are going to be occurring after school, you know, at the party. So, you know, I hope LAUSD really does, you know, the right thing here and makes it available to teens, give it to teens, you know, send it home with them, put it in their cars, and teach them how to use it. And I actually hope that schools across the state and across the nation will follow suit, because this is an essential strategy to keep kids safe. [subdued music in]

Brian De Los Santos  

Should parents be freaked out by now?

Joseph Friedman  

Absolutely. I mean, I think, you know, parents should be concerned, teens should be concerned. Our goal as a society, in medicine and harm reduction and public health, needs to be guiding that concern towards appropriate solutions and avenues. Right, and not kind of taking it into unfortunate-of places based on hysteria and based on panic, right. And really saying: "Okay, what does the evidence actually say is happening? And what is the evidence, extra support? What are the real solutions? What are the things we can actually do to help keep the teams in our state and our society safe?"

Brian De Los Santos  

Thank you so much, Joe, I appreciate you taking time to talk to us about this crisis and epidemic.

Joseph Friedman  

My pleasure.

Brian De Los Santos  

Okay, folks, that's all we have for you today. Thanks for sticking through this very heavy but important topic. I truly hope you learned something, I know I did. This story is ongoing. And we're gonna be following up on how this Narcan plan rolls out throughout the school district. And please, I'm really asking you, please share this episode with a friend or a loved one, especially if you know anyone with high school kids or younger. We want to spread the word and keep our community safe, and maybe even save a life. From LAist Studios, this is How To LA, I'm your host Brian De Los Santos. Catch us Tuesdays through Thursdays wherever you get your podcasts. And don't forget to subscribe to our newsletter at Laist.com/HowToLA. Aaricka Washington writes or newsletter. Our producers are Evan Jacoby, Meg Botel and Kyle Chang. Chris Farias handles our social media. Check us out on Instagram @LAistPics and on Tik Tok @LAistvids. Our intern is Olive Bieni. Hasmik Pohosyan engineers the show. Megan Larson is our Executive Producer, Shana Naomi Krochmal is the Vice President of LAist Studios. Much love to the LAist engagement team who connect us with community members and another special shout out to the LAist digital and marketing teams. Support for this podcast is made possible by Gordon and Dona Crawford who believe that quality journalism makes Los Angeles a better place to live. This program is made possible in part by the Corporation for Public Broadcasting, a private corporation funded by the American people. [subdued music fades out]