Before the overdose, Griffin Hoffmann was a sophomore, about to lead his Portland, Ore., high school's tennis team. Sienna Vaughn was a junior in Plano, Texas, who participated in Girl Scouts and cheerleading. Laird Ramirez was 17 years old living near Charlotte and competing on his high school's wrestling team. He was rarely seen without his skateboard.
The teens thought they were taking prescription pills for pain and relaxation, drugs like Valium or Percocet, that they bought from friends or from social media. But the pills they took were counterfeits – they hadn't come from a pharmacy and it turned out they contained fentanyl, a potent, often deadly, synthetic opioid. Just 2 milligrams can kill you.
"[Fentanyl's] infiltration into schools is certainly something that cannot be ignored," says Alberto Carvalho, the superintendent of the Los Angeles Unified School District. LAUSD is one of the largest districts to stock naloxone, a medicine that reverses opioid overdoses, throughout its schools.
"We cannot close our eyes. We cannot look the other way," he says.
Fentanyl was involved in the vast majority of all teen overdose deaths – 84% – in 2021, and the problem has been growing. According to the Centers for Disease Control and Prevention, fentanyl-related adolescent overdose deaths nearly tripled from 2019 to 2021. And nearly a quarter of those deaths involved counterfeit pills that weren't prescribed by a doctor.
Lauren Tanz, an epidemiologist who studies overdose prevention at the CDC, says a number of factors contributed to these alarming numbers.
"The combination of more easily available drugs – particularly highly potent drugs like fentanyl that are available via social media and through counterfeit pills – and a mental health crisis among adolescents that was exacerbated during the COVID-19 pandemic is resulting in an increase in overdose deaths among kids."
This academic year, education leaders are grappling with how to approach a drug use crisis unlike any they've seen before.
"If our students are having contact with these substances, considering the devastating implications and consequences," says Carvalho, "then we need to be active participants in the solution, and not necessarily shy away from it or punt it to somebody else because it falls outside of the realm of traditional education."
Schools can't do it alone
It's happening all across the country – from Tennessee to Texas; from Maryland to Oregon. In some cases, a single high school or school district has seen multiple fentanyl overdose deaths. School buildings have posters in the hallways memorializing students who have died. Social media posts and back-to-school messages from school staff include warnings and pleas to turn in pills students have bought online, "no questions asked."
In addition to stocking naloxone – often known by the brand name Narcan – schools have revamped their drug awareness and prevention programs. Some are promoting the use of test strips to help identify if a pill contains fentanyl, although the small paper tests can still be considered drug paraphernalia and are illegal in several states.
But Becky Pringle, president of the National Education Association, the nation's largest teachers union, warns schools are just one piece of the puzzle.
"We can't possibly do this alone. This is not a school crisis. This is a community crisis," says the former middle school teacher.
"So it's not just educators in schools. It's parents and families. It's the communities themselves. It's every level of government. We have to come together. Too often, the ills of society find the way to our schoolhouse doors, but the resources of society don't follow them."
There are multiple bipartisan pieces of federal legislation aimed at supporting schools in dealing with fentanyl, including one proposed bill that would give money to schools to stock naloxone and train teachers and nurses in updated drug education.
Mourning families are often leading the charge
Some families of students who have died have been frustrated with how schools are responding or say schools could do more. Of the 20 largest districts in the country, only five confirmed to NPR that they stocked naloxone in all of their schools last school year. And in schools across the country, drug education is ad-hoc, not standardized and oftentimes outdated. The 2021 National Survey of Drug Use and Health found only about 60% of surveyed 12-17-year-olds self-reported that they saw or heard drug or alcohol prevention messaging in school.
Avery Kalafatas, an 18-year-old from the Bay Area, says she knew nearly nothing about fentanyl until it killed her cousin, Aidan Mullin. He was like an older brother to Kalafatas; the two shared a love of the outdoors and camping. Mullin had an interest in agriculture, and a fondness for growing peppers and playing the guitar.
In November of 2020, Mullin, then 18, took what he thought was a Percocet. It contained a lethal dose of fentanyl. His death was a devastating blow.
"And it took me a while in my grieving process to obviously get past the shock and the sadness of it. But in that process, I was honestly pretty angry that this wasn't talked about more," she says.
Kalafatas began to educate herself about the synthetic opioid.
"As I became more aware of it through my cousin's death, I really saw a big need for more education, both among parents, and especially teens."
Kalafatas founded the nonprofit Project 1 Life with a mission to educate adolescents and foster youth-led conversations about fentanyl, the deadly and frighteningly ubiquitous opioid found in so many counterfeit pills. "This isn't like the drug crisis we were dealing with 20 years ago, it's a completely different ballgame," Kalafatas says.