‘The nightmare of a lifetime’: Illicit pills bring efforts to keep teenagers alive to a critical juncture

Students, parents and educators across Los Angeles have recently found themselves on the frontlines of a fight they never wanted to be a part of: the fight to keep teenagers alive.  

In Los Angeles Unified School District, fentanyl-laced substances have left behind a string of student overdoses and mourning communities. The district, which annually enrolls more than 460,000 students between grades kindergarten and 12, saw seven overdoses in September of 2022, of which at least one student died. An LAUSD spokesperson confirmed that over the 2022-23 school year, the district administered nasal naloxone, a quick-acting overdose reversal medication, to students 38 times.

Sheila Scott, the founder of lukelove, an organization focused on training Los Angeles teens and schools on overdose reversal, called the fight to end such overdose “the nightmare of a lifetime.” 

“I am a mother with a dead child. I am the most feared type of person in the world,” Scott said. “And I am watching more and more people become me.”

The illicit, counterfeit pills connected to this overdose trend, often sold through social media platforms like Snapchat and Instagram to teens who believe they are receiving the pharmaceutical-grade version, have brought efforts to protect students from tragedy to a critical juncture.

Advocates of harm reduction want training to empower people, including students, to test for lethal substances, recognize and reverse an overdose with naloxone, commonly referred to by brand name Narcan. Meanwhile, LAUSD’s anti-drug curriculum remains rooted in abstinence-based Drug Abuse Resistance Education programming, where the program still has its vociferous proponents.

The urgency of updated curriculums comes as fentanyl — and other, more pernicious substances — continues to pollute drug supplies across Los Angeles.

Drugs and teenagers are by no means a new combination, but it is an increasingly fatal one. Between 2019 and 2020, the number of fatal overdoses of youth aged 14-18 increased by 94% despite overall drug use in the demographic decreasing. Dr. Chelsea Shover, Assistant Professor-in-Residence at UCLA’s Geffen School of Medicine, explained that until recent years, teens experimented with pills without brushing death.

“[Using pills] has never been risk-free,” Shover said. “There have always been consequences; some people would develop substance use disorder, some people would overdose, some people would have legal consequences or a bad experience. But now, it’s a lot more likely the first time [a student] encounters [an opioid] it’s a counterfeit pill very likely to result in death.”

A new approach emerges: “Just say know”

In the wake of this crisis, numerous organizations have embraced harm reduction, including LA Recovery Connect and lukelove. 

Indrid Corddry, who uses they/them pronouns, is a 17-year-old LAUSD student leader for LA Recovery Connect and lukelove. They described the organizations’ harm reduction approach as the most effective way to promote recovery. Shover had a similar take. 

“Hey, if ‘don’t do drugs’ works for you, great, awesome! But we know that people do drugs and we’d like you to stay alive,” Shover said. “So not using drugs is a great way to avoid overdose. That’s plan A. Let’s talk about plan B and let’s talk about what’s actually happening.” 

Scott echoed Corddry and Shover, defending harm reduction — frequently criticized as “enabling” substance use – as the most realistic way to keep teens from fatally overdosing. 

“I wish saying ‘don’t do drugs’ worked. I’ve said it, I’ve shouted it, I’ve done an interpretive dance about it and people are still doing drugs,” Scott said. 

As Scott defended her organization’s approach, she placed three grains of salt, representing a fatal dose of fentanyl, into a small plastic bag for a training she was preparing to lead. 

“There are two worlds: one with harsh rules, long prison sentences and violence. One with naloxone, recovery and alive kids,” Scott said with a laugh. “I know which world I’d rather live in.”

Scott said keeping kids alive long enough to enter recovery is exactly why she started the organization in honor of her late son, Luke Scott, who died in 2016 of a heroin overdose. 

“Luke can’t go into recovery. He’s dead. Look me in my eyes and tell me you’d rather he be dead than still breathing and using an ‘enabling’ test strip,” Scott said.

She gestured to a table in her backyard covered with QR codes linking to safe-use apps, rainbow bags filled with naloxone and her own shirt that read “F*CK OVERDOSE, CARRY NALOXONE.” 

“All that this enables is breathing,” she said.

Cornerstone of LAUSD stands strong, not without critics: “Just say no”

The idea of safer use is where harm reduction organizations most notably depart from D.A.R.E., said Dennis Osborn, D.A.R.E.’s Western Regional Director.

“When we’re talking about specifically fentanyl, I would never advocate for [harm reduction] because there are too many unknowns and there are too many irregularities with things like testing strips,” Osborn said. 

LA Recovery Connect founder Thea Golden said another key aspect of her and Scott’s work is dismantling antiquated stereotypes so often cast by popular substance education initiatives, like D.A.R.E., of what somebody at risk of overdose looks like.

“In the lessons teens get, they’re shown photos of people in a car passed out, right? The dad and the mom are passed out and a kid is trapped in the backseat,” Golden said. “And I’m just thinking, you go in and show that to teens. They don’t see themselves in that. Maybe [their] friend over there is using, but they’re not sitting in a car passed out with a baby in the backseat.”

Thea Golden, left, sits with Sheila Scott, right, before a naloxone training event in July. Golden said funding remains the biggest worry for organizations like LA Recovery Connect, but regardless of the money, she’s determined to continue her work. “When we train one person, they go home at night and they talk to their family about it at dinner. And now, there are five people that can save a life — that’s what we’re going to keep chasing.” (Photo courtesy of LA Recovery Connect)

Scott said when she initially told her friends and family her son had overdosed, they couldn’t come to terms with Luke Scott — a 23-year-old production assistant lauded as a brilliant, responsible hard worker — dying of an overdose.

“Oh, but Lukey was so lovely,” Scott recalled being told. “What? Oh yeah. Because [drugs] don’t kill lovely people. Don’t kill students, don’t kill highly functioning people, don’t kill just anybody. Yeah, they f—— do.” 

Drugs, Scott said, don’t care what type of person uses them, which only further propels her work to get naloxone into as many hands as possible.

Since lukelove and LA Recovery Connect began collaborating in October of 2022, Scott, Golden and their team of teen volunteers — whom Scott and Golden have dubbed their “naloxone battalion” — have packaged 1,826 naloxone kits, distributed 1,249 and held 48 trainings. In total, they have educated at least 2,000 students, parents and teachers about fentanyl, overdose and naloxone.

Through distributing naloxone, LA Recovery Connect and lukelove have seen 18 confirmed successful cases of reversed overdoses. In one such case, a man who lives in an unhoused encampment in L.A. saved his friend’s life by reversing an overdose with a naloxone kit supplied by the two groups. 

A man who lives in an unhoused encampment in Los Angeles sent these text messages to his mother after an overdose was successfully reversed using a naloxone kit supplied by lukelove and LA Recovery Connect. In Los Angeles, overdose mortality amongst unhoused people is 39 times the mortality of housed residents, a recent LA County study found. (Image courtesy of Sheila Scott)

In another case of successful overdose reversal, a teenage lifeguard noticed an unconscious man on the sidewalk as she left her shift at the pool, Scott said. Within minutes of administering naloxone, the man was “trying to get up and leave,” the young lifeguard told Scott.

After a teenager successfully reversed a man’s overdose with naloxone, she sent this text message to her friend, another teenager, who had trained her on how to administer it. (Image courtesy of Sheila Scott)

Scott said though the organizations encourage people to report back when they use their overdose kits, many people never reach out. The 18 confirmed successful reversals lukelove and LA Recovery Connect kits have enabled, Scott said, “is no thanks to the schools, it is despite the schools.”

“It is because of the bravery of our high school team, who are everything in this crisis,” she said.

Students on the frontline say the time for action is now

Corddry and fellow teen leader Ayla Blumberg agreed schools have the opportunity to play a crucial role in stopping the string of fentanyl overdoses amongst L.A. teens. In January, LAUSD began allowing students to carry naloxone with them on campus, and made naloxone available at every K-12 school, according to a spokesperson for the district. 

But, Corddry said those are baby steps, not a solution. Corddry said they noticed naloxone was placed in their school library in February, but without an announcement or offered training. 

“Oh, there’s a Narcan box in the library. I hope someone knows how to use it,” Corddry recalled thinking when they first noticed the change.

Blumberg, on the other hand, explained how she had to initiate most discussions about fentanyl at her school, and even then, was often met with indifference or students completing schoolwork mid-presentation. The line she credits with reigning in her peers’ attention? 

“This isn’t for you. I’m not here to save your life. I’m not here to tell you not to do drugs. I’m here so that your parents don’t have to go to your funeral,” Blumberg said.

Effectiveness and historical controversy collide with modern D.A.R.E. goals

D.A.R.E. claims that preventing students from trying illicit substances in the first place is just as effective in curbing overdose as providing naloxone and other related trainings. A hallmark of LAUSD primary education since 1983, the program has faced pervasive pushback and undergone substantial revision in the past 40 years. But, Osborn promised, D.A.R.E.’s main purpose, promoting substance abstinence, has held steadfast.

D.A.R.E.’s original programs, notorious for having graduates pledge to never use substances, were found widely ineffective by 2000, prompting a rebranding effort and launch of D.A.R.E.’s current Keepin’ it REAL curriculum. 

The new curriculum, Osborn said, is different from the old, and most notably stays away from fear tactics.

“[Keepin’ it REAL] is really built around [practicing] to be able to get out of a situation that you’re not comfortable in prior to you actually being in that situation. Because then, a lot of times kids might panic, they might freeze, they might make a decision they really didn’t want to [make] because they didn’t have any practice on how to get out of the situation.”

According to Osborn, D.A.R.E. is taught in all 50 U.S. states and reaches approximately 1.5 million students in the U.S. annually through more than 2,000 law enforcement officers trained to teach the program. 

In response to the fentanyl epidemic, Osborn explained that D.A.R.E. released a fentanyl-focused enhancement lesson to law enforcement stations across the country to share with their communities. The enhancement lesson, which Osborn provided, dedicates one slide to naloxone, and discusses how it may be ineffective in reversing a xylazine overdose. The slide and its subsequent proficiency quiz do not explain how naloxone works, how it can be accessed, or encourage students to carry it. 

This, Osborn explained, is in line with D.A.R.E.’s core goal of substance use prevention. 

Osborn later clarified that, should a student ask about naloxone in a D.A.R.E. lesson, there’s nothing preventing the law enforcement instructor from answering such a question.

Despite the changes D.A.R.E. has made, some hold firm that no matter how collaborative the discussion or how trained the law enforcement officers, the very premise of D.A.R.E. is what makes it pale in comparison to newer approaches. Harm reduction advocates specified two places where D.A.R.E. leaves something to be desired: in its messengers and timeliness. 

Amidst a growing movement to remove law enforcement from schools, cops teaching D.A.R.E. may be ineffective, Shover said. “It matters who the messenger is,” Shover said, adding that law enforcement discussing substance use “doesn’t foster an environment where people feel like they can ask questions that might reveal that they themselves or their friends are doing things that are, you know, illegal.” (Photo courtesy of D.A.R.E. America)

Critics also worry about the length of D.A.R.E. programs. The D.A.R.E. modules, Osborn detailed, vary between age groups: elementary and middle school students receive 10 45-minute lessons for a total of 7.5 hours, and high school students receive four 60-minute lessons, totaling four hours of curriculum. 

In contrast, Shover said, “As far as the things people need to know to prevent themselves or their friends from dying, you can cover that in 10 minutes.” 

For all involved, the race against time and death continues 

As for the future of the battle against teen overdose, there’s a wide spectrum of response. 

Some, like Shover and Blumberg, said they hope naloxone administration and training becomes as easily accessible and destigmatized as CPR. 

For D.A.R.E., Osborn shared he hoped to see a “rebound” in the popularity and reach of D.A.R.E.’s programs — especially its fentanyl enhancement lesson — across schools nationwide. He said he also hopes people give modern D.A.R.E. programs a chance.

“It’s a different D.A.R.E. now than it was in the 80s and the 90s,” Osborn said.

Golden said she’s also open to a future where harm reduction fuses with more traditional means of substance education.

“There’s power in law enforcement talking about drug use when it’s done correctly, when it’s done right. Right now, it’s not,” Golden said. “But, what we do here is we embrace all pathways of recovery. Some people learn this way, some people learn that way. Finding a middle ground and combining forces is really important.”

Emily McNeil, a rising senior in high school and volunteer who spent her Friday afternoons over summer break packaging naloxone kits for lukelove and LA Recovery Connect to distribute, said she hoped for LAUSD to adopt earlier, expanded substance education — education she never received. 

“By the time [students] are in middle school, they’re already exposed to drugs, and then by the time they’re in high school, they’re already used to [them],” McNeil said.

McNeil and other teen volunteers at a training held at Scott’s house in late June said they also hope to see California legislature choose for the 8 mg, not 4 mg, naloxone to be selected as the primary medication when the measure is put up to vote. (Photo courtesy of LA Recovery Connect)

Theodore Caputi, an Economics and Health Researcher at MIT who has extensively studied the opioid epidemic and its varying responses, offered that, much like Golden suggested, the shared goal of ending overdose needs to be prioritized over differences in opinions, a dispute Caputi said is wasting time and resources. 

“We should all recognize that there’s a political opportunity with this epidemic: we can use that to build up the framework for a really good addiction and substance use treatment structure in the United States,” Caputi said. “We can use the fact that people care about fentanyl now to build a structure that will live past this epidemic because we don’t know who’s going to be affected by the next one.” 

Caputi further encouraged LAUSD to utilize its resources to conduct updated, extensive research on the opioid crisis within its schools and the effectiveness of its various attempts at curbing it.

When asked what Scott envisions for the future of her work, she didn’t stop a tear from rolling down her cheek. 

“What I hope is that one day we can get this education and these [naloxone] kits to everybody before anybody dies,” Scott said. “People don’t realize they need training until people are dead. That’s someone’s child who had to die before people cared. Why do any more mothers and fathers and siblings and friends need to feel this heartbreak? Why can’t we do it before they die?”