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More Kids Are Dying of Drug Overdoses from Counterfeit Pills Laced with Fentanyl

April 6, 2024 | FlaglerLive | 12 Comments

Hospitals are seeing more fentanyl-caused drug overdoses among children. (© FlaglerLive)
Hospitals are seeing more fentanyl-caused drug overdoses among children. (© FlaglerLive)

A 17-year-old boy with shaggy blond hair stepped onto the scale at Tri-River Family Health Center in Uxbridge, Massachusetts.

After he was weighed, he headed for an exam room decorated with decals of planets and cartoon characters. A nurse checked his blood pressure. A pediatrician asked about school, home life, and his friendships.




This seemed like a routine teen checkup, the kind that happens in thousands of pediatric practices across the U.S. every day — until the doctor popped his next question.

“Any cravings for opioids at all?” asked pediatrician Safdar Medina. The patient shook his head.

“None, not at all?” Medina said again, to confirm.

“None,” said the boy named Sam, in a quiet but confident voice.

Only Sam’s first name is being used for this article because if his full name were publicized he could face discrimination in housing and job searches based on his prior drug use.

Medina was treating Sam for an addiction to opioids. He prescribed a medication called buprenorphine, which curbs cravings for the more dangerous and addictive opioid pills. Sam’s urine tests showed no signs of the Percocet or OxyContin pills he had been buying on Snapchat, the pills that fueled Sam’s addiction.

“What makes me really proud of you, Sam, is how committed you are to getting better,” said Medina, whose practice is part of UMass Memorial Health.




The American Academy of Pediatrics recommends offering buprenorphine to teens addicted to opioids. But only 6% of pediatricians report ever doing do, according to survey results.

In fact, buprenorphine prescriptions for adolescents were declining as overdose deaths for 10- to 19-year-olds more than doubled. These overdoses, combined with accidental opioid poisonings among young children, have become the third-leading cause of death for U.S. children.

“We’re really far from where we need to be and we’re far on a couple of different fronts,” said Scott Hadland, the chief of adolescent medicine at Mass General for Children and a co-author of the study that surveyed pediatricians about addiction treatment.

That survey showed that many pediatricians don’t think they have the right training or personnel for this type of care — although Medina and other pediatricians who do manage patients with addiction say they haven’t had to hire any additional staff.

Some pediatricians responded to the survey by saying they don’t have enough patients to justify learning about this type of care, or don’t think it’s a pediatrician’s job.




“A lot of that has to do with training,” said Deepa Camenga, associate director for pediatric programs for the Yale Program in Addiction Medicine. “It’s seen as something that’s a very specialized area of medicine and, therefore, people are not exposed to it during routine medical training.”

Camenga and Hadland said medical schools and pediatric residency programs are working to add information to their curricula about substance use disorders, including how to discuss drug and alcohol use with children and teens.

But the curricula aren’t changing fast enough to help the number of young people struggling with an addiction, not to mention those who die after taking just one pill.

In a twisted, deadly development, drug use among adolescents has declined — but drug-associated deaths are up.

The main culprits are fake Xanax, Adderall, or Percocet pills laced with the powerful opioid fentanyl. Nearly 25% of recent overdose deaths among 10- to 19-year-olds were traced to counterfeit pills.

“Fentanyl and counterfeit pills is really complicating our efforts to stop these overdoses,” said Andrew Terranella, the Centers for Disease Control and Prevention’s expert on adolescent addiction medicine and overdose prevention. “Many times these kids are overdosing without any awareness of what they’re taking.”

Terranella said pediatricians can help by stepping up screening for — and having conversations about — all types of drug use.

He also suggests pediatricians prescribe more naloxone, the nasal spray that can reverse an overdose. It’s available over the counter, but Terranella, who practices in Tucson, Arizona, believes a prescription may carry more weight with patients.

Back in the exam room, Sam was about to get his first shot of Sublocade, an injection form of buprenorphine that lasts 30 days. Sam is switching to the shots because he didn’t like the taste of Suboxone, oral strips of buprenorphine that he was supposed to dissolve under his tongue. He was spitting them out before he got a full dose.




Many doctors also prefer to prescribe the shots because patients don’t have to remember to take them every day. But the injection is painful. Sam was surprised when he learned that it would be injected into his belly over the course of 20-30 seconds.

“Is it almost done?” Sam asked, while a nurse coaches him to breathe deeply. When it was over, staffers joked out loud that even adults usually swear when they get the shot. Sam said he didn’t know that was allowed. He’s mostly worried about any residual soreness that might interfere with his evening plans.

“Do you think I can snowboard tonight?” Sam asked the doctor.

“I totally think you can snowboard tonight,” Medina answered reassuringly.

Sam was going with a new buddy. Making new friends and cutting ties with his former social circle of teens who use drugs has been one of the hardest things, Sam said, since he entered rehab 15 months ago.

“Surrounding yourself with the right people is definitely a big thing you want to focus on,” Sam said. “That would be my biggest piece of advice.”

For Sam, finding addiction treatment in a medical office jammed with puzzles, toys, and picture books has not been as odd as he thought it would be.

He mom, Julie, had accompanied him to this appointment. She said she’s grateful the family found a doctor who understands teens and substance use.

Before he started visiting the Tri-River Family Health Center, Sam had seven months of residential and outpatient treatment — without ever being offered buprenorphine to help control cravings and prevent relapse. Only 1 in 4 residential programs for youth offer it. When Sam’s cravings for opioids returned, a counselor suggested Julie call Medina.




“Oh my gosh, I would have been having Sam here, like, two or three years ago,” Julie said. “Would it have changed the path? I don’t know, but it would have been a more appropriate level of care for him.”

Some parents and pediatricians worry about starting a teenager on buprenorphine, which can produce side effects including long-term dependence. Pediatricians who prescribe the medication weigh the possible side effects against the threat of a fentanyl overdose.

“In this era, where young people are dying at truly unprecedented rates of opioid overdose, it’s really critical that we save lives,” said Hadland. “And we know that buprenorphine is a medication that saves lives.”

Addiction care can take a lot of time for a pediatrician. Sam and Medina text several times a week. Medina stresses that any exchange that Sam asks to be kept confidential is not shared.

Medina said treating substance use disorder is one of the most rewarding things he does.

“If we can take care of it,” he said, “We have produced an adult that will no longer have a lifetime of these challenges to worry about.”

—Martha Bebinger, WBUR

This article is from a partnership that includes WBUR, NPR, and KFF Health News. KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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Reader Interactions

Comments

  1. JimboXYZ says

    April 6, 2024 at 5:52 pm

    Where are the kids getting these drugs ? Classmates at school, classmates ? What’s the distribution network ? Did hey start on alcohol abuse, recreational pot ? What does their dealer supply them with ? Those children & adults need to be dealt with. How much of this is Biden’s weak border policies ? And the healthcare system, why isn’t the relative cure being offered by doctors ?

  2. Anonymous says

    April 6, 2024 at 9:55 pm

    They aren’t dying from Fentanyl overdose, they’re dying from Fentanyl poisoning.

  3. Cheech and Chong says

    April 7, 2024 at 2:27 am

    I’m sorry, I do not do drugs, not interested in starting, but China has ruined drugs with F… Proudly Made in China Kids! Beware! Want some pot? Want to also end up a lifeless bag attached to a ventilator? CHINA! Ha! Thats your options, and you must chose both if you choose pot! Want other than pot? Odds just went up you’ll be dead before the high wears off… No thanks, I’ll stick to anything else but crap from CHINA.

    And BTW, what’s with the lazy US? Can we get some organic drugs, made in the US? MAGA, right? High quality, proudly US made, clean, additive stuff. Surely, big ‘farma’ is not far off from my train of thought? We are talking a multi-billion dollar market just waiting to be captured. Anyone got an RV and some chemistry equipment? Think of all the lives you’d save, and how much you’d impact CHINA’s GDP. MAGA man, tellin’ you. MAGA.

  4. Deborah Coffey says

    April 7, 2024 at 6:58 am

    Sorry, Jimbo, you can’t blame Biden for this. Here are the charts and graphs.
    https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates

  5. TR says

    April 7, 2024 at 7:26 am

    Let me give it a shot to answer your questions.
    Where are the kids getting these drugs ? The drug dealers on the streets.
    Classmates at school, classmates ? Maybe, but they got them from the drug dealers on the streets.
    What’s the distribution network ? Hand to hand distribution.
    Did hey start on alcohol abuse, recreational pot ? Most likely.
    What does their dealer supply them with ? Article says fake drugs laced with fentanyl.
    How much of this is Biden’s weak border policies ? 100%
    And the healthcare system, why isn’t the relative cure being offered by doctors ? I’m guess it is like with any other cure, there is no money in the cure only in the treatment.

  6. JW says

    April 7, 2024 at 7:28 am

    Very important story!
    This demonstrates that America and its health care system is the problem and that it can be resolved. Drug addiction is not “imported” but created here by us!
    However, it is easier to blame other countries so we don’t have to feel guilty for our own dysfunction. You don’t solve this at the border! We created our own market here at home! We need a better healthcare system and education, including training of healthcare workers and maybe teachers. This article may be helpful to educate parents, because we are not good at parenting our children!
    But we have taken the easy road! Shame on us.

  7. dave says

    April 7, 2024 at 8:49 am

    That’s ok, once weed is legal, all of these troubles will go away, r.i.g.h.t. !. The bigger issue will be laced drugs by people ( Dealers or home grown distributors) knowingly wanting to hurt someone i.e……In the case of fentanyl, an amount the size of a couple grains of sand can be enough to cause an overdose.

  8. Nephew Of Uncle Sam says

    April 7, 2024 at 9:42 am

    You are talking about the Senate passed border bill that the Republican controlled House won’t bring to the House floor for a Vote correct? If there is a “weak border” it’s the GOP holding it up including the 4 years that #45 was in control and didn’t do one thing to make it better, including 2 years when the GOP had full control.

  9. another one lost says

    April 7, 2024 at 12:03 pm

    The fentanyl problem is no longer only about addiction. The DEA’s latest statistics claim that if drugs are purchased on the street there is a 7 out of 10 chance that it is laced with fentanyl. This means that nothing is safe unless it is coming from a pharmacy. This means that experimentation of any kind or use in a social setting can lead to overdose fatality. The way to begin to combat this now is for everyone having access to Narcan. It is suggested that every household in Florida have Narcan in your medicine cabinet and glove compartment. For more information on training and free Narcan please contact The Flagler County Drug Court Foundation
    the email address is: [email protected]

  10. Deborah Coffey says

    April 7, 2024 at 5:29 pm

    The Republican House wouldn’t pass the very bipartisan bill because Trump made a phone call to the Speaker and some others “friends” and told them not to…he needed border problems to blame on Biden while campaigning to run the country. Looks like TR didn’t see the charts and graphs, either. When you don’t WANT the truth, you certainly don’t go looking for it. Truly Trumpian.

  11. JimboXYZ says

    April 8, 2024 at 4:58 am

    More data:

    https://www.npr.org/2023/05/18/1176830906/overdose-death-2022-record

  12. Laurel says

    April 8, 2024 at 4:54 pm

    Another one: Good advice.

    We also need to educate kids, and it can be done. Pay attention! Talk to your kids! Stay interested in their lives. Know who their friends are. Giving them misinformation like “it’s Biden’s fault,” or “it’s the border problem,” or “marijuana is a gateway drug,” or “reefer madness” is NOT going to work! That just tunes kids out as fast as you possibly can. Might as well drive them to the dealer with that BS.

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