The Gryphon Gazette

By Rohan D. ‘25

In the suburbs of San Francisco, fentanyl is considered an alien entity. But fentanyl is here, and tragedy is inevitable without a comprehensive approach. 

The United States is currently facing a fentanyl public health crisis, with an alarming increase in the number of fatal overdoses caused by the synthetic opioid. Fentanyl, a powerful drug that is 50 to 100 times more potent than morphine, is often mixed with other drugs like heroin or cocaine, making it difficult for users to know the strength of the dose they are taking. According to the U.S. Department of Justice, “From August 2021 to August 2022, 107,735 people died of drug overdoses in the United States. Two-thirds of those deaths involved synthetic opioids – primarily fentanyl.” According to the California Department of Public Health, in 2021,  5,722 Californians died from fentanyl overdoses; 224 were teens aged 15-19. Moreover, fentanyl accounted for 1 in 5 deaths of California young people ages 15-24 (EDSource). With chemicals from China, the Sinaloa Cartel and Jalisco Cartel in Mexico have trafficked the vast majority of the drug into the United States (U.S. Drug Enforcement Administration [DEA]). 

From a hospital standpoint, opioid overdoses have increased. Dr. Daniel Poon, Medical Director of Emergency Medicine at Mills-Peninsula Hospital in Burlingame, CA, said in an exclusive interview with the Gryphon Gazette, “We do see opioid overdoses and [they] have been increasing over the last three years [especially after Covid], specifically fentanyl.” Regarding teens, he continued, “We are also seeing more often than not accidental overdoses.” More teens are coming to Mills-Peninsula Hospital and others around the country after accidentally unknowingly ingesting fentanyl from illegal substances. 

History of Fentanyl 

Fentanyl, a powerful synthetic opioid, was first developed in the 1950s as a painkiller for surgeries and other medical procedures. It quickly gained popularity due to its effectiveness in treating severe pain. Over the years, various analogs were developed, including sufentanil and carfentanil, which are even more potent than fentanyl. While intended to treat humans and animals, fentanyl and its analogs have also been linked to a growing number of overdose deaths when used inappropriately. This phenomenon has led to increased awareness and concern among public health officials and law enforcement agencies, who are working to address the opioid epidemic and the associated risks of fentanyl and its analogs.

The antidote to fentanyl is naloxone, also known as NARCAN®. This opioid antagonist in the form of a nasal spray is “indicated for the emergency treatment of known or suspected opioid overdose, as manifested by respiratory and/or central nervous system depression” and should be used immediately in emergency settings where opioids may be present (narcan.com). In March 2023, the FDA approved Narcan’s use without a prescription.  Now able to be purchased over-the-counter, naloxone is one of the key strategies to combat the opioid overdose crisis (FDA).  

The combination of fentanyl with other drugs such as methamphetamine has dire consequences for users. When combined with methamphetamine, a stimulant drug that increases heart rate and blood pressure, the risk of adverse reactions including seizures, cardiac arrest, and death is amplified. According to the CDC, the number of deaths involving fentanyl and methamphetamine has risen. Other activities thought to have minimal adverse effects, such as smoking marijuana or vaping, can result in death if these other substances are unknowingly laced with fentanyl (NBC). One of the most dangerous drug cocktails is a mixture of fentanyl and xylazine, a FDA-approved animal sedative used by veterinarians. This mixture, called Tranq, has side effects that include skin necrosis requiring amputations. According to Administrator Anne Milgram of the DEA, “Xylazine is making the deadliest drug threat our country has ever faced, fentanyl, even deadlier.” San Mateo County Sheriff Christina Corpus explained to the Gazette, “Xylazine makes you incapacitated, and is deadly when mixed with fentanyl because Narcan is ineffective when it [encounters this mixture of substances.] Unfortunately, you can only be saved if you are rushed to the hospital and given the antidote.”  

Unknowing Consumption

The trafficking of fentanyl continues to be a growing concern among law enforcement agencies worldwide. However, what’s particularly worrisome is that teenagers can now access fentanyl through the internet and social media, which puts them at risk of inadvertent poisoning and death. Ingesting only a few grains is lethal, as shown in the graphic below. 

Parents of teens who have succumbed to fentanyl when inadvertently experimenting with drugs are educating others on the dangers of fentanyl. Sixty families have filed a lawsuit against Snapchat, the preferred use of communication for drug dealers as the chats disappear (NBC); their children purchased counterfeit pills that contained fentanyl online. Other parents have placed billboards along highways across California to increase awareness of teens and parents about the deadly threat of fentanyl (NBC). They urge open and honest conversations with teenagers about the risks of purchasing drugs online. Even yet, parents and officers of the DEA have called for the government to label fentanyl as a “weapon of mass destruction” (The Addiction Podcast).

The crisis has prompted urgent calls for action to increase access to addiction treatment and harm reduction services, as well as to reduce the availability of fentanyl in communities. California Governor Gavin Newsom recently created a Master Plan, a comprehensive approach to the public health and safety crisis which builds on the $1 billion he has invested to combat this. According to his website, “The Master Plan outlines aggressive steps to support overdose prevention efforts, hold the opioid pharmaceutical industry accountable, crack down on drug trafficking, and raise awareness about the dangers of opioids, including fentanyl.” This plan allows for increased naloxone distribution to communities, grants for education and support services, increased availability of fentanyl test strips, and funding to provide overdose medication to all middle and high schools. In this way, various fronts of this crisis will be targeted by law enforcement and the government in an attempt to decrease the ever-increasing rate of deaths from fentanyl. 

Community Interventions

Communities are exploring options to mitigate the crisis. For example, Hillsborough Town Council Member Leslie Ragsdale said in another exclusive interview with the Gazette, “Without having a downtown, Hillsborough has less to worry about. But it is much more important that our kids, as well as their parents, are educated on the dangers of fentanyl. It could be that your kids go to a party…they need to understand that it’s dangerous.” 

Sheriff Corpus shared that her officers carry Narcan. Two years ago, they used it once per week; now, they administer it daily. At parties, kids may take pills that they think are Adderall, but they are either true counterfeit pills or laced with fentanyl. Unfortunately, there is no way to know. There are no symptoms. It only takes one pill to overdose. Sheriff Corpus emphasized, “You are really playing with your life if you buy these pills. It’s like Russian Roulette if you take a pill because you don’t know what you are taking.” Sheriff Corpus has assembled a Narcotics Task Force where detectives and agents on the Peninsula are trying to stop the drugs before they hit the streets. Moreover, she urges the education of parents, teachers, and students. “People think it won’t happen in my backyard.”

On the healthcare provider side, hospitals are attempting to change the culture around opioid addiction. Dr. Poon stated, “Sutter Health has spearheaded substance use navigators [which] are specialists in addiction medicine, social workers with special backgrounds in addiction.” Dr. Poon also discussed a county-led endeavor to allow his department to distribute Narcan for free without a prescription or order. 

However, the first step, as argued by Hillsborough Town Council Member Al Royse, is to “build awareness and then knowledge. The most important thing to do is to make people aware of the danger and then make them exactly aware of the consequences.” This crisis is being communicated through newspapers, books, speeches, billboards, and documentaries, such as “Dead on Arrival” (https://www.youtube.com/watch?v=iJgPmrLjkuo). Additionally, May 9th is National Fentanyl Awareness Day, a day meant to “amplify nationwide efforts to increase awareness and decrease demand for fentanyl.” (U.S. D.E.A.).

What is truly needed? A comprehensive local program disseminating information to all parents, students, and teachers as well as distributing Narcan to every public, private, and charter school and home. This is what has been proposed in San Francisco by its youth commission. This is a bold initiative that requires foresight and funding. In short, spreading the word about fentanyl poisoning to teens and parents is critical to effectively combating this crisis. As Sam Quinones says in his book, The Least of Us, “Silence is what is killing people.” Education and action are necessary now in order to limit the losses of the next generation. Why wait for someone, a teen, to die?