By Safia Samee Ali and Daniella Silva -
NBC News
The night before José Alberto Pérez died of a fentanyl overdose, the 14-year-old begged his mother not to take him to the hospital because he "was not a drug addict."
“She had ash-white lips.
His pupils bulged out," said the boy's mother, Lilia Astudillo.
She gave in to what she asked of her, even though it was obvious how much she was suffering.
Astudillo planned to take his son for medical attention the next day, but by morning he was already dead.
"It hurts to see your son after he's gone and ask yourself: Why didn't I know about this sooner to help him?" said the mother.
Jose, who died in January, is one of nearly a dozen students at three different schools in the Carrollton-Farmers Branch Independent School District in Texas who overdosed on fentanyl between September and March.
He is one of three children who have died.
Lilia Astudillo with her son José Alberto Pérez, 14. NBC News / Getty Images / Lilia Astudillo
This wave of overdoses has caused shock and anger among families in the Carrollton community, about 20 miles north of Dallas.
It is also a reminder and a lesson of how rampant fentanyl has become among young people in recent years.
“I never thought a high school would have drugs like this,” said a mother whose 14-year-old daughter, also a student in the Carrollton-Farmers Branch district, survived a fentanyl overdose this year.
[The opioid crisis is not just a white problem: deaths among Hispanics have skyrocketed]
“I cannot imagine the pain of another mother going through what I am going through,” said the woman, who asked that her name not be used to protect her daughter's privacy.
Fentanyl, a highly potent and addictive synthetic opioid that can be deadly with a dose as small as the tip of a pencil, has devastated adult populations for nearly a decade.
But the massive proliferation of the drug in recent years, coupled with a COVID-19 pandemic that eroded adolescent mental health, has made its way further among young people.
Fentanyl is a synthetic opioid 50 times more potent than heroin.
Even a small dose can be deadly. Jae C. Hong / AP
The monthly mean of
fentanyl overdose deaths in people ages 10 to 19 increased 182%
from July to December 2019 compared to the same period in 2021, according to a December report from the Centers for Disease Control and Prevention. Diseases (CDC).
More than 2,200 teens suffered a fatal overdose in the two-and-a-half-year period from July 2019 to December 2021, with fentanyl involved in 84% of the deaths, the report found.
Teenage fentanyl overdoses have been reported in communities across the country, from Arlington, Virginia, to Portland, Oregon.
In the Los Angeles school district alone, at least seven teens overdosed within a month last year after taking pills possibly laced with the drug.
[The new drug mix that makes the “deadliest substance the country has ever faced, fentanyl, even deadlier”]
The overdoses in the Carrollton-Farmers Branch Independent School District were linked to three people who lived within a few blocks of the school, according to a federal complaint.
All have been charged with conspiracy to distribute and possess with intent to distribute a controlled substance.
But that's little comfort to parents in Carrollton who are devastated and terrified for their children.
Pills of fentanyl, methamphetamine and other drugs seized in Tempe, Arizona, on February 23. Arizona Attorney General Kris Mayes/Twitter
“I painted a world of wonder for my children,” Astudillo said, adding that he immigrated to the United States to get away from crime in Mexico.
"And it turns out that here it was worse."
The mother of the 14-year-old boy who survived an overdose said families of victims are clinging to each other for support.
Many, like her, are Spanish-speaking immigrants who have been unable to get help accessing treatment and resources, she said.
Some are too embarrassed to speak.
“I think they are ashamed, but we shouldn't be ashamed, because this can happen to anyone,” he said.
"This is how they are hooking so many children"
Carmin Williams' daughter, Khloe, was introduced to and addicted to fentanyl when she was just 12 years old while attending Bea Salazer, an alternative education school in the Carrollton-Farmers Branch school district, last spring.
Williams said Khloe, now 13, had been transferred to the school, the same one Jose attended, for behavioral issues.
She had been battling anxiety and depression, Williams said.
Someone at school “offered her a pill and said, 'If you're down or if you're going through something, this lifts you up,' and that's how they're hooking so many kids,” said Williams, 39.
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That story is not unusual, said Dr. Scott Hadland, an addiction specialist and chief of adolescent medicine at Massachusetts General Hospital in Boston.
Hadland said that fentanyl began to seep into the adolescent population before the coronavirus pandemic, but the period of social isolation negatively affected the mental health of young people, leading some to seek ways to self-medicate with drugs that have not been used for them. prescription and are often counterfeit.
According to the CDC's 2021 Youth Risk Behavior Survey, released in February, more than 40% of boys and girls said they felt so sad or hopeless in the past year that they were unable to do their usual activities, such as chores school or sports, for at least two weeks, with girls being more likely to report such feelings.
A separate CDC report found that 41% of adolescents who died from an overdose had evidence of mental health conditions or treatment.
Adolescent mental health is a crisis now superimposed on the "overdose crisis," Hadland said.
Opponents of the sale of illegal drugs on Snapchat protest outside the company's headquarters to call for tighter restrictions on the social network, following fatal fentanyl overdoses, Santa Monica, California, June 13, 2022.Ringo Chiu/AFP via Getty Images
“For some teenagers, many of whom I care for, taking a pill or medication for a mental health problem is exactly the right treatment,” she said.
"It's just that you want to be evaluated by a doctor, connected to therapy, and prescribed the correct medication, not some counterfeit illicit pill."
After her daughter overdosed on fentanyl last summer, Williams moved with her family to Carrollton to give her daughter a new environment away from the one that led to her addiction.
[Drug overdose deaths are at an all-time high, and the coronavirus pandemic isn't just to blame]
“We should talk more about mental health and be more open to getting help when we know we need it,” he said.
“This starts at home, but it must continue at school.”
Some Carrollton parents said their anger has been compounded by a lackluster response from the school district.
Astudillo said that despite the language barrier, he had asked the school for help for his son many times before he and the other students overdosed, but the school did not act.
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In a statement to NBC News, the district said it is "deeply concerned" about the safety of its students.
“We have taken several steps to educate parents about the dangers of fentanyl.
In November, CFB organized and conducted two community parent drug awareness programs (in both English and Spanish) to educate parents about the dangers of drug use among teens.
Our Crisis Team and two Licensed Chemical Dependency Counselors have developed drug awareness presentations for students and are presenting these talks on secondary campuses.
CFB has begun doing random canine searches on our campuses.”
[Authorities Investigate Accidental Overdose of 10-Month-Old Baby with Fentanyl in San Francisco]
Some parents criticized the school for acting too late.
"The worst thing is, how could they not know that all this was happening?"
Astudillo said.
The community needs a “comprehensive plan of attack”
More than 30% of Carrollton residents are Hispanic or Latino, many of them immigrants.
Latino teens are proportionally overrepresented in overdose deaths, according to CDC data, which counts fatal and non-fatal overdoses of all drugs, not just fentanyl, and that 21% of victims were Hispanic or Latino.
About 60% of those who died were white and 13% were black.
'Rainbow' fentanyl pills hidden in Lego blocks, found by New York City police, on October 5, 2022.NYPD
“It is a major problem that affects everyone, but it is exacerbated in the Latino community,” said Carlos Quintanilla, who runs Accion America, a nonprofit group that works on issues facing Latinos in the Dallas metropolitan area.
“The parents are monolingual, many are undocumented, many are afraid to contact the police, many believe that they cannot access any type of medical treatment, so they remain silent, they are ashamed and then they are devastated,” Quintanilla said.
The approach to the community must be specialized, original and unique, he added.
“These kinds of traditional white counselors and vice principals talking about fentanyl addiction, that doesn't work in our community,” he said.
“You have to go to the bazaars, you have to go to the shops.
You have to go to the soccer fields, you have to go out and create a comprehensive plan of attack to deal with this situation that is a threat of life or death.
However, schools rarely receive guidelines or standards for drug education, so it becomes "house picks," said Nichole Dawsey, executive director of PreventEd, a Missouri nonprofit group that educates youth about drugs
For most, education happens after tragedy strikes, she said.
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“There is no comprehensive education, prevention or early intervention at the federal or state level,” Dawsey said, adding that the nonprofit groups or foundations “were mostly started by parents of victims or after someone lost their lives, they are the ones who go out to educate.”
[Drug overdose deaths are at an all-time high, and the coronavirus pandemic isn't just to blame]
Like PreventEd, these groups are funded in part through government grants and private donations.
Federal grants awarded intended to fund drug prevention programs have not always produced results that match the prevention goals of the National Drug Control Strategy, the nonpartisan Government Accountability Office found in a 2020 report.
Dawsey said fentanyl awareness was incorporated into PreventEd's drug program about two years ago as overdose rates increased.
Fentanyl-laced pills seized at Los Angeles International Airport, California, on Oct. 19, 2022.AP
In his State of the Union address last month, President Joe Biden promised to "launch a national campaign to educate young people about the dangers of fentanyl and how naloxone saves lives," via the Office of Policy National Drug Enforcement and Ad Council.
Schools should be given more support and funding and infrastructure to take on this, but the onus isn't just on them, said Dr. Sarah Bagley, an associate professor of medicine and pediatrics at the University of California's Chobanian and Avedisian School of Medicine. Boston.
Prevention is "a shared responsibility," and federal and state strategies to address youth overdoses would be helpful in identifying stakeholders in the community who might be responsible for the different parties.
After Khloe survived an overdose, Williams said she visited several treatment centers that refused to treat her daughter because of her age.
She had to face treatment alone, like many other parents in Carrollton.
“Parents want their kids to get help, but it just isn't working,” she said.
“They fight the battle, it is not easy.
It's hard.
It's stressful.
Bill passes."
If you or someone you know is struggling with an alcohol, drug, or other substance abuse problem, call the Substance Abuse and Mental Health Services Administration's free and confidential helpline at 1-800-662-HELP (1-800-662-4357 ), or visit
findtreatment.gov.