Kate Lacroix was screaming at the top of her lungs on social media. Boulder teens were dying of fentanyl, swallowing pills that looked like real pharmaceuticals but instead were counterfeits laced with lethal doses of the synthetic opioid.
“URGENT COMMUNITY WARNING,” she said in one February Facebook post, begging others to help spread the word. “Another teen fentanyl death in Boulder County tonight,” she wrote in another.
Lacroix, a branding consultant with 2,500 Facebook friends, didn’t get much traction. The reason was that her information was bubbling up from high school students, including her daughter, and there was no official word from county officials about the teens’ cause of death.
Months later, and at least 12 more lethal overdoses later, there has been no news conference or communitywide announcement to tell residents about the string of deaths that included two University of Colorado students and several other young people. Since February, when two 18-year-olds died three days apart, 12 others have died in Boulder County from overdoses caused by fentanyl or by a combination of fentanyl and other drugs. Toxicology reports for six more deaths in which fentanyl is suspected are pending.
The official coroner’s report on the toll fentanyl has taken on Boulder County in 2021 is due out sometime in 2022. But The Colorado Sun spent more than $400 and filed multiple requests under the Colorado Open Records Act to learn the scope of the destruction caused in the county during the past several months by the little blue pills called “mexis” and “blues,” and the white, rectangular-shaped “xanny bars.”
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Lacroix, other Boulder moms and community organizers, meanwhile, have tried to blast the alarm themselves in what they say is a lack of coordinated effort among local officials.
While not many joined Lacroix’s posting crusade, one follower sent her multiple cases of fentanyl test strips used to determine whether pills contain the potentially deadly substance, and Narcan, the nasal spray that can reverse an opioid overdose.
Since then, she’s been passing them out to high school students, no judgment attached and no questions asked. Lacroix keeps them in her house next to her COVID-19 rapid tests from the pharmacy. “I’m not having a conversation about whether drugs are good or bad and whether we should do them,” she said. “I’m jumping ahead to, ‘Here are some test strips. Here is naloxone.’”
Lacroix’s daughter, who was shaken by the February death of her friend, took several of the test strips to pass out to her friends. “I just wanted very much to say, ‘Take it. We don’t have to have a conversation,’” Lacroix said. The test strips can detect fentanyl on a pill, but they are considered unreliable by some in the drug-use-prevention community — one side of a pill might not contain fentanyl while the other has a deadly dose.
Boulder County Public Health has dispatched warnings that potentially lethal counterfeit pharmaceuticals are on the streets and sold via TikTok and Snapchat, and the warnings have been amplified by the law enforcement, the school district and the University of Colorado Boulder. But those alerts have not mentioned deaths, and have fallen short in the eyes of Lacroix and others.
“We have basically a rash of deaths and then people are so caught off guard because it hasn’t been able to be reported in a timely way,” Lacroix said. Last summer, when Lacroix heard of more fentanyl deaths — this time of University of Colorado students — she again shouted on social media.
“These kids think they are going to lay down and listen to some music and relax,” she said in an interview. “But it’s one and done. It’s a loaded gun.”
When no Boulder government agency called a community meeting to address the overdose deaths, another Boulder woman called an “emergency town hall” herself. Avani Dilger, who runs a nonprofit substance abuse prevention program in Boulder called Natural Highs, learned of the February overdoses because she sits on a state substance abuse task force. About 50 people joined the virtual meeting held mid-winter during the pandemic, including staff from Boulder Valley School District. “I felt that this information needed to come out,” Dilger said.
Dilger held another virtual town hall last week, still frustrated by the lack of an official coordinated effort. About 80 people, mostly parents, attended this time, and students shared their experiences with counterfeit opioid pills containing fentanyl and with vaping high concentrations of THC. “We feel that nobody is getting the information out,” Dilger said. “When people talk about fentanyl, they think it’s this hard-core drug. But it could be a one-time thing. A party drug.”
But many teens are paying attention at this point, as evidenced by the amount of the overdose antidote nasal spray that Natural Highs gives out in its after-school peer mentor program. In the past few months, Natural Highs gave out 432 doses of Narcan, sometimes 20 doses per week, from the supply received through a state grant.
“There is a crisis,” Dilger said. “Teens are very concerned about their friends.”
February was a particularly difficult month because the deaths caused a collective grief that pushed more young people to use drugs, which resulted in several nonfatal overdoses, Dilger said. “When a death like that happens, there is a ripple effect in the community,” she said. “Oftentimes, people act out in very destructive ways. We had that in February. We had several close calls of overdoses where people were saved.”
Naloxone training and teen-only memorials
After the fentanyl overdose death of 18-year-old Jack Swanson in February, Boulder counselor Mila Long, 24, held a private memorial service requested by the teen’s friends. At the end, she taught them how to use naloxone to save a friend from an overdose.
Long, who battled her own opioid addiction and now works as a peer recovery coach, has trained dozens of young people in Boulder during the past several months to use the nasal spray. She tells them how to recognize the signs of an overdose, to place a person on their side and immediately call 911. And she demonstrates how to put it up a victim’s nose and press a button on the antidote.
At the end of her trainings, offered at the Natural Highs, nearly everyone walks out with a dose of naloxone, Long said.
“With the deaths that happened in Boulder, they are freaked out,” she said. “If they’re not freaked out for themselves, they are freaked out for their friends.”
Long, whose own experience with addiction began when she was prescribed opioids for pain as a teenager, said the speed at which counterfeit pills containing fentanyl overtook other street drugs in Boulder has been shocking. “Three years ago, we weren’t seeing fentanyl,” she said. “It was very rare. And now it’s everywhere, and it’s getting into the hands of people who are younger.”
It’s not just deaths — Long knows several people who have nearly died from fentanyl poisoning or who have been seriously injured, including a 16-year-old boy who took a pill at a party and ended up on life support, she said.
And she’s attended other memorials too, typically organized by teens and separate from services arranged by family. “It’s just so sad,” Long said. “It’s becoming a more common thing.”
The requests for memorial services underscore the need for more public awareness, she said, noting that she tries to spread the word by sharing public health alerts and posters warning about counterfeit pills.
Most of Long’s clients don’t know at first that the pills they purchased on the streets or the internet contain fentanyl as their active ingredient, and young people who use pills recreationally at parties often have no clue. Long-time users eventually realize they are taking fentanyl and by that point are so addicted, she said, they continue to buy the counterfeit pills anyway.
Fentanyl overdoses have spurred changes at health department, school district
Boulder Valley School District, too, saw a spike in students requesting naloxone after the deaths in February.
The district recently received cases of the nasal spray through a state health department program, and plans to place at least one dose in all 64 school buildings and bus terminals by January. School nurses are receiving training this week to learn to use naloxone.
BVSD also warned parents in a community email that dangerous counterfeit opioid pills were circulating. “We wanted to acknowledge that we knew that there was a huge issue that was going on,” said Jordan Goto, the district’s health and wellness coordinator. “It was our neighborhood. It was everywhere.”
While some in the community have criticized the school district for not doing more, Goto said that after the February deaths, “there was a huge push about what can the school district do to prevent this.”
“There was such a widespread community concern,” she said. “Because of so many of the victims being young, there was that fear that even younger students might have access to these counterfeit fentanyl pills.”
Drug awareness curriculum in the district begins in elementary school, starting with tobacco in second grade. By high school, students are learning about a swath of illegal drugs, including fentanyl and the opioid antidote, naloxone.
The plan to put Narcan in every school building came after the deaths of two Boulder teens in February and several nonfatal overdoses among students and recent graduates in March and April, said Georgia Babatsikos, the health department’s harm reduction program manager.
Babatsikos, whose son is a 19-year-old college student, feels more education about drugs is necessary.
“It’s not consistent and it sort of needs to be done every year,” she said. “More education in the schools would be helpful.” Fentanyl has posed a unique challenge as it is landing in the hands of young people who are often, she said, “just experimenting.”
“They are pretty naive and don’t know anything about drugs. A lot of people in our program are pretty seasoned and they know what the dangers are, but I think for this, the way it has been coming in, it has been very concerning,” Babatsikos said. “They think it is just a fun pill to try and then it is tainted with fentanyl.”
At the Boulder County Public Health Department, officials are planning to get a machine that will rapidly analyze a sample of drugs and can detect fentanyl.
The idea behind the machine is to test drugs to get a better idea of what is circulating in the streets and give drug users reliable information about what they’re consuming. Using the drug-detecting machines to fight fentanyl is relatively new in the U.S., though other large cities, like Boston and Chicago, are also using them.
“Finding out about it really late with all of the post-mortems is really too late,” she said.
The machines are more accurate in detecting fentanyl than the strips, Babatsikos said.
After the string of overdose deaths in Boulder this year, the county health department and other agencies, including law enforcement, are searching for better ways to warn the public about the dangers of counterfeit pills. Unified messaging strategies from public health leaders, on social media platforms teens frequently use, are key to raising awareness about the drug, Babatsikos said.
“I think we need to use social media more and we need to use messengers who are young people to really get that message out in the networks where they listen,” she said. “This is not a local health department thing, this is something that needs to happen through a coordinated (effort) by the state, or a national initiative to warn these people because these drugs are going everywhere.”