Drug overdoses claim lives of four USC students within three weeks last semester

Students dealing with mental health issues can contact the 24/7 phone line (213) 740-9355 or can walk into USC Student Health centers for professional assistance. Students, faculty and staff members concerned about a fellow Trojan can notify Trojans Care 4 Trojans online or by calling (213) 821-4710. Faculty and staff members can reach out to the Center for Work and Family Life at (213) 821-0800.

In the span of 17 days last semester, four USC students died in what turned out to be drug-related accidents, the coroner’s reports show. Three of the students died of fentanyl overdose and one died from the effects of a novel designer drug.

These drug-related deaths came amid the alarming number of student deaths, causing panic and concern in the USC community. In total, nine USC students died last semester. Four of them were caused by drug abuse, three were suicides, one was a traffic accident and the last one is unknown. The initial communication from the university was unclear about the cause of these deaths. Annenberg Media has obtained coroner’s reports for eight cases.

The review of the coroner’s reports for the four drug-involved cases, which are all categorized as accidents, shows a wide variety of drugs in each person’s system at the time of death. Around the time of the deaths, USC officials sent an email warning all students against drug use, but the reports, which were made available by the coroner’s office in the past month, offer details of what may have happened.

FIRST DRUG-RELATED STUDENT DEATH

The 21-year-old male student was a senior majoring in cinematic arts and television production. He was found dead on Oct. 25 due to an overdose of fentanyl and cocaine along with antidepressant medicines, the coroner’s report shows.

He had bupropion and citalopram in his system, which are common antidepressants sold as Wellbutrin and Celexa, the report shows. He had likely taken a normal dose of the antidepressant drugs, but an addition of fentanyl might have further depressed the central system, the report shows.

The student had a history of using different substances in addition to anxiety and asthma, but he never had suicidal ideations or attempts, his father told the investigator, according to the report.

Four days before his death, he went to a local hospital for a bleeding head injury and was unable to remember the cause of the injury. He was released the following day after treatment, the report shows.

On Oct. 25, a USC professor filed a welfare check after receiving information from his fellow students about his erratic behavior. The police found the student unresponsive when they entered his room. Paramedics pronounced his death at 5:25 p.m. that day.

The family was unaware of the student’s cause of death when they were contacted by Annenberg Media on Feb.8, which was nearly one month after the coroner’s report was made public, according to the student’s brother.

SECOND DRUG-RELATED STUDENT DEATH

Two weeks passed and then a 24-year-old senior majoring in screenwriting was found dead in an apartment near campus. Both students were in the School of Cinematic Arts. He died after taking oxycodone, a common pain reliever, and flualprazolam. Flualprazolam is a derivative of the most commonly prescribed medication benzodiazepines, or Xanax. But flualprazolam is not prescribed for clinical use in the United States, according to the report.

“[Flualprazolam was] never approved for human use, but widely available as a research tool,” said USC drug toxicology expert Daryl Davies. “There are many of these derivatives that are popping up on the street.” The World Health Organization’s newly released critical review report on flualprazolam states there is little published literature about the novel drug.

The student had been diagnosed with anxiety and depression but had no suicidal ideation or attempts, his mother said, according to the report. He had also previously abused drugs like oxycodone. He had been prescribed various medications, but his mother did not think he was abusing them, the report shows.

His mother told the investigator that the student had withdrawn from the school last semester and stayed with her, but returned to school after his friend, the first student, died, according to the report. During his last conversation with his mother on Nov. 7, the student expressed his wish to return to school and finish the screenwriting program at USC, his mother said, according to the report.

THIRD DRUG-RELATED DEATH AND USC’s WARNING ON DRUGS

On Nov. 9, one day after the 24-year-old student’s death, a 21-year-old USC student was found dead by his roommate in their off-campus student housing. The report attributed his death to fentanyl, cocaine, ketamine, MDMA, alprazolam and quetiapine.

In a conversation the night before his death, the student reportedly told his brother that he had been drinking alcohol, inhaling whippets gas, taking ecstasy, ketamine and oxycodone. His parents told the police that their son “was a social drinker, who was known to have used marijuana, and had been prescribed Xanax,” according to the report.

This was at the same time as USC issued its first vague email acknowledging student deaths. Two days later, the university sent another email with a warning about drug use, which was followed with a specific caution against the mixing of certain drugs on Nov. 14.

“In addition to the direct effects of each substance, drugs shared for recreational use can be tainted or mixed with other substances to increase its effects, sometimes without a user’s knowledge. This practice is rising and is linked to overdose and deaths,” USC Department of Public Safety Chief John Thomas wrote on Nov. 14 in that university-wide email.

The university also hosted its first Drug Take Back Day to encourage the USC community to dispose of unused or expired drugs.

FOURTH DRUG-RELATED DEATH

On Nov. 11, two days after the previous student’s death, a 27-year-old aerospace engineering graduate student, who lived off-campus alone, was found dead from the effects of a mixture of fentanyl and alcohol. The report shows that he had a history of ethanol abuse and had gone to alcohol rehabilitation previously. He also had a history of depression and anxiety and was prescribed medication, but had no history of suicidal statements or attempts, according to the report.

His mother spoke with him last on Nov. 7, when he planned to go home for the weekend. His mother asked the USC DPS to check on him on Nov. 10 after she was unable to reach him. The officers left after receiving no response from his room. A day later, USC DPS received a second call from the mother and checked his apartment again. When they unlocked the door, officers found the student dead inside, the report shows. The report did not specify his time of death.

Surveillance video shows that the student had entered his apartment on Nov. 6 and did not exit after that date, the report shows.

CBS Los Angeles reported that nine days after this student’s overdose, police arrested 26-year-old USC student Bill Hsiao, who had drugs and an unregistered rifle in his off-campus apartment. According to CBS Los Angeles, it is unknown whether Hsiao is linked to any student death and the investigation is ongoing. The university declined to comment about Hsiao’s associations with these student deaths, referring Annenberg Media to the Los Angeles Police Department.

THE ROLE OF FENTANYL

While different kinds of drugs were detected in each of these cases, three of the students had a relatively high concentration of fentanyl compared to other drugs, the reports show. As a synthetic opioid that is 80 to 100 times stronger than morphine, fentanyl has an estimated minimum lethal dose of only 250 micrograms.

“You can send in a shoebox enough [of the] drug (fentanyl) to use across the state for a year,” said UCLA professor Steven Shoptaw, who studies substance abuse.

“The fentanyl is kind of the bigger player [in these student deaths] probably,” Jonathan Lucas, Los Angeles County chief medical examiner-coroner, told Annenberg Media, “but we can’t really exclude other ones.”

Lucas said that the Department of Medical Examiner-Coroner could not confirm the source or distributor of the fentanyl consumed in these cases. Although the detected fentanyl concentrations in the blood of two of the dead students appear to be similar, it is unclear where the substance came from.

“One of the people may have taken it in some single substance, while the other one may have taken them separately and the concentrations may just be coincidentally the same. They also could have gotten it from the same distributor,” he said.

Sarah Van Orman, USC’s chief health officer, said that fentanyl tends to be mixed with other illegal drugs such as cocaine.

“People may think they're using cocaine but it actually contains fentanyl. We’ve also seen people get a pill and they may think it's a prescription pill, but it is actually being manufactured illegally, and it contains fentanyl,” she told Annenberg Media.

Shoptaw suggested that the students might have bought the drugs laced with fentanyl without knowing it, just like previous fentanyl-related deaths in Los Angeles. And cases like these leave so many unanswered questions. “The question you can’t answer is whether they were looking for that [fentanyl] experience or whether that was something that surprised them,” he said.

“The problem with fentanyl is that it's so inexpensive and it's been synthesized by the boatload,” Davies said.

Meanwhile, the drug can do so much harm so quickly, causing the heart to stop working, that unless the drug users are close to emergency services or have access to medication that can reverse the effects, there is no way to revive them, he explained.

Unintentional fentanyl deaths have skyrocketed since 2016, according to statistics from the Los Angeles County Department of Medical Examiner-Coroner. Two hundred and fifty-five deaths in the county were fentanyl-related in 2018, which is a 150% increase from 2016. The increase in the result stemmed from the drug’s potency and its prevalence on the street, said Lello Tesema, Associate Medical Director for Prevention at LA County Department of Public Health.

Fentanyl overdoses are a much bigger issue on the East Coast, Shoptaw said. He also explained that there has been a steady southward trend of fentanyl overdose deaths that starts with Vancouver on the West Coast, coming down past areas including Davis and San Francisco, and finally hitting Los Angeles.

“Sometimes people think that when we’re on a campus, and we’re immune to these issues,” Van Orman said. “I think it highlights an important issue that drug use and misuse are not USC issues. They’re really community issues.”

USC’s RESPONSE AND SUPPORT

Lynette Merriman, associate vice provost for campus support and intervention, said that the university has been supporting the students’ families and those from the USC community who are impacted by the tragedy.

She said USC will support the families by providing transportation, counseling services and other arrangements such as mortuary. But the university will not discuss with the family details of the case, she said. Instead, “we're going to have the coroner and law enforcement speak directly to share with the families their findings from their investigations,” she said.

In a statement sent to Annenberg Media, USC said that “like many universities, we have seen significant increases in the mental health needs of students, including increases in the number of students with depression and anxiety.”

“While drug abuse other than alcohol is uncommon on campus, USC has increased efforts to identify communities engaging in use and provide targeted education and intervention,” the statement reads.

After the student deaths, the Los Angeles Department of Public Health has reached out to the USC Institute for Addiction Science to offer more training for students on campus. LA Public Health has also been promoting overdose prevention education and Naloxone training on college campuses, Tesema said.

Naloxone, known more commonly as Narcan, is a medication that can reverse the slowing of breathing caused by opioids that sometimes lead to death.

Van Orman said that since the student deaths, the university has been working on the education about the risks of using illegal drugs and the availability of Narcan.

“This semester, we've launched a bystander education program that informs students about the availability of Naloxone,” she said, adding the first training session is scheduled at the end of March.

With USC’s student health insurance plan, students can get Narcan for free from the USC Pharmacy and the CVS near campus. Van Orman said she is happy to learn that numerous students are getting the Narcan after the campus-wide education. DPS has also carried Narcan with them since November, she added.

Unlike UCLA, which is trying to put Narcan in residential halls, Van Orman said USC will not bring Narcan to on-campus housing since most students living there are freshmen. The data on drug overdoses she had show that juniors or seniors who are living off-campus are the people most at risk.

“For students who are using drugs recreationally, it’s about education. But we also know we have some students who are developing drug use dependence issues,” she said. “We also want to send the message that there’s treatment available.”

Students dealing with mental health issues can contact the 24/7 phone line (213) 740-9355 or can walk into USC Student Health centers for professional assistance. Students, faculty and staff members concerned about a fellow Trojan can notify Trojans Care 4 Trojans online or by calling (213) 821-4710. Faculty and staff members can reach out to the Center for Work and Family Life at (213) 821-0800.

*Annenberg Media decided not naming any of these four students due to privacy.