It’s January 2020, and the coroner has started work early. Jessica Filson, 29, and her boyfriend, Nicholas Castillo, 30, have been pronounced dead in their apartment in Redlands, California.
A few hours later, two other deaths are reported.
Five months later, Alexander Neville, 14, is pronounced dead at 9:59 a.m., four minutes before a rehab center in Orange County, California, calls to inquire about his urgent intake request.
All of the autopsies revealed the same cause of death — fentanyl, the deadly synthetic opioid responsible for an estimated 64 percent of drug deaths nationally from April 2020 to April 2021.
Filson and Castillo died from ingesting fentanyl-laced cocaine. Neville died from taking a counterfeit Oxycontin pill he bought from a drug dealer on Snapchat. It was laced with enough fentanyl to kill four people. The deaths were not an overdose; they were poisonings because the users did not know what they were ingesting.
In the period between 2017 and last year, Fentanyl-related deaths increased from 2017 to 2020 by more than 240 percent in Los Angeles County, 800 percent in Riverside County and 960 percent in San Bernardino County. In Orange County, fentanyl-related deaths increased 1,015 percent, from 57 in 2017 to 636 in 2021.
It is the number one cause of death for children 17 years and under in Orange County, with 19 opioid-related deaths in 2021.
The growing fentanyl epidemic across the nation exposes the limits of drug messaging campaigns of old: Today’s young adults are rarely tempted to try substances like heroin or cocaine. Community leaders and educators are leading a campaign to change the narrative from focusing on “gateway drugs” to “one pill can kill.”
Amy Neville, a mother of two as well as a yoga and fitness instructor, never imagined a drug she had never heard of, much less thought her children had heard of, would change her whole world.
She met with a small group of police officers, district attorneys, educators and Counter-Drug Task Force Sergeants in a rented-out backroom of a research company in Irvine, California, in late February.
They came to discuss a proposal to build a comprehensive drug education program.
Neville started the meeting by having guests introduce themselves. When her turn arrived, she introduced herself as “Alexander’s mom.”
“Without what happened to Alexander, I wouldn’t be standing here in front of you today,” she said.
She said her son began experimenting with drugs at the onset of the COVID-19 pandemic, taking marijuana, Xanax and Oxycontin.
Alexander approached his parents on June 22, saying he had an addiction to oxycodone. Immediately after their conversation, Neville said she and her husband called to book their son into a treatment center. He died on June 23, 2020.
“In this last year or so that I’ve been meeting with parents, talking to legislators, talking to just the general public, people who aren’t necessarily in the know on this, the big misconception these days is that drug deaths only happen if you have a drug problem,” Neville said.
She provided several real-life examples of children who died of fentanyl poisoning after taking pills to treat pain: A teenager gets hurt at football practice on Friday and is in extreme pain, but they can’t get to the doctor until Monday. A friend gives them something, and they’re gone. There is a teenager who has anxiety about a first date that’s coming up. A friend gives them something, and they’re gone. A teenager has a dental procedure, but her family can’t afford the pain medication. A friend gives them something, and they’re gone.
Retired San Bernardino County Police Sgt. Steve Filson, whose daughter Jessica died of fentanyl poisoning, appeared alongside Neville.
He and his wife are raising their granddaughter Elara after Jessica’s death.
“Don’t take a pill unless you get it from your doctor or pharmacy. Don’t even take a pill from a friend or relative.”
“If that doesn’t come with your name on it, it’s a counterfeit. You’re playing frickin’ pill roulette.”— Steve Filson
Orange County deputy district attorney Nikki Elkerton sat at a table with pocket-sized cards of photos of children lost to fentanyl poisoning.
She said prescription pills “have been normalized.”
“There is a paradigm that needs to be shifted that these things are not innocuous. These things are not harmless. It can still kill you.”
According to the DEA, only 2 milligrams of fentanyl is a lethal dose.
Orange County Sheriff Don Barnes spoke at a March 3 fentanyl hearing outlining the alarming increase of fentanyl seizures in the community.
In 2021, the Orange County Sheriff’s Department seized 104 pounds of fentanyl.
In just the first two months of 2022, that number has been surpassed with the seizure of 205 pounds of fentanyl and 143,000 illegally-manufactured pills, according to Barnes.
“Fentanyl is cheaper to produce, easier to traffic, it’s not dependent on climate to grow the opium poppy, and it is much more lethal, and the profit margins are much more significant,” he said.
Barnes said that people have asked him why drug cartels would sell a product that kills so many customers.
“The cold-hearted reality is that it’s the business of the drug trade. The bottom line is all that matters, and profits are put above the lives of people.”
He added that drug kingpins, cartels and drug trafficking organizations have “done the math and determined that creating new addicts is more important.” The sheriff said the lost lives are just a number to them and the “business of narconomics that exists.”
Listen to Dr. Clayton Chau, Director of the Orange County Health Care Agency & County Health describe fentanyl’s effects on the brain and body
Lauren Gallegos, the Orange County community prevention director at the Wellness and Prevention Center, partners with high schools throughout the county delivering presentations about drug prevention. Most schools reach out after the death of a student from opioids.
At one south Orange County High school, 41 percent of 750 students responded to a survey after Gallegos’ presentation saying they had never heard of fentanyl.
“That’s pretty scary,” she said. “Close to half of the school campus [is] not even aware of what this is.”
In California, drug education isn’t mandatory. The state education code requires education on alcohol and drugs, but critics say the wording is vague and doesn’t include specific drug topics. Gallegos said it is up to the school districts to determine what education is required.
“I’d like to say we could be a little more preventative and not do something in response to a death,” she said. “We’re a very reactive community.”
Parents aren’t readily on board with drug education workshops being taught in schools, because there is a misconception that their children can become prone to drug use solely based on hearing about drugs.
“If you put the word drug in any title, they’re not coming because they don’t want to be associated with that word,” said Orange County Sheriff Sgt. Brian Gunsolley.
The looming threat of fentanyl poisoning for students has caused the Orange County Department of Education to ramp up awareness efforts, deliver presentations throughout the county and talk with school districts about stocking Naloxone. Commonly known as Narcan, Naloxone is a medication designed to reverse the effects of an opioid overdose on campus.
Stephan Lambert is the prevention coordinator at the Orange County Department of Education. His office gives presentations to nurses, counselors, social workers, school psychologists and teachers to help them “understand that this is a different animal.”
An increase in stress and anxiety brought on by the pandemic turned some young adults to prescription pills, like Xanax or Adderall, according to Lambert.
“It doesn’t have the same stigma attached to it as other street drugs or even alcohol,” Lambert said, referring to what might be perceived as more hardcore drugs like methamphetamine or cocaine.
He mentioned the counterproductive messaging campaign of the 1983 Drug Abuse Resistance Education program, which aimed to reduce drug-taking among young people.
“The literature introduced specifics about drugs too early developmentally and then actually in a counterproductive way increased [young children’s] perceptions of peer use,” Lambert said. “What we know is important to emphasize for young people, which is not just hit them over the head with a bunch of facts, but rather make sure that they have the skills to understand the information they’re receiving from their peers, from the media, from their classroom teachers.”
Parents need to hold candid conversations with their children about drug misuse, specifically concerning fentanyl, and discuss how much more dangerous it is than cocaine, methamphetamine and morphine.
“It’s not the same landscape,” Lambert said. “There is no recourse. If you get poisoned by one of these things, you’re the one left holding the bag. There’s no-return policy.”
SB 1060, which would have increased prison sentences for those who traffic fentanyl by the amount of weight sold, failed to pass the Senate Public Safety Committee in late March.
Barnes said education and treatment policy solutions are “critical to address the demand for drugs, but without tougher penalties, our ability to address the supply is hindered.”
“The status quo of minimal consequences for crime is not working,” Barnes said.
California State Assemblymember James Ramos introduced AB 1627 in January with the goal of making Narcan more available to the public. It would also allow the state Department of Public Health to “award grants to local law enforcement agencies to create overdose response teams to confront the ongoing opioid crisis in their communities,” according to a press release from Ramos’s office.
A second measure introduced by Ramos, AB 1628, would hold social media platforms like Snapchat accountable for the illegal distribution of controlled substances on its platform. It would also require these companies to clearly post their policies on drug trafficking.
Two years since her son’s shocking death, Amy Neville spends much of her waking day speaking with parents who have gone through a similar tragedy of losing a child or reaching out to people about the dangers of fentanyl.
“[Alexander’s] death can’t have been for nothing,” she said.
Neville also started the Alexander Neville Foundation in honor of her son and continues to keep in touch with local Orange County law enforcement and the Orange County Department of Education.
She holds several speaking engagements throughout the year and goes to high schools, speaking to students and delivering a simple yet potentially life-saving message:
“One pill can kill.”