By Gavin J. Quinton
and Mia Alva
Charlie Ternan was a typical 22-year-old college student who was set to graduate in just three weeks when he suddenly died of a fentanyl overdose in 2020.
After spending two months with his parents during the COVID-19 lockdown, he wanted to spend his last few weeks of college on campus with his friends at Santa Clara University in the Silicon Valley. After one week back at school, his college friends found him dead.
As fentanyl deaths were not as common at that time, Ternan’s parents had no idea it would soon become a full-blown crisis in cities big and small, including Burbank.
“Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine. It is a major contributor to fatal and nonfatal overdoses in California and the United States,” states the California Department of Public Health website.
Burbank data rates for fentanyl overdose deaths gathered by the CDPH are staggering.
The data is tallied by zip codes as part of a state-wide study, and is listed per 100,000 residents in 2021. This means figures are lower than they appear, as most zipcodes have populations lower than 100,000. In the 91501 zip code of Burbank, there were 5.41 fentanyl overdose deaths per 100,000 residents, while the 91504 had a rate of 21.95 deaths per 100,000. In the 91505, the rate was 9.63, and the 91506 zip code had a rate of 16.93. The 91502 had no fentanyl related deaths in 2021. See the data map on page 6 for more details.
There were no reported deaths in 2017 or 2018.
Locally, the growth of fentanyl-related deaths is in line with national trends showing overdoses have doubled every year since 2019. Those are not expected to slow anytime soon, according to the CDPH. In the San Fernando Valley, Los Angeles County reported that about 75% of fentanyl deaths in the region were people between the ages of 18 and 39.
In the San Fernando Valley, there were 663 total deaths in the period between 2016 and 2021, and 495 of those were people between the ages of 18 and 39.
Overdose is more common in young people like Ternan as they fall into a demographic that is more likely to experiment with drugs or purchase pills over the internet.
The issue touches every corner of the country. Deaths by drug overdose in the United States surpassed 100,000 annually in 2021 and death by synthetic opioids — which includes fentanyl — increased 97-fold in a 10-year span.
Fentanyl is manufactured in a variety of bright colors, shapes and sizes, and has been made to look like prescription pills such as oxycodone, hydrocodone, Adderall and Xanax in the illegal drug trade, according to police.
Fake pills are often pressed with markings that imitate real prescription medication. Other street opioids like heroin are also commonly laced with fentanyl because they have similar effects, while fentanyl is cheap, easy to manufacture and is extremely potent in small sizes, making it convenient for drug traffickers to transport.
But even a tiny dose of fentanyl, no larger than a grain of sand, is often lethal. When illicit drug makers who have no pharmaceutical training combine fentanyl with other drugs and fillers, the results can be deadly.
That’s what happened to Ternan, who went on social media with a friend from his fraternity to find pills. They were initially looking for Xanax to take for the afternoon to relax and play video games, but Ternan noticed that the person online was also selling Percocet.
Ternan had back surgery in 2018 and was originally prescribed Percocet for the pain. This was why he chose Percocet over Xanax since his back was still hurting.
“Our family’s full of spinal stenosis, a narrow spine,” said Charlie’s father, Ed Ternan. “Mary’s had the surgery and Charlie’s sister had the surgery. He had a surgery for a damaged disc.”
The last time anyone had talked to him was 3:15 p.m. on the day he died, and it wasn’t until his friends checked on him a few hours later that they knew anything was wrong.
“Charlie was found by his friends, when they were getting ready to make dinner around 7:30 p.m. that night and by that time, he’d been gone for hours, and we got the phone call,” Ed Ternan said.
Ed and Mary Ternan were devastated when they heard the news about their son. It was their first time hearing about sudden fentanyl overdoses and it left the couple in shock.
“According to the doctors, within 15 minutes of taking the pill, he probably died,” said Ed Ternan. “So, we know that’s what killed him because they found the other pills that he and his friend had bought in the room. So, we know that he took one pill, and we know that that one pill killed him.”
The family at first thought their son died from overdosing on Xanax, asking themselves how this could be possible. They knew their son was not an addict.
“How many Xanax would Charlie have had to take to die from it? What did we miss?” they asked. “We didn’t see any signs of addiction, and he was gone in a week. We were with him for two months. He was fine.”
It wasn’t until the next day that they found out their son had died from fentanyl and not a series of Xanax pills. The homicide investigator told Ed Ternan that he had seen seven fentanyl deaths in the previous 10 days in Santa Clara County.
Charlie Ternan was just like any other kid in college, said Ed Ternan, as he reminisced on his son’s character. He was warm-hearted, smart, empathetic and someone who could bring people together. He had a passion for economics and the arts.
Now, after three years, the void of their son passing still looms large.
“It’s still a disaster,” said Ed Ternan. “We suffer every day. Anyone will tell you that the loss of a child is the most devastating thing you can experience.”
Ed Ternan said that if they had known to teach their son of the dangers of fentanyl, he probably wouldn’t have died. The family, just months after their son’s death, started their nonprofit, Song for Charlie, that brings awareness to young adults, parents and educators about counterfeit prescription pills being sold online targeting young people.
Their tagline is three simple words: “No random pills.”
“We need to empower young people, and parents and caregivers with accurate information delivered in a nonjudgmental way, so they can have productive conversations about the new chemical drug landscape, in the home, at school, with their friends, what they see online,” said Ed Ternan. “People just need to know what’s really going on so that they can make healthier choices.”
“We said to ourselves, ‘we need to tell other people that this is happening,’ because we began to meet other parents who it has happened to,” he added.
DOCTORS SPEAK OUT
Dr. Edwin Peck is an emergency medicine physician and fentanyl expert at Huntington Hospital in Pasadena. Peck treats addiction and overdose cases daily and is developing several programs in Huntington’s emergency department around the treatment of opioid use disorders with opioid overdose as a focus.
According to Peck, fentanyl deaths are usually sudden, and the resulting trauma of the families of the deceased can be different than that of a lifelong user.
“The issue with fentanyl now, is that you can have a teenager experimenting, or just using Adderall that they did not get from a physician for productivity reasons. These things can now be laced with fentanyl, and these people will die suddenly with nobody around,” Peck told the Leader.
Peck said that the grieving process is markedly different with fentanyl overdoses.
“There’s no difference in the tragedy between a family losing a loved one to a drug addiction problem over decades versus a sudden one. But there is a difference in the trauma that occurs to the four-person family when one of the teenagers makes a single mistake and is very abruptly taken away,” he said.
“That’s similar to losing somebody to gun violence or to a car accident where that abrupt trauma really brings the whole family to its knees and many families do not make it through,” he added.
To Peck, there is no better immediate solution to the opioid crisis than getting Narcan into every home, business and public organization. Still, for the long term, better education and policy is needed to combat the crisis, Peck said.
THE NARCAN/NALOXONE EFFECT
Naloxone, also referred to by the brand name Narcan, is an opioid antagonist that rapidly reverses the effects of an opioid. Touted as a “miracle drug,” Narcan has proven to be incredibly powerful against opioid overdose. With a fentanyl overdose specifically, public health experts recommend two or more doses of Narcan may be needed.
“If it were a perfect world, I’d have everybody with [Narcan] in their backpack, in their pocket, because it’s such an easy, safe solution when someone is overdosing,” Peck said. “But, long term, that solution can be seen as a Band Aid for a gunshot wound, because when you’re alone, it doesn’t matter how much Narcan there is. The education, the understanding and the greater approach to how we go about drug use has to improve because fentanyl will not be the last thing that comes up.”
Dr. Angelique Campen, an emergency physician and fentanyl expert, said that fentanyl-related overdoses are a daily occurrence in the emergency room at Providence St. Joseph Medical Center in Burbank.
“In my eight-hour shift yesterday, there were two patients that needed Narcan to reverse the effects of fentanyl. It happens daily,” Campen told the Leader.
Narcan, which can be bought over the counter or picked up for free at most hospitals, including PSJMC and Huntington Hospital, comes as a nasal spray, and is incredibly safe and easy to administer, Campen said.
“When I train police officers or community members about the use of Narcan, I stand in front of them and spray one up my nose just to show that it will not hurt you. If you think of using it, use it. You cannot hurt someone by giving them Narcan,” said Campen, who engages in training and public education when she is not busy saving lives at PSJMC.
Though Narcan can be purchased without a prescription for about $100 at some local pharmacies, others do not yet sell it. That’s because the drug just got FDA approval for over-the-counter sale. The manufacturer states that Narcan will be widely available for purchase in stores by “late summer 2023.”
SCHOOL, POLICE, STATE EFFORTS
As Narcan becomes more commonly adopted as a lifesaving remedy against fentanyl overdoses, school districts and police departments are taking advantage of the tool.
The Burbank Unified School District has at least one kit that carries two doses at each of their school sites.
“All of our schools also have Narcan available and our staff have been trained,” said Superintendent Matt Hill in an interview in June.
“We continue to partner with L.A. County of Health, Burbank Police Department, parents, and other providers to provide information about substance abuse and the harms of fentanyl,” he said.
Hill said that a big factor in combatting overdoses in children and teens is education and communication. Specifically, he said that parents and guardians should use honest language that emphasizes their values and concerns around drug use. Open conversations that evoke adolescents’ understanding and experiences are more effective than lecturing and utilizing scare tactics.
There are not yet Narcan kits in every classroom, though each school has at least one kit located in the health office and grades 7-12 campuses have more supply kits located throughout school sites.
BPD officials were unsure of how many fentanyl overdose cases there have been in the city for the last year or recent years. Local police and fire departments are not mandated to report on overdose death data.
BPD has partnered with the school district for years to educate staff and students on the dangers of fentanyl and the use of naloxone.
Last summer, Burbank police officers stopped two men in the early morning hours as they drove through town. A search of their vehicle resulted in the recovery of over 100,000 fake oxycodone pills, which later tested positive for fentanyl.
“This arrest, just [one year] ago, brings the realization that fentanyl exists in our community, and we need to be aware of the dangers,” BPD spokesperson Sgt. Brent Fekety told the Leader.
“Please remember the only safe medications are ones that come from licensed and accredited medical professionals. The Burbank Police Department reminds the community that pills purchased outside of a licensed pharmacy are illegal, dangerous, and potentially deadly,” Fekety said.
About 83% of all opioid-related deaths in the state can be attributed to fentanyl, and it is a leading killer nationally, taking the lives of more young Americans than COVID-19, car accidents or gun fatalities.
Despite the widespread availability of Narcan, fentanyl cases and deaths in California are increasing at “an unpredictable pace,” according to the California Department of Public Health. The most recent statistics from the CDPH show that there were 5,961 deaths due to fentanyl overdose in 2021, and 7,175 opioid deaths statewide.
In the upcoming year’s state budget, Gov. Gavin Newsom planned investments of more than $1 billion to crack down on opioid trafficking and enforce the law, combat overdoses, support those with opioid use disorder and raise awareness about the dangers of opioids.
Under the CalRx Naloxone Access Initiative, the state will allocate $30 million to support a partner in developing, manufacturing, procuring and distributing a naloxone nasal product under the CalRx label.
“One more fatal overdose is one too many. California is tackling the opioid epidemic from all sides,” said Newsom. “Naloxone is, quite literally, a lifesaver — so we are making it more accessible and affordable for anyone who needs it.”
The Department of Health Care Services created the Naloxone Distribution Project in 2018 to combat opioid overdose-related deaths in California through the provision of free naloxone. As of June 25, the NDP has distributed more than 2.6 million naloxone kits, resulting in more than 181,665 reported overdose reversals.
As federal and state government attempt to treat the drug crisis, public health experts say that municipalities are still a far cry away from closing the gap on the local level. According to the California Department of Public Health, cities that want to fight fentanyl locally can:
• Increase the distribution of naloxone.
• Promote overdose prevention education.
• Expand equitable access to treatment for substance use disorders.
• Intervene early with individuals at the highest risk for overdose.
• Improve detection of drug-related overdose outbreaks and facilitate a timely and effective response.
Community members can also order Narcan and learn how to tell the signs of an overdose. For more information, visit cdph.ca.gov and search “NaloxoneStandingOrder,” or visit a hospital. For educational resources, visit the Ternans’ website at songforcharlie.org.
First published in the July 22 print issue of the Burbank Leader.