The fentanyl epidemic is hitting young kids in Tarrant County. We all must act | Opinion
“Help my child!” a frantic mother calls out in the Emergency Department, holding her limp toddler. The medical team rushes to her side and sees a child who is not breathing. They quickly force oxygen into his lungs, and soon, his color returns.
“Mom, what happened before this? Was he sick? Are there any medications in the home?” A barrage of questions ensues as the team searches for the cause of his illness. “No, nothing, he is healthy.” Nothing points to the cause until they look into the child’s eye and see a telltale sign — pupils the size of a period.
“Administer Narcan!” the physician calls out. Moments later, the child begins to breathe and awaken to a tearful mother. Mere moments later the outcome could have been catastrophic.
Tarrant County has grappled with multiple waves of opioid crises for three decades, but the fentanyl emergency today has cascaded. Between 2019 and 2020, the Dallas-Fort Worth area saw a 400% increase in fentanyl-related deaths. We see tragic stories involving adults, high school students, middle school students and toddlers overdosing on the synthetic drug — many in their own homes.
The 1990s saw unscrupulous marketing and overprescribing of narcotics. It was followed by a second wave of heroin in the 2010s laying the groundwork for synthetics such as fentanyl. These opioids are insidious, with some synthetic products 50 to 100 times more potent than heroin.
What is specifically happening in Tarrant County? Based on data from North Texas Poison Control, between 2018 and 2022, there were just four cases of children 12 and younger ingesting fentanyl. For individuals ages 13-18 during the same period. there were 11 reported cases of ingestion, whether intentional or not.
This data is significant because it shows how little insight we have into the current effects of the fentanyl crisis on Tarrant County’s pediatric population. The Centers for Disease Control and Prevention observed a nationwide 109% increase in pediatric opioid overdoses from 2019 to 2021.
Deaths involving illicitly manufactured fentanyl increased by 182% in this age group. Opioids accounted for 90% of the overdose deaths, and illicitly manufactured fentanyl accounted for 84%. Nearly a quarter of the deaths involved counterfeit pills.
Unfortunately, there is a widespread lack of understanding about the opioid epidemic and its effect on children. Opioid-related deaths in children from poisoning were responsible for 24% of the time in 2015 but now have risen to 54% as of 2018.
This high potency means small doses easily produce a high and tragically an overdose. Another contributor to their ubiquity is that synthetic narcotics are easily ingested or absorbed through the skin, making them more accessible to young toddlers and infants or “laced” for effect into other drugs. Recent studies show southern states bearing the brunt of reported opioid overdoses, with most cases occurring in metropolitan areas with populations exceeding 250,000.
Dallas-Fort Worth is not the epicenter but contributes significantly to fentanyl-related deaths. Several school districts in North Texas have been affected, leading to discussions about the need for readily available naloxone given to unresponsive students.
It’s alarming to note that possibly 1 in 8 children in the United States lives with a caregiver who has a substance abuse disorder, significantly increasing the child’s risk of exposure, whether purposeful or accidental.
This epidemic will not disappear overnight. As it continues infiltrating our classrooms, homes and daily lives, we can’t stand by and watch our children be destroyed by this monster. Whether it’s a child finding a grandparent’s leftover fentanyl patch or an inquisitive teen who ingests a potent counterfeit, we, as a community, owe it to them to find a solution.
We need more reporting, more cooperation, and more members of the community to step up. The wave has rolled in, and the tide is rising, but it’s not too late to protect these “little victims.”
Dr. Sam Selby is a pediatric emergency medicine physician at Cook Children’s Hospital and an assistant professor at the Texas College of Osteopathic Medicine . Contributing to this piece were Jared Ivan and Ryan White, fourth-year medical students at TCOM, and Dr. Priya Bui, chair of the Department of Pediatrics and Women’s Health at TCOM.
