LA HONDA, Cal. (Reuters) – This April, a friend of high school ice hockey player Sequoyah Klingele became concerned when Sequoyah wasn’t responding to messages. The friend went looking for the 16-year-old and found him unresponsive in a house in La Honda, California, a small town in the Santa Cruz Mountains.

The friend dialed 911, police records show. There was nothing emergency responders could do: Sequoyah, who had accidentally overdosed on methadone, had been dead for several hours.

Last year, with schools, youth sports and other programs closed nationwide in an attempt to slow the spread of the coronavirus, the rate of drug-related 911 calls for young people aged 20 and under increased by 43%, an analysis of emergency response data by Reuters found.

For the previous three years, rates had remained stable at about 25 emergency drug responses per 100,000 calls. During the pandemic, those numbers spiked to more than 37 per 100,000, according to data from the National Emergency Medical Services Information System.

Last year, NEMSIS collected data on 27.3 million 911 emergencies from 47 states; 10,166 of those were drug-related calls involving young people. The last four years’ worth of call data NEMSIS shared with Reuters include granular information about each call, such as the age of the patient and the type of medical issue, without identifying anyone.

The NEMSIS data, collected voluntarily from 911 response agencies nationwide, represents about 87% of all U.S. emergency responses. Because the number of agencies that report data vary annually, it is not possible to compare the total number of young people requiring drug-related emergency care from year to year.

More than 80% of the drug emergencies involved use of opioids such as pain medications, fentanyl and heroin, but included all classes of drugs.

The rate of emergency calls involving young people who required naloxone – a drug that reverses an opioid overdose – increased by 34% from 2019 to 2020, to the highest rate of use since at least 2017, the earliest data available, according to NEMSIS data. Naloxone successfully revived a patient about half the time, the data showed.

Brandon Marshall, an epidemiologist at Brown University who studies overdoses and drug use, said shelter-in-place and other social restrictions both exacerbated risk factors for youth to start using drugs and created a more dangerous environment for drug use, resulting in more extreme emergencies. Typically, drug use among young people is social, with friends around to help amid an overdose situation, he said. That changed during the pandemic.

“What we know is that the way that people use drugs during adolescence shapes and influences their drug use later on and into adulthood,” Marshall said. “What’s alarming me is that if people become accustomed to using isolated and not in a social setting now, that establishes itself as a norm that could continue to put people at risk, well into adulthood.”

Last year, about 93,000 people nationwide died after overdosing, a nearly 30% increase from the year before, according to data released in July by the Centers for Disease Control and Prevention. National data separating out the number of children and young adults who died won’t be available until late this year or early 2022.

Reuters obtained data from nine cities and states; eight of the jurisdictions showed a significant increase in youth overdose deaths in 2020.

Los Angeles, for instance, reported 37 drug overdose deaths among those 17 years old or younger, up from the previous three years when between 10 and 15 children died annually. The trend follows in Denver, which reported 10 deaths among minors in 2020 after only seeing three overdose deaths in 2018 and 2019 combined.

In cities such as San Francisco, paramedics say they are dealing with the grim fallout from drug abuse by the young. Jeff Covitz, a paramedic in the northern California city, said many of the calls he attends involve street fentanyl often cooked up in illicit labs, which can require more than three times as much naloxone to reverse than heroin. “It would wake up an elephant,” he said.

The number of overdoses, including pediatric overdoses, his unit handled during the height of the pandemic was “absurd.” He recalls one shift in which he and colleagues attended eight overdose calls, some involving minors.

Many health experts connect the spike in drug emergencies to school closures, cancellation of sports and social isolation. In a January health alert, San Mateo County, where Sequoyah Klingele lived, warned of an increase in youth and young adults dealing with significant mental health issues and substance use.

“The length of time we have asked the community to shelter in place, avoid being in large groups, and curtail many of the avenues for social interactions have really taken a toll on the health of our community,” Vanessa de la Cruz, then the county’s medical director of Behavioral Health and Recovery Services, said in the alert.

A SEASON CANCELLED, IDLE TIME

Sequoyah Klingele’s mother, who had struggled with drug addiction, left when he was young, his father Kenny Klingele said. Klingele raised their son in California’s Half Moon Bay area.

Hockey was central to Sequoyah’s life: Big for his age, he started playing in elementary school and excelled as a defenseman, winning the coveted game puck when his team won the state championships in 2019. In what would be his final season, his father drove him 90 minutes each way three times a week to practices and games in Oakland.

In 2019, Sequoyah was caught with a vape pen at hockey practice. Klingele told him he could take one of two paths. One path included vaping and probably little else. The other included high level sports. Doing both was not an option, he stressed.

Then the coronavirus pandemic hit, and his high school ice hockey spring tournaments were cancelled.

Sequoyah struggled with the loss of structure, said Klingele, a tree service business owner who would leave for work in the early morning and return in the evening to find his son still in his room. Klingele had bought him synthetic ice panels, so he could practice on his own. Sequoyah showed little interest.

The father felt his son needed to socialize so, in late 2020, he gave the teen more freedom – more, he says, than he would have otherwise.

Sequoyah spent increasing amounts of time with his friends in La Honda, staying overnight at his grandfather’s in the Klingele family’s RV park in the redwoods.

In January, Sequoyah looked up “symptoms of depression,” his Google search records shared by the family showed, and later, “do I have a mental illness?” A number of his searches starting in late 2020 involved drugs. In early April, he Googled “methadone” and “how long does methadone last.”

Kenny Klingele had been preparing to get Sequoyah back playing hockey once practice restarted, he said. The sport would have consumed him, Klingele said, as the level he played at was highly competitive and players would have been jockeying for college scholarships.

Instead, Klingele is now trying to piece together the last hours of his son’s life. “No matter what happened, he would have said, ‘Dad, it is my fault,’ ” Klingele said. “But he’s a kid. He still needed protecting.”

TROUBLE IN THE HOME

Some youth begin to struggle after seeing their parents lose jobs or fight their own addictions. In the pandemic, some descended into depression as their daily structure collapsed with schools going online.

Tracey Weeden, the chief operating officer for First Step of Sarasota, Inc., a Florida-based drug and mental health treatment provider, said her programs saw an 85% rise in children seeking outpatient substance abuse treatment in 2020 compared to 2019.

“Youth have taken the biggest hit,” she said. Many children who come in for treatment have a parent who is abusing drugs or alcohol, she said.

In San Diego, Willough Jenkins, a child psychiatrist at the Rady Children’s Hospital, said more teens are reporting buying drugs online, a trend that was particularly apparent at the height of the lockdown. The hospital also saw an increase in younger children accidentally ingesting drugs as they spent more time at home.

In one case in March 2021, a two-year-old girl got into her parents’ fentanyl stash and became unresponsive. She was rushed to a hospital and required life support for several days, said Natalie Laub, a child abuse pediatrician at Rady and assistant professor at the University of California’s San Diego campus.

Hospitalizations for children under five who ingested drugs such as fentanyl, marijuana and methamphetamines rose by 21% in the first four months of the pandemic compared to the same months a year earlier, according to Laub’s analysis of data from 50 U.S. children’s hospitals.

“That’s a dramatic increase we attribute to COVID,” said Laub.

Amanda Faith Eubanks started giving her 13-year-old son, Luca, more phone time as a way to socialize during the lockdown last spring, she said, after noticing he was increasingly depressed.

Luca began buying marijuana from a stranger on Snapchat, his mother said. After he had a root canal, he complained about the pain to his pot dealer, who offered him a Percocet pain pill, she said.

On August 12, 2020, police officers and paramedics in Redding, California, responded to a report of a 13-year-old boy found unresponsive in his bedroom by his father. Instead of a pain pill, he had received a fentanyl pill that killed him, according to police.

Together with Homeland Security Investigations agents, detectives found 19-year-old Ryan Harrison was using social media to advertise and deal drugs to his clients, many of whom were minors, police said. Harrison was arrested in July 2021 on charges related to Luca’s death, including murder and selling a controlled substance to a minor. He has pleaded not guilty.

“You see signs,” said Eubanks. “But unfortunately we didn’t really catch on, until Luca died. It’s still really hard to say. Luca died. I have to remind myself every single day.”

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