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When One Pill Can Kill: Fentanyl Crisis Hits Home

By Mia Alva and
Gavin J. Quinton
The Review

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 South Pasadena.
“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.
Experts at the CDPH estimate that 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.
Locally, the growth of fentanyl-related deaths is following national trends as overdoses double each year in the region and are not expected to slow anytime soon, according to the CDPH. In the San Gabriel Valley, L.A. County reported that 64% of fentanyl deaths were people between the ages of 18 and 39.
In the San Gabriel Valley, there were 315 total deaths in the period between 2016 and 2021, and 204 of those were people between the ages of 18 and 39. More than half of those 315 deaths took place in 2020 and 2021, indicating a significant increase in overdose cases.
The CDPH reported about three fentanyl overdose deaths in South Pasadena in 2021.
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 problem 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 Ternan’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 Xanax. 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. The Loyola High School graduate 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.


Dr. Edwin Peck is an emergency medicine physician and fentanyl expert at Huntington Hospital. 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 Review.
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.


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.”
Narcan, which can be bought over the counter or picked up for free at most hospitals, including Huntington Hospital, comes as a nasal spray, and is incredibly safe and easy to administer.

Charlie Ternan right is remembered as a young man who could bring people together


As Narcan becomes more commonly adopted as a lifesaving remedy against fentanyl overdoses, school districts and police departments are taking advantage of the tool.
Domenica Megerdichian, deputy city manager for South Pasadena, told the Review that the South Pasadena Police Department is not capturing statistics specific to individual types of narcotics.
All officers are trained in the recognition of opioid overdose and the use of Naloxone nasal spray, said Megerdichian.
“The SPPD initiated a Narcan program in early 2019 to train and equip first responding officers in the use of Naloxone nasal spray,” said Megerdichian.
The department does not currently have a formal campaign related to the dangers of fentanyl use, but conversations are being held on a one-on-one basis between officers and those most susceptible to using opioids or fentanyl.
The South Pasadena Unified School District currently has Narcan available at the middle and high school.
According to Abby Silver, the SPUSD coordinator of health services, the district is looking into getting Narcan into the three elementary schools as well, even if overdose might not be common there.
“We keep up on the expiration dates and make sure that we have enough in all locations,” said Silver. “And then, I have been providing training to the staff. So, I’ve done training, both at the middle school and the high school.”
Currently the office staff, administrators, counselors, health staff and campus supervisors are trained, but the district is looking to expand that to other staff and teachers.
Silver said that the district has started implementing training and awareness in 2022.
The district has held an online event to talk about the dangers of fentanyl in 2021, which they continue to share with parents and staff, South Pasadena High School Principal John Eldred said.
“It’s something that’s still posted on our PTSA website and something that we reference in our parent communications,” said Eldred.
Fortunately, the district has not seen an overdose case, but is working on being prepared if one does happen.
“Now that we have sort of created an awareness with our community, we’re really trying to prepare our staff for a medical emergency if there is fentanyl use or fentanyl overdose on campus,” said Eldred.
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 has allocated 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 state 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.
Community members can also order Narcan and learn how to tell the signs of an overdose. For more information, visit and search “NaloxoneStandingOrder,” or visit a hospital.
For educational resources, visit the Ternans’ website at
To view the online event hosted by South Pasadena Unified School District, visit

First published in the September 8 print issue of the South Pasadena Review.

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