In early May, just a few weeks before graduation, Zoe Ramsey and Niko Peterson were sitting in an unlit, empty classroom at Animas High School in Durango, Colo., sorting through photos on a laptop.

The two high school seniors were wrapping up work on a two-page yearbook spread of words and images to honor their friend Gavinn McKinney.

In one photo, Peterson sits, wearing a knit cap and a goofy expression on his face. Another boy, with a tousled puff of dark hair, looking more sober and serious, stands behind with his chin on Peterson’s head.

This is Gavinn McKinney, who died two years ago during their sophomore year, just nine days before his 16th birthday.

“It represents our friendship pretty well, I think,” said Peterson. “I would have never imagined that this would be an in memoriam type of picture, but it’s a pretty good one.”

Youth susceptible to fake pills

On the evening of Friday, Dec. 10, 2021, McKinney and a friend took pills they believed to be the narcotic Percocet. But the pills were counterfeit and laced with fentanyl. Paramedics saved the other boy’s life with Narcan, a nasal spray that can quickly reverse the effects of an opioid overdose. McKinney died before anyone could reach him.

“He was just like a wise soul,” Ramsey said. “I feel like he just knew something that none of us knew. And I’m never going to know what that is.”

Historically, drug overdose deaths among teenagers have been extremely rare. Even today, teen overdose deaths account for a small fraction of the total number of overdose fatalities nationwide. But in the past five years, the number of teen overdose fatalities rose sharply and suddenly, driven by a surge in the availability of counterfeit pills.

“I think people don’t realize just how complex and terrifying the illicit drug supply is becoming in the age of synthetics,” said Joseph Friedman, who studies addiction and illicit drugs at UCLA. “There’s this huge array of novel substances that are being synthesized, mixed in with fentanyl, in many cases sold as these preformulated counterfeit pills.”

While teens are unlikely to experiment with powder substances, they are more comfortable trying what they think are prescription drugs, and the swift rise in counterfeit pills has produced deadly results. Friedman co-authored a January 2024 study in the New England Journal of Medicine linking the rise in teen overdose deaths with the widespread availability of counterfeit pills, especially in the American West.

“We know that many teens (who) are fatally overdosing do not have an addiction, or a problem with drugs,” Friedman said. “In many cases, it’s just teenagers that are just experimenting with counterfeit pills. They may have only experimented a handful of times when a tragedy happens.”

This was precisely what happened to Gavinn McKinney in December 2021, according to his peers — he was experimenting with pills he believed to be safe. McKinney’s death was a sudden blow of shock and despair for the students and staff at Animas High School.

“We ended up just pulling the 10th graders together that morning,” said humanities teacher Lori Fisher, recalling the first morning at school following McKinney’s death. “We had grief counselors on hand, and then we had these three rooms of kids just crying and remembering and dealing with their grief.”

Among those closest to McKinney, Zoe Ramsey and Niko Peterson turned overwhelming grief into a resolve to take action.

“They were adamant from the very beginning that they wanted his death to mean something,” said Fisher. “It took them a while to figure out exactly what that looked like and what that meant for them. When they came upon this idea of harm reduction, Zoe was like, ‘This is it. This is what we need to be doing. This is where we need to be going.’”

Gavinn McKinney and Zoey Ramsey became close friends in their 10th grade year at Animas High School

Zoe Ramsey/courtesy Zoe Ramsey

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Zoe Ramsey/courtesy Zoe Ramsey

Fighting for the right to carry Narcan in school

Harm reduction is an approach to addiction treatment that prioritizes compassion and safety over shame and punitive action. Rather than insist on sobriety and abstinence, harm reduction attempts to minimize the harmful consequences associated with drug use. It’s better to provide tools that help a drug user live, rather than have the person die of an overdose.

As Ramsey and Peterson read up on harm reduction, they learned about fentanyl test strips, which allow a drug user to detect lethal opioids. They also discovered Narcan, with its active ingredient naloxone, which can reverse a fentanyl overdose.

“I had no idea what naloxone was. I had no idea what a fentanyl test strip was. I didn’t even know how little fentanyl it could take to kill somebody until after Gavinn’s death,” said Ramsey. “Then I realized, after the fact, that this could have been prevented, and nobody was teaching us about what could have been done instead…That’s when Niko (and I decided), ‘If the teachers, parents, and administrators aren’t telling us about this, then we need to tell our peers, and we need to do what we can to protect them.’”

Many schools stock Narcan for teachers and staff to use. But when it comes to students, there’s a legal gray area, and school administrators worry about liability. So when Ramsey, Peterson and other teens in Durango asked for permission to carry Narcan on campus, they ran into drug policies prohibiting the possession of any medication.

Undeterred, the teens lobbied Durango’s school board for permission to carry and administer Narcan on school grounds. They carried picket signs outside monthly school board meetings and spoke during public comment periods of those meetings.

Following that successful campaign, the teens worked with a Colorado state representative on a bill to give that same right to students across the state.

By February, Niko Peterson and other teens were testifying at a legislative hearing in the state capital. During that testimony, skeptical legislators challenged the idea that students were emotionally prepared to act as first responders in school.

“My son in high school is 14,” said state Rep. Anthony Hartsook. “I don’t know that he can evaluate whether somebody is having an allergic reaction, a medical reaction, a drug reaction.”

It was a moment when the teens wondered whether the bill would pass.

“I was worried we wouldn’t be able to convince them,” Ramsey recalled. “I spent more time on this than my college applications, and I just wanted all my hard work to pay off.”

The hard work did pay off near the end of April, when Colorado’s lieutenant governor signed the bill into law.

“Seeing it actually pass, and seeing people agree with it, was like a deep breath, a breath of fresh air,” said Ramsey.

After changing local school policy, and helping rewrite state law, it was time to graduate from high school.

But in the final days before graduation, as Ramsey and Peterson wrapped up senior projects and planned a class camping trip, each milestone was another reminder of their friend’s absence.

“We’re grieving still,” said Peterson. “I’ve been struggling with trying to still find the happiness in things … even though he’s not doing them with me.”

“I just finished a 32-page thesis on what the most effective harm-reduction educational strategies are,” said Ramsey. “I wonder what Gavinn would have written about? Would it have been quantum computing? We have no idea. We have no idea.”

On May 24, Animas High School left an empty seat at its graduation ceremony to remember Gavinn McKinney.

“He’s not going to be able to walk with us,” said Ramsey, her voice breaking. “But he would have graduated with us. Yeah. He would have graduated with us.”

Adam Burke and Clark Adomaitis have been covering Narcan in Durango schools since January 2023. You can find their stories here.