When Addison Mott found a small, white pill in her kindergarten classroom in October 2021, it piqued her curiosity.
The tiny tablet was smaller than the tip of her pinkie finger, she said, and for some reason, the 5-year-old decided to put it in her mouth.
“I don’t know what I was thinking,” Addison, now 8 years old, told Scripps News during an interview with her mom nearby.
Addison had been attending an after-school program, called SAFE, at Grenada Elementary School in Grenada, California, when she suddenly started experiencing the terrifying consequences of consuming a pill laced with fentanyl.
“I was dizzy. When I would walk, I would start wobbling,” she said. “I wanted to go to sleep so bad … My eyes were like, drifting off … and then, everyone’s like, ‘No! Wake up! Stay up!’”
Several school staff members seemed stumped by the kindergartner’s symptoms as her breathing became labored and her eyes rolled back in her head.
Addison had not told anyone about the pill she had consumed.
“It kind of looked like a concussion or something. I don’t know what it was,” Frederick Knudsen, a Grenada Elementary School teacher, told a sheriff’s deputy during a recorded interview, after the incident.
Heather Stratos, another school employee who tried to comfort Addison while calling an ambulance, told a detective, “We honestly thought she had a seizure or something.”
But rapidly, the substance, considered by the United States Drug Enforcement Administration to be “the single deadliest drug threat our nation has ever encountered,” was tightening its grip on Addison’s body, and no one knew how to help her.
“This was something that could have been completely prevented. It was nothing that she ever needed to be exposed to,” said Danyel Mott, Addison’s mother.
No Narcan antidote and no fentanyl test at first
The opioid reversal antidote Narcan (also known as naloxone) has frequently saved children’s lives when administered in time, but Scripps News could find no records showing anyone treated Addison with the medication at the school.
Through an open records request, Scripps News learned the school had a policy in effect since at least 2019 that would have allowed for “emergency naloxone hydrochloride or another opioid antagonist [to] be available at schools for the purpose of providing emergency medical aid to persons suffering, or reasonably believed to be suffering, from an opioid overdose.”
However, the school would not confirm whether any doses were accessible on campus prior to Addison’s poisoning.
Two doses of the remedy were “made available on campus, following a staff wide training,” at Grenada Elementary School within days of Addison’s overdose, according to Shannon Cash, a school representative.
“I feel like it’s something that needs to be trained on, and if there’s signs and symptoms – you know, she had pinpoint pupils. She was itchy. She wasn’t breathing. She was turning purple. Her oxygen was low. At one point, she ended up throwing up, which honestly, I think is one of the few things that saved her. These are all symptoms of a drug overdose. If they’re having it, at least try it. Try some Narcan, and see what happens,” said Mott, a registered nurse.
Mott arrived at Addison’s school ahead of an ambulance and rushed the kindergartner to Fairchild Medical Center.
Mott currently works at Fairchild Medical Center but did not work there when Addison was being treated.
“I remember they were worried about new onset diabetes with her, and I had mentioned, ‘Do we think she ate something, or, you know, ingested something?’” Mott said. “The pediatrician came in and looked at her and he agreed — he felt like she was on something. We did a [toxicology] panel, and at that point the tox panel came back negative.”
Medical records show Addison received a standard urine drug screening at Fairchild Medical Center, and she was “below threshold” for 12 types of drugs including methamphetamines, oxycodone, PCP, cocaine and opiates.
“That was what was scary,” said Mott, recalling the uncertainty about what caused her daughter to become critically ill when the initial toxicology test seemed to indicate her daughter may not have been poisoned by a substance.
“It went from, ‘She might be on something or … ingested something to, well, maybe she has a brain tumor, and it’s neurological,” said Mott.
The standard drug test, however, did not screen for fentanyl, a synthetic opioid.
Addison was transferred to UC Davis Medical Center, and a more comprehensive drug test the following day confirmed she had been poisoned by fentanyl.
“I was a little frustrated that we weren’t testing for it already,” said Mott of the initial tests at the first hospital that did not include a rapid test for fentanyl. “We know [fentanyl] is here, and it’s in our area, so we need to be adding it to our screen. We need more education about it.”
Mott said she sent a letter to the hospital board after the incident to request that fentanyl testing be included in a routine toxicology screening.
In April 2022, Fairchild Medical Center “implemented fentanyl testing in-house, allowing for quick test results for Fairchild providers to take prompt, appropriate action,” said Michael Madden, a spokesperson for the hospital. “Fairchild continues to respond to the changing healthcare needs of our community and felt the need (in 2022) to add this fentanyl test as part of our drug screen.”
Addison Mott was able to make a full recovery, but many children do not survive after ingesting fentanyl.
Two-year-old Mitchell Robinson died in Louisiana in July 2022 after authorities said he suffered three drug overdoses in the span of a few months.
Initial hospital drug screenings did not include fentanyl, and the boy tested negative for other drugs, so workers from the Louisiana Department of Children and Family Services did not initially open an investigation to remove the child from his home.
The boy was revived with Narcan at the hospital the first two times, then returned to the same, contaminated environment where he would be poisoned again.
In March, the state inspector general released a review of his case, blaming a lack of drug screening as one of several contributing factors in the child’s death.
“Toxicology screens used by the hospital did not test for synthetic opioids, leading to initial ‘negative’ results that caused confusion among DCFS personnel not familiar with the medical use of Narcan,” the report found.
Testing research
Scripps News wanted to know how often young children nationwide are being tested for fentanyl in emergency rooms when they are being treated for symptoms that resemble an overdose.
We posed the question to Epic Research, a group that has access to millions of de-identified medical records from hospitals throughout the country.
As a result, the group conducted a study using data from 1,370 U.S. hospitals. The study also included data from a health system in Lebanon, according to Ryan Ellis, a spokesperson for Epic Research. Researchers found fentanyl testing for children between the ages of 1 and 12 who had been diagnosed with an overdose in an emergency department increased from less than 2% in 2021 to nearly 10% in 2023.
In 2023, according to Epic Research, nearly 7% of the children who were tested were positive for fentanyl.
Researchers also examined other age groups and found fentanyl testing has increased for most patients.
New state fentanyl testing laws
In 2023, a new law called Tyler’s Law required all general acute care hospitals in California to include testing for fentanyl if they are already conducting a urine drug screening for other substances in a patient’s system.
The law is named after Tyler Shamash, who died in 2018 of a fentanyl overdose after a prior hospital test during a previous overdose failed to screen for the drug.
Since then, Maryland and Pennsylvania have passed similar legislation while lawmakers in North Carolina and Michigan have been discussing the idea.
“As long as we have a fentanyl epidemic … then that should be the standard of care,” said Dr. Roneet Lev, a San Diego emergency physician who helped draft Tyler’s Law.
Lev also served as the chief medical officer in the White House Office of National Drug Control Policy under President Trump.
“People will get a [standard] drug test and they’ll say, ‘Oh it’s negative for opiates,’ and they don’t know the difference between opiates and opioids. And then they think, ‘OK, it’s negative for fentanyl,’ but that’s not the case because that [test] doesn’t include [fentanyl].”
While some medical professionals have argued a specific test for fentanyl is not necessary because a patient’s treatment would not change because of it, Lev said providing additional information to a patient or a parent could be life- changing.
For example, she said, some overdose patients believe they have consumed a different drug without realizing it is laced with fentanyl.
“You may be saving more than one person’s life with that information and motivating patients to change their life around knowing that they almost died,” she said. “I think it’s important, clinically, as a physician, for those children to understand what happened to them and to prevent it.”
Federal proposal
Congressman Ted Lieu, D-Calif., and some fellow legislators introduced bipartisan legislation in 2023 aimed at increasing hospital fentanyl testing, but it does not go as far as the state laws.
The federal proposal, also called Tyler’s Law, would require the United States Department of Health and Human Services to “complete a study on how frequently hospitals test for fentanyl in patients experiencing an overdose, and to use the results of the study to issue guidance to hospitals on implementing fentanyl testing in emergency rooms.”
“We just want not only the hospital to know, but also other places that they could refer the patient to, to know why they’re referring the patient and what possible drug might be in that patient’s system,” said Lieu. “It’s so tragic because kids, especially when they’re young, they may not know what they’re ingesting.”
“It’s something that should be added to the list of substances that you’re testing for because it can prevent a whole host of other consequences from happening as a result of not being tested,” said Rep. Sydney Kamlager-Dove, D-Calif., who introduced the House bill with Lieu and Rep. Bob Latta, R-Ohio. “I think there might be some concerns about judgment, you know, but that’s something that we should just take off the table and deal with the health crisis that that individual is dealing with in that moment.”
“As we continue the fight to curb this deadly epidemic, it’s important that hospital emergency departments and medical personnel are testing for fentanyl overdoses,” said Latta, in a press release.
According to the current bill language, HHS would be required to complete the study “not later than one year” after the bill becomes law.
As Scripps News has reported, medical professionals in several states have already recommended that hospitals add fentanyl to standard drug screening panels based on their own research, data and observations.
Lieu said he would be open to reconsidering the required government study since so much research has already been conducted.
“We could shorten the timeline for this study. I think that is something that seems reasonable, and that’s something we’ll look into,” he said. “I would absolutely want to make this bill speedier in terms of implementation, and if we can do that, we will.”
In December, Sen. Joe Manchin, D-W.V., and Sen. Mike Braun, R-Ind., introduced a companion bill in the U.S. Senate.
How did a kindergartner get fentanyl?
While Addison Mott is thriving now — doing flips on her backyard jungle gym, riding bikes and jumping on her family trampoline — her mother continues to question how the child accessed fentanyl in her kindergarten classroom in the first place.
The investigation stalled within a few months of the incident, according to records obtained by Scripps News.
“There’s definitely things that were discussed in the police report that raised red flags,” Mott said. “We still just don’t have answers.”
Through an open records request, Scripps News obtained the Siskiyou County Sheriff’s Office reports pertaining to the incident.
They show Addison’s teacher’s aide, whom Scripps News has chosen not to identify, overdosed on fentanyl at home two days after Addison’s incident in her classroom.
According to a sheriff’s office report, deputies responded to the woman’s home when her husband, also a school employee at the time, told dispatchers that his wife was “out of her mind” and “coming down off of something.”
A deputy said the woman told them she had taken two and a half fentanyl tablets prior to their arrival. According to the incident report, she also said, “she had been taking these tablets for a few days now, but her drug of choice for years had been Norco (prescription medication).”
Deputies said they conducted a search warrant at the woman’s home, but the husband “made sure [she] flushed everything” so they did not find any fentanyl.
While the school district confirmed to Scripps News that it terminated the teacher’s aide within weeks of Addison’s poisoning, the district would not say for what reason.
Scripps News could find no indication in any report that sheriff’s deputies ever asked the teacher’s aide about Addison’s incident even though they interviewed other teachers and school personnel who were at the school.
A deputy reported that it was his belief that “the child’s fentanyl exposure was related to [the teacher’s aide’s] use and/or possession of fentanyl.”
However, in January 2022, a deputy wrote, “This investigation has been closed at this time due to no further leads at this time. If something else should come up this investigation can be re-opened.”
“It’s very frustrating that nothing’s been done,” said Mott. “There’s implications in the police report, and then it’s just kind of dropped, and I don’t know why.”
Via email and through phone calls, Scripps News repeatedly asked the sheriff’s office for additional information about why the investigation was closed, but the office stopped responding to questions.
After multiple ignored interview requests, Scripps News traveled to Yreka, California, where we tracked down the sheriff in a public parking lot, outside his office.
“We should interview the teacher’s aide,” said Sheriff Jeremiah LaRue when Scripps News inquired about the case. “I’m not super familiar with all the details of it, but that’s what we would normally do.”
LaRue said he had been reexamining some of the evidence after Scripps News inquired about the investigation.
“It might appear we didn’t do a comprehensive investigation, but we did … the problem is the delay in time from when the school contacted us and locating evidence. It just starts to diminish,” he said.
According to sheriff’s records obtained by Scripps News, it was not the school that first reported the poisoning to the Siskiyou County Sheriff’s Office.
It was a retired sheriff’s employee who reported the incident to a detective on Oct. 22, 2021, the evening after her poisoning.
That person had learned of the incident through Addison’s family.
On Oct. 25, the deputy arranged for other deputies to “go to Grenada Elementary School and search the classroom,” according to the report. They did not find any clues in the classroom.
“It’s really hard because we can’t locate the source of the fentanyl, and we couldn’t locate enough probable cause to find the suspects,” said LaRue.
Days after Scripps News interviewed the Siskiyou County sheriff, Mott said a detective contacted her, asking to speak to her family again about the case.
