In the U.S., someone dies of a drug overdose about every five minutes. In 2022, more than 111,000 people died as a result of an overdose. One of those people was Marissa Ladatto, a 21-year-old college student from Duncanville who was killed by a fentanyl overdose just before midnight on Dec. 30, 2022.
She was the only child of her parents, Amy Brewer and Mark Garbade. With Ladatto’s death, everything they had planned for the future — college graduation, seeing their daughter walk down the aisle, grandkids — was gone.
“When she died, our future died,” Brewer said.
In Dallas County, drug overdoses and overdose deaths have steadily risen over the past few years. Fentanyl, a synthetic opioid normally used to treat pain in hospitals, is responsible for a large percentage of deaths, according to a community needs assessment.
The report, from Dallas County Health and Human Services and the Recovery Resource Council, was released this month. It is the first such study done by the county health department and was funded by a grant from the Centers for Disease Control and Prevention.
DCHHS director Dr. Philip Huang said the grant is part of a CDC program called Overdose Data to Action, which provides funding to 90 health departments across the U.S. to study overdose data and find ways to reduce overdoses.
The study showed that hospitalizations for drug overdoses have steadily increased each year since 2018, with 2,419 overdoses reported in 2018 compared with 3,818 reported in 2023. Overdoses increased by about 550 from the previous year.
The study also notes these figures likely don’t reflect the true number of overdoses in Dallas County because they do not include unreported overdoses or overdose cases where a patient is not taken to the hospital.
The study also showed that drug and alcohol-related poisoning deaths, otherwise known as overdose deaths, have increased 81% since 2019. In 2019, 347 people reportedly died of an overdose, compared with 648 in 2023, according to the report.
Fentanyl has become the dominant drug involved in overdose-related deaths, the study reported. In 2018, synthetic fentanyl was only responsible for 11.4% of all overdose deaths in Dallas-Fort Worth. In 2022, 70.5% of all overdose deaths in D-FW were related to fentanyl, according to the study.
According to the DCHHS data dashboard, in Dallas County, fentanyl was responsible for 282 overdose deaths in 2023. Comparatively, Dallas saw 246 homicides in the same year.
The number of fentanyl-related overdoses has increased steadily since 2019, when only 25 overdoses were linked to fentanyl, per DCHHS numbers.
A potent killer
Dr. Kurt Kleinschmidt, a toxicologist, emergency medicine specialist and medical director of Parkland Memorial Hospital’s Perinatal Intervention Program, said that just two years ago, about 90% of the opioid overdose or addiction cases at Parkland were from heroin. Now, they’re 90% fentanyl.
Kleinschmidt said part of the big increase in fentanyl overdose cases comes from other drugs being laced with the synthetic opioid. Many patients are surprised to find out they had taken fentanyl. Parkland has seen cases where patients believe they took counterfeit prescription pills, heroin, cocaine and methamphetamine and ended up with fentanyl, Kleinschmidt said.
But some people are actively seeking out fentanyl, Kleinschmidt said. The drug is far more potent than other opioids like heroin and is cheaper, too, he said, making it more appealing to opioid addicts.
“The word on the street is clearly that it is more potent and, in addition, the pricing is better,” Kleinschmidt said. “If I get something with a little better price and it actually has more potency, if you’re a person with an opioid addiction, that will certainly be an attractive thing.”
On Dec. 30, 2022, Garbade went into Ladatto‘s room at the family’s Duncanville home. It was just before midnight, and Garbade wanted to check on her and make sure she had taken her medication. He found her unresponsive. She had overdosed on fentanyl at the age of 21.
“I heard the most awful scream from him and I ran to her room,” Brewer said. “She was laying there. She had foam, and a little bit of blood. I slapped her face and I shook her, and said, ‘Wake up Marissa.’ The next thing I knew, an officer was moving me away from her.”
Brewer said she believes Ladatto knew she was getting fentanyl, but believed the pill she took was a mix of fentanyl and Percocet. Ladatto had gotten the pill from a good friend of hers, who is now facing charges of delivery of a controlled substance and evidence tampering in relation to Ladatto’s death.
Brewer said she had no idea her daughter did drugs until a few months before her death, when she admitted to Brewer she had been experimenting with different drugs. Ladatto swore she had stopped, and Brewer believed her.
Ladatto had struggled with her mental health, which may have led her to try drugs, Brewer said. She had been going through a lot mentally in the years leading up to her death, including the death of several close friends and family members, Brewer said.
At the time of her death, Ladatto was a student at Dallas College, studying to become a teacher. She loved to sing, and had an extremely outgoing personality, making friends with as many people as possible.
“She lit up a room,” Brewer said. “She still shines.”
More resources needed
While the study notes that Dallas County has made strides toward harm reduction strategies, roadblocks have been set in place by the state government and “war on drugs” policies. The study mentions that fentanyl test strips, a method to test illicit drugs for fentanyl, are illegal in Texas. The state also does not have a clean needle program, something the study said is a key harm-reduction strategy in curbing the spread of infectious diseases among drug users.
Huang said more inpatient facilities are needed in Dallas County to provide help to those in need, and said harm reduction strategies are needed to reduce overdoses.
“More treatment resources, more inpatient facilities that serve some of these populations that don’t have access to that,” Huang said. “Some of the policies that we don’t have, things like fentanyl test strips and things that are sort of state-level policies. Syringe exchange programs have some controversy, but again, can have public documented public health benefits.”
Huang said other large cities in Texas, such as Houston or San Antonio, have also seen increases in overdoses in recent years.
While Huang said there may be room for improvement in the number of treatment facilities in Dallas, Kleinschmidt said Parkland is always ready to accept patients seeking treatment for their drug addiction. The perinatal clinic that Kleinschmidt runs helps pregnant women who are addicts, and the hospital also has many community partners, such as Nexus in East Dallas or Homeward Bound, which has several locations in the Dallas area.
Kleinschmidt said treatment for opioid addiction includes methadone, a drug that can counter the effects of opiate withdrawal, which can be life-threatening. Methadone is an opioid itself, Kleinschmidt said, but has a slower onset and lasts longer. Patients take methadone doses daily for a few months until they are able to wean themselves off.
Kleinschmidt said the treatments for opioid addiction can be life-saving.
“The best treatment by far is medication,” Kleinschmidt said. “It’s more important than even some of the counseling and rehab. The best treatment is both of them together.”
For Garbade and Brewer, they believe education about the dangers of fentanyl can prevent people from taking the drug in the first place. A few months after Ladatto’s death, they started Marissa’s Voice, a nonprofit dedicated to spreading awareness about fentanyl to honor their daughter’s memory.
Brewer said they participated in the Dallas Police Department’s Youth Empowerment Expo and have spoken at other events to spread awareness of fentanyl among youth, a group especially at risk regarding fentanyl. According to the Drug Enforcement Administration, the leading cause of death for Americans age 18 to 45 is fentanyl poisoning.
Brewer said one thing she and her husband want to see is a wider availability of Narcan, the brand name of the drug naloxone, which can be used to reverse the effects of an opioid overdose if administered quickly enough.
Brewer said the death of Ladatto led her and Garbade to make sure no one else loses their loved ones to fentanyl.
“We want to afford other people the opportunity to have grandchildren,” Brewer said.
