In his final hours, 15-year-old Chanze Laplant used his cellphone for an internet query: "Can you OD on morphine?"
You can, and he did.
The next morning the teen was found dead in his bed at the Bowling Green foster home where he had lived for only six days, the cause of death "multiple drug intoxication" from a mix of substances including morphine and codeine.
As addiction continues to sweep Kentucky, a panel of experts is warning of an alarming rise in cases of children who take drugs that are often found in the home.
From toddlers to teens, a growing number of children are ingesting drugs, sometimes with fatal outcomes, according to members of the Child Fatality and Near Fatality External Review Panel who review cases of child abuse or neglect that result in a death or life-threatening injuries.
Most ingestion cases are by accident. Some, involving older children, are intentional.
“I do feel like we are seeing more of them and more of the ingestion cases are of illicit drugs,” said panel member Dr. Melissa Currie, a pediatric forensic physician with the University of Louisville. “It seems pretty clear that the increase seems to be related to our drug epidemic that we have right now.”
And Currie believes authorities are detecting only a fraction of cases, since parents may not seek help unless their child becomes seriously ill.
Currie, whose department at U of L evaluates children for suspected abuse, said medical staff have begun ordering drug tests on hair samples of children examined for other reasons, such as bruises or broken bones. Drugs remain in hair for months.
"Kids are coming back with their hair positive for methamphetamine, heroin, cocaine —it’s unbelievable," Currie said. "To me, it seems pretty clearly connected to rampant substance abuse."
Even infants are affected, sometimes with tragic consequences.
In Madison, Indiana, police recently arrested a couple after their 3-month-old son died in July from acute methamphetamine ingestion. The parents, Deven Frisque and Tara Savage, acknowledged using the drug and tested positive for it after the infant's death, according to court records.
"I would say that we were surprised that the child had methamphetamine in his system when we saw the autopsy report," said David Sutter, a Jefferson County, Indiana, prosecutor.
Both parents have pleaded not guilty and are being held in jail.
Court records don't indicate how the infant ingested the illegal drug, but experts say children can inhale it if adults smoke methamphetamine around them or can absorb it through the skin by contact.
Drugs also can be transmitted to the fetus by a pregnant woman, which accounts for Kentucky's high rate of babies born with drugs in their system.
In Kentucky, the youngest child to die last year from drug exposure was an infant delivered stillborn at 36 weeks. The cause was acute intoxication from methamphetamine and morphine, according to medical examiner records.
The mother reported injecting heroin during her pregnancy, the records said.
Even small amounts of drugs can be dangerous to young children and infants, said Dr. Ashley Webb, director of the Kentucky Poison Control Center.
"Kids are not just little adults," Webb said. "Their metabolism of drugs is different, which puts them at higher risk."
A report from the Indiana Department of Child Services for fiscal year 2016, the most recent available, listed two other child deaths linked to drug ingestion in cases of abuse or neglect.
A 2-month-old who died from apparent suffocation also was found to have Xanax, a tranquilizer, in her system. A 1-year-old died of acute morphine ingestion believed to be from narcotic pills prescribed to an adult in the home.
In Kentucky, the review panel said incidents involving drug ingestion cases are overtaking head trauma as the leading cause of child death or serious injury from abuse or neglect. While the panel won't have final numbers until the year's end when it produces an annual report, members say they are concerned.
"My sense is that the numbers have greatly increased," said Roger Crittenden, chairman of the panel established in 2012 as an oversight body. "Ingestion has become a real problem."
Last year the panel reported 32 child deaths or near deaths from ingestion, making it the second-highest category behind 34 cases of abusive head trauma, which occurs when a child suffers a brain injury from being beaten or shaken violently. It reviewed a total 150 cases.
This year, the panel has identified 15 cases involving ingestion, compared with 12 of abuse head trauma, and is only about halfway through its review of more than 130 cases from 2016 and 2017.
Most ingestion incidents the panel reviews involve small children getting dangerous substances adults don't secure, including prescription pills and illicit drugs such as heroin or methamphetamine. Some cases involve over-the-counter medications.
Related: Opioid abuse surged in Jefferson County as JCPS drug education fell apart
A 1-year-old Somerset boy nearly died last year after he ate a heroin-soaked cigarette. The child was revived with Narcan, a drug to reverse overdoses, and was flown to the University of Kentucky children's hospital in critical condition. He recovered. Both parents, with a history of drug involvement, were charged with abuse.
A 2-year-old Louisville boy died in 2016 from a morphine overdose after he was reported ill and struggling to breathe by his mother's boyfriend, who was watching him while she worked. The child died at Norton Children's Hospital with the mother and boyfriend denying any knowledge of how the toddler ingested morphine. No one has been charged and a homicide investigation is still pending, according to Louisville Metro Police.A 5-year-old girl in Bell County who died in the last year was found with high levels of Benadryl, an over-the-counter antihistamine in her system. A relative had given her the medication and found her dead in bed. An investigation by social services officials found relatives caring for the girl had given her two adult Benadryl pills for allergies over a four-hour period the night before, an amount a medical provider who had treated the girl previously said could cause "respiratory depression" and death in a small child. While the coroner found the cause of death to be undetermined, the panel concluded the medication contributed, with members saying high levels of the commonly used drug can be dangerous in children.
Suboxone more accessible
Another concern for panel members is that as medically assisted treatment for adults with addiction increases, medications prescribed to relieve cravings for narcotics, such as Suboxone or Subutex, are becoming more common in homes and accessible to children.
Currie said a number of cases the panel reviewed involve such medications that small children ingested, resulting in near-fatalities. In some cases, adults were abusing drugs meant to treat addiction, she said.
"We see a lot of Suboxone and Subutex ingestions," she said. "Very often, it is not actually prescribed to the parent."
And such drugs are highly risky for children.
"That is some dangerous medication for a kid to get a hold of," Currie said. "A pill or even a fragment of a pill can be deadly."
Webb said the poison control center has received a "significant increase" in calls about children getting into medications such as Suboxone.
"That’s been a steady trend over the past several years," she said. "And that’s not surprising because as more people get treatment and have the drug in their home, we do expect to see more exposure. The concern for us is that people aren’t keeping it in a safe place away from and out of sight of the children."
Another concern is Clonidine, a drug commonly prescribed to treat attention deficit disorder.
"That medication tastes sweet and kids tend to eat a lot of it when they get into it," Currie said.
That happened in a recent case the panel studied in which a toddler in Somerset climbed on a dresser, found a bottle of Clonidine prescribed to a teenage relative in the home, opened it and began eating the pills. Her father found her with the open bottle, according to records of the case.
The 20-month-old girl was flown to the UK hospital in critical condition. She recovered.
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'Nothing is childproof'
Webb, with the poison control center, says adults must understand there are no "childproof" containers for medication. While most are considered "child resistant," it doesn't mean kids can't get them open, she said.
"Nothing is childproof," she said. "If they have it long enough, they'll be able to get into it."
Webb said she advises adults to store medicine "up and out sight, not just where they can't reach it."
Also, she said, "Don't take your medication in front of kids. They like to mimic, they don't understand what the consequences are."
However, Webb acknowledged that adults involved in illegal drug use may be less likely to take such precautions — and wary of seeking help for fear of being arrested.
"I think there's a fear of calling," Webb said. "In a couple of cases we've had, it's been clear that the parents avoided calling us or EMS for a period of time hoping they could treat the child."
Kentucky Poison Control Director Dr. Ashley Webb discusses the trends she has seen with calls to Poison Control over the last 10 years. Jeff Faughender, Louisville Courier Journal
Webb said calls to poison control are confidential and adults should always seek immediate help.
"Our job here is to make sure the child gets the best possible medical care," she said.
Experts say while all drug ingestion cases are dangerous, outcomes generally are better for young children because they tend to take smaller amounts and can be treated if discovered quickly.
By contrast, older children may suffer more serious effects, including death, because they are taking the drugs on purpose to get high or to attempt suicide.
"Older kids, and adolescents often intentionally ingest things," said Dr. Brit Anderson, a pediatric emergency physician at Norton Children's Hospital. "These can be particularly dangerous because they can take a large amount of something."
'I can berely type'
In the hours before his death, Chanze Laplant knew he was becoming seriously impaired after drinking codeine cough syrup mixed with a soft drink and snorting crushed morphine pills.
"Bro, I can't even begin to explain," he texted a friend who asked how high Chanze was. "I can berely type."
The next morning he was found dead in bed when his foster parent went to wake him.
State investigators determined Chanze and another foster youth in the home had found the cough syrup in a cabinet. They did not determine how he obtained morphine pills.
The foster father, who had cancer, previously had been prescribed morphine for pain but said he wasn't using the medication at the time of Chanze's death.
The youth, who had been at the home only six days, had just been released from a hospital where he was being treated for issues including substance abuse.
The state later found the foster parents had neglected and failed to supervise children in their care, although the parents "do not believe they contributed to the death of Chanze," according to records of the investigation of the state Cabinet for Health and Family Services, which oversees foster care.
His mother, Michelle Kennedy, of Bowling Green, had turned over custody of Chanze to the state just six months before his death, saying he was beyond her control.
Kennedy, who has a lawsuit pending against the private foster agency that operated the home where Chanze died, declined to comment.
The Warren Circuit Court lawsuit alleges the foster agency and the foster parents' negligence caused Chanze's death. The agency and foster parents denied any wrongdoing.