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On the morning of January 31, U.S. District Court Judge William L. Osteen wondered aloud whether any sentence he might impose on a Durham drug dealer would do anything to keep Triangle college students from using illicit drugs.
The dealer in question, Cye Frasier, pleaded guilty in October to charges that sprung from two deaths a day apart last year. Joshua Skip Zinner, 23, a former student at UNC-Wilmington, died in Raleigh on March 10. Elizabeth Grace Burton, 19, a student at UNC-Chapel Hill, died on March 11, two days after paramedics found her unconscious body in a dorm room at Duke University.
Both had consumed fentanyl-laced cocaine that Frasier supplied. He and an accomplice, Carlisa Allen, were charged with distributing cocaine and fentanyl that led to Zinner’s death. Allen was found guilty after a trial. No one has been charged with Burton’s death, leaving her family deeply disappointed.
Osteen ultimately pushed the sentencing to next month to give him time to consider whether Frasier, a haircutter who was known to student customers as “The Barber,” knew the cocaine he sold was laced with fentanyl. But the veteran judge, who was holding court in Greensboro, debated whether any sentence would make a difference when college students are using cocaine so casually.
He noted that three years ago, law-enforcement agencies arrested 21 people who sold marijuana, cocaine, and other drugs at Duke, UNC-Chapel Hill, and Appalachian State University. “How long,” he said, “are we going to tolerate it?”
His question reverberates on the campuses. A UNC-CH official told campus trustees last summer that three students and one young alumnus had died of fentanyl poisoning in the prior 20 months. UNC-CH said nothing publicly about Burton’s death, or the three recent overdose deaths.
Dean Blackburn, UNC-CH’s director of student wellness, disclosed the overdose deaths at a board of trustees meeting in July. He declined to be interviewed by The Assembly.
The chair of UNC-CH’s Board of Trustees wants the school to do a better job of educating students about the risks of using cocaine.
“My hope would be that there’d be a greater emphasis on acknowledging the obvious reality that fentanyl poses a terrible threat to all students on any college campus today,” chair John Preyer told The Assembly.
Preyer, who lives in Chapel Hill, said he spoke with interim Chancellor Lee Roberts about the university doing more about the risk of drug use now that fentanyl is so widely circulated. There should be a “much greater public awareness that this will kill you,” Preyer said.
“It’s a tragedy on multiple levels,” he said of Burton’s death. “The tragic loss of life, and the tragic inability to communicate the risk by both UNC’s communications department and by Duke University.”
No Public Statement
Neither Duke nor UNC-CH has made a public statement about Burton’s death, either before or after The Assembly first reported on it last October.
UNC-CH board member Perrin Jones said he spoke with former chancellor Kevin Guskiewicz shortly after Burton’s death, and both agreed it was important to respect the family’s desire for privacy. “Unfortunately, there is a pretty significant stigma that is associated with these types of deaths,” said Jones, an anesthesiologist from Greenville, N.C.
Even if UNC-CH had made an announcement without naming Burton, people could have put the pieces together and identified her, Jones said.
Chloe McCotter, a university spokesperson, said that the families of the recently deceased told Blackburn about the overdose deaths directly. The university does not track student deaths or causes of death, McCotter said.
North Carolina State University is another school in the UNC System that has wrestled with student deaths, mostly from suicide. Unlike UNC-Chapel Hill, NCSU does track student deaths and their cause to provide support for those who are impacted, spokesperson Mick Kulikowski said, although it is “not necessarily a formal tracking mechanism.”
As a matter of policy, UNC Police only sends out campus-wide notifications if the death poses a threat to others in the university community. The university also considers the wishes of the deceased’s family.
“It’s a tragedy on multiple levels.The tragic loss of life, and the tragic inability to communicate the risk by both UNC’s communications department and by Duke University.”
John Preyer, chair of UNC-CH’s Board of Trustees
Frank Tramble, vice president of communications at Duke, said that since Burton was not a Duke student, they deferred to UNC-CH. However, “Duke’s general practice is to promptly communicate when a member of our community passes away,” he said.
Nabarun Dasgupta, a UNC-CH scientist who has been involved in opioid overdose prevention research for 20 years, said while perhaps UNC-CH could have sent an alert about the risk of fentanyl, public health communications research has found that such mass messaging is not effective.
“If the communication comes from an authority, it loses the power of the personal connection,” he said.
The most effective communication about fentanyl happens between peers, Dasgupta said. An alert should come in the form of something people want to post, text to each other, or show someone in person.
He envisions students in the community working with faculty to develop messages with information about campus and local resources, testimonials, and what rights students have, using tools such as an Instagram account. Students can use their connections to disseminate those messages into “the network of students who are using together,” such as Greek organizations, sports teams, and clubs.
The message can’t just be, “there is fentanyl in coke,” Dasgupta said. It should emphasize how to get naloxone.
Reversing Overdoses
Dealers sometimes add fentanyl to cocaine because it’s cheaper and increases the potency. But even in small amounts, fentanyl can kill.
Orange County Sheriff Charles Blackwood, whose department investigated Frasier and Allen, said fentanyl is 100 times more potent than morphine. It depresses the respiratory system, slowing down breathing and preventing the brain from getting enough oxygen.
Naloxone is an injectable medication that reverses opioid overdoses, and Narcan is a nasal spray version. Both work by blocking the receptors that fentanyl affects, which can keep people breathing. The amount of doses required can vary with a person’s tolerance and how much fentanyl is in their body. Blackwood said that because of its potency, fentanyl overdose reversal might take several doses.
Dasgupta noted that based on national EMS data, one to two doses, or between 4 and 5 mg, is usually effective for both fentanyl and other opioids.
Both said that naloxone should be widely available. But people should call 911 immediately so that medics, who have equipment to support breathing, arrive as soon as possible.
A couple of weeks into the fall 2023 semester and about six months after Burton’s death, UNC Student Wellness set up a table on campus with Narcan, a nasal spray version of naloxone, in honor of International Overdose Awareness Day.
They distributed about 75 kits with Narcan and educational materials, McCotter said. In 2023, the university’s pharmacies distributed 167 kits.
“Providing naloxone does not increase drug use. It increases safety.”
Scott Weiner, emergency physician
The Student Wellness table came after UNC students Caroline Clodfelter, Riley Sullivan, Callan Baruch, and Kathleen Ready formed the Carolina Harm Reduction Union, which has handed out more than 1,150 naloxone kits and 300 fentanyl testing strips since last fall.
At least three overdoses have been reversed as a result of their efforts, the students said.
The students initially sought a more direct partnership with the university, but said that some campus administrators indicated they felt that students shouldn’t be handling overdose mitigation.
Each week, the students set up a table at a central part of campus called “the Pit.” For about two hours, they hand out naloxone kits and walk students through a step-by-step tutorial on how to inject it, Clodfelter and Sullivan said.
They offer to demonstrate and allow students to practice going through the motions until they’re comfortable administering naloxone. Carolina Harm Reduction Union members also explain how to recognize an overdose and call 911.
The national nonprofit Remedy Alliance for the People provides the naloxone, which is cheaper than the nasal spray version, Narcan, and trains the student leaders.
Reaching Fraternities
Carolina Harm Reduction Union has also met with eight campus clubs and social groups. Four of those are Greek organizations, including Zeta Tau Alpha, where Burton was a member.
They said they have not met with or approached the Delta Kappa Epsilon fraternity, several of whose members and former members testified in Allen’s trial. Neither have they worked with Sigma Alpha Epsilon, where Burton frequently socialized, including the night before she overdosed.
Clodfelter and Sullivan said they hope to spread their efforts to other campus groups and other universities. Guskiewicz, UNC-CH’s former chancellor, referred them to Innovate Carolina, a school-wide entrepreneurship initiative, to help them establish as a nonprofit and expand its reach.
Aside from the student-driven efforts, McCotter, the university spokesperson, said that Narcan is available “for free, without a prescription, and anonymously” at Campus Health Pharmacy and Student Stores Pharmacy. A statewide standing order permits pharmacists to dispense naloxone.
However, several students who spoke to The Assembly said that the availability of Narcan is not widely known.
“It’s a passive system,” Sullivan said. “I don’t think a lot of people even know about its existence.”
Student Wellness should make all students aware that Narcan is available for free, a UNC-CH student wrote to The Assembly and asked to be anonymous. He said students should also be able to easily obtain testing strips that can indicate whether drugs contain fentanyl, the way “campuses provide free condoms at different locations.”
McCotter also said the school publishes an annual Drug and Alcohol Prevention Program report that is sent to all faculty, staff, and students, “with warnings about alcohol consumption and drug abuse, as well as resources available to the campus community.”
Several students and board members said they were unaware of this report.
McCotter said Student Wellness uses several strategies to address the risks of substance abuse. She noted UNC-CH’s recovery programs, educational outreach, and harm reduction models.
Dasgupta said the university provides off-campus housing for people recovering from drug disorders that are staffed by counselors who struggled with addiction while they were at UNC-CH.
Duke’s campus pharmacy provides free Narcan to students on school health insurance and at varying prices for others. Students there are also working with the administration to put boxes of free, over-the-counter Narcan in each dorm, and to advertise it.
Shortly after Burton’s death, student Eddie Scott formed the Drug Overdose Prevention and Education Project, or DOPE, which has since trained almost every fraternity in how to use Narcan, the nasal spray. Those that haven’t been trained yet are scheduled to be trained this spring and Scott hopes to train people who reside in dorms.
The university “has been very supportive of all these efforts,” Scott said.
Preyer, the UNC-CH board chairman, has doubts about the naloxone approach. He worries that with easy access to naloxone, students will be less diligent about avoiding drugs.
“I don’t want the students doing drugs,” he said. “In 2024, you run the risk of killing yourself the second that you ingest something that’s laced with fentanyl.”
Scott Weiner, an emergency physician at Brigham and Women’s Hospital in Boston, led a study on naloxone’s effectiveness. The sooner a person experiencing an overdose gets naloxone, the sooner the person will improve, he said.
“Providing naloxone does not increase drug use,” Weiner said. “It increases safety.”
Pervasive Drug Culture
In the federal court in Greensboro last week, Josh Zinner’s father told the judge that his son and Grace Burton were killed by “Mr. Frasier’s poison.”
“This is murder,” Cliff Zinner said.
James Burton, Grace’s uncle, also addressed the judge. Lisa Burton, Grace’s mother, sat in the back row and whispered her daughter’s name. Then she broke into tears.
As he spoke, James Burton’s voice cracked. He told Osteen that she was “murdered for $40.” Frasier, he said, preyed on young people like Grace.
She had met a Duke student, Patrick Rowland, who picked her up in Chapel Hill in the early morning hours of March 9. Around 4 a.m., Grace told Rowland she wanted to do cocaine, according to court testimony. She called Frasier, who came to campus and sold them cocaine.
Rowland has said he became so sick that he vomited for the next 19 hours. Grace lost consciousness. Rowland called Frasier, who came back to campus and carried Grace up to Rowland’s dorm room.
James Burton said Frasier was callous. “He didn’t call 911,” Burton said. “He didn’t seek help. He left her there to die.”
But James Quander, Frasier’s attorney, said Frasier had no idea that the cocaine he sold was laced with fentanyl.
Prosecutors presented evidence at Allen’s trial that she had a note in her phone’s Notes App describing the amount of fentanyl one can add to cocaine to increase its quantity and quality. The note also included instructions for how to dilute cocaine with fentanyl. DEA agent Stephen Razik said the note was a formula for making as much money as possible.
Prosecutors emphasized the last line in the note in which Allen says to wear a mask and gloves “while working.” They pointed to that line as proof that Allen knew fentanyl is deadly.
Judge Osteen said it was inconceivable that Frasier wasn’t aware that Allen was lacing cocaine with fentanyl.
But in the end, Osteen said, giving Frasier a long sentence won’t solve the bigger problem—a culture of casual drug use among college students.
“So long as this activity—drug use—is promoted on these college campuses, people are going to take Mr. Frasier’s place and Ms. Allen’s place,” he said.
Charlotte Kramon, a Duke University senior from Los Angeles, worked for the Los Angeles Times last summer and reports for The Ninth Street Journal. Her email is charlotte.kramon@duke.edu.
Michael Hewlett is a staff reporter at The Assembly. He was previously the legal affairs reporter at the Winston-Salem Journal. You can reach him at michael@theassemblync.com.