Fentanyl stole Juniper Rose Knapp's future; her mother wants to make sure it doesn't happen to anyone else

Julie Knapp went to sleep in her tent May 19 with the belief that her daughter had 20 months of sobriety under her belt.

Julie was camping with family at Ashley Lake, a spot with no cell service, that night. Her 16-year-old daughter Juniper had plans to join the family the following day for another night of camping, a pastime all of them enjoyed.

But instead of Juniper, it was Julie’s ex-husband who pulled into the campsite the next morning, coming to deliver the news in person since no one could get through to the campers by phone. Juniper was dead.

The teenager had accidentally overdosed on a pill laced with fentanyl as Julie slept under the night sky.

“She was here, and then she just wasn’t,” Julie said.

ADDICTION IS not one-size-fits-all. Juniper had been in recovery, sober since the end of September 2021. She was not defined by her substance use disorder, Julie said, and will not be defined by it in her death either.

Leading up to that last day, without her parents’ knowledge, Juniper began again experimenting with drugs and alcohol. She wasn’t in an unlit room shooting up heroin, her mother said, she was using marijuana, mushrooms and alcohol. But she had recently begun experimenting with pills.

When Juniper took a pill that she thought was hydrocodone or oxycodone — something her mom thinks she took to help her sleep — she didn’t know it contained a lethal dose of fentanyl. Instead of falling asleep after a fun night at a friend’s house and getting up to meet her family the next day, she went to bed and never woke up.

“Addiction is basically defined by the consequences in a person’s life,” said John Rausch, a licensed addiction counselor and the director of Many Rivers Whole Health’s addiction service line. “It is a medical condition. It’s not necessarily a moral choice and it's not easy for a person to just stop.”

Attorney General Austin Knudsen’s office earlier this year announced a nearly 11,000 percent increase in fentanyl seizures by anti-drug task forces in Montana since 2019, with three times the amount of fentanyl seized in 2022 as in 2021.

“A lot of drugs are cut with fentanyl these days and a lot of the time you don’t know what drugs have fentanyl in them,” Rausch said. “Fentanyl is a very potent, potent opioid and it can take you into an overdose almost immediately.”

A synthetic opioid, fentanyl was originally created as a painkiller for surgery. The drug now dominates the illegal opioid supply, according to the Centers for Disease Control and Prevention.

Fentanyl is roughly 50 times more potent than heroin and 100 times more potent than morphine. Just a small amount can prove to be deadly. If the user is unaware that the drug they bought has been altered and cut with fentanyl, it could easily lead to an overdose.

The drug has legitimate medical use under the supervision of a licensed professional. But illicit fentanyl — in the form of powders, nasal spray or pills — are unregulated and often contain a deadly dosage. Just two milligrams of fentanyl can be lethal, causing the body to go into respiratory failure.

For Juniper, an accidental overdose is what ended her life.

JUNIPER ROSE Knapp, formerly Sophia Rose Knapp, was born in Henderson, Nevada on Sept. 2, 2006 and had lived in Great Falls prior to moving to Kalispell. A bright light, as her mother calls her, she was on track to receive her high school diploma this year, at 16, and was set to graduate from her high school program just two weeks after her death.

The week after she died she got accepted into the Flathead Community College’s art program. She loved art, her mom said, from painting to makeup.

She attended Glacier High School until her sophomore year when she attended a wilderness rehabilitation program at age 15. She had struggled with abusing drugs and alcohol since she was about 12 years old. She was gone for six months and returned sober with a new light, her mom said.

She even got her certified nursing assistant license when she turned 16 and was looking forward to a future of education in the arts.

There were a multitude of factors that led to her addictions, her mom said. Juniper struggled with depression and her mental health, which worsened after the pandemic. Partying was an easy way for Juniper to connect with other kids because it evened the social playing field.

“She was just a 16-year-old kid navigating growing up,” Julie said. “I just want people to know this can happen to anybody. The drugs are there. People are going to take them.”

Illicit drug use, or addiction or any kind, is not unique to the Flathead Valley. But there are ways to get help locally.

Mandie Fleming, the family planning and harm reduction manager at the Flathead City-County Health Department, pointed toward her agency’s programs. Fleming and her colleagues give out fentanyl testing strips, wound care kits and Narcan. Clinics in the valley offer addiction counseling services to help people find a way out of addiction.

“This is affecting everyone in our community,” Fleming said. “Anyone you meet, if you ask if they know someone who has struggled with addiction issues, most people will say yes.”

Narcan is the brand name for naloxone, a medicine that rapidly reverses an opioid overdose. The medicine blocks the effects of opioids like heroin, oxycodone, morphine and fentanyl when someone is actively overdosing. It has no effect on someone who does not have opioids in their system.

It comes in two federally approved forms: injectable and pre-packaged nasal spray. The former is usually injected with a needle into the muscle. The latter comes in a prefilled device that is sprayed into one nostril while the person who is overdosing lays on their back.

It can be given to anyone who shows signs of an overdose or whenever an overdose is suspected. Many clinics give out Narcan for free.

“[Naloxone] needs to be in people’s pockets,” Julie said, “not on the shelves.”

It is important to talk about addiction openly and honestly, Fleming said. Empowering individuals to recognize and respond to an overdose victim is essential to harm reduction. Drugs are everywhere and people will take them, she said, and a lot of times there is uncertainty about what is in them. It is better to be prepared.

“I feel like people always stigmatize the people who use drugs,” Fleming said. “Lots of people from lots of different walks of life have addiction.”

Rausch has had fentanyl addicts come through his clinic. It is more common for patients addicted to other substances to come into contact with fentanyl by accident, usually while taking other drugs. According to Rausch, methamphetamine is common among addicts in the Flathead.

“Right now we have a crisis in addiction and mental health in this area,” Rausch said.

There is a lack of support to help battle substance use disorders at the clinic level, especially as cost of living increases and the available hiring pool shrinks, he said. They need more government support, Rausch said.

Gov. Greg Gianforte said last week that he is willing to lend support to any city or county official who wants to launch a campaign that warns against the dangers of opioids like fentanyl.

“With fentanyl, one pill can kill,” Gianforte told the Inter Lake.

Flathead County is seeing a sharp increase in the use, possession and distribution of dangerous drugs over previous years, according to Sgt. Alan Brooks of the Flathead County Sheriff's Office. Brooks also serves as commander of the Northwest Montana Drug Task Force, which covers six counties and about 17,600 square miles. Cocaine and fentanyl have “significantly increased at the street level,” he said.

The task force seized 40,561 pills containing fentanyl along with 28 grams of fentanyl in powder form in 2022. The byproduct of the growth of the illicit fentanyl trade has been the increase in overdoses in the region.

Tamara Nauts, a licensed addiction therapist with the Montana Primary Care Association, reiterated that addiction is not a choice. As drugs become more common across the community, specifically among the region’s youth, it's essential that people are equipped to deal with the consequences, she said.

“When fentanyl came on the scene, we saw nationwide an increase of at least 20,000 deaths per year. It's laced in many things, it is being produced right now in part by thinking of attracting kids,” Nauts said, referencing how pills sometimes come in colorful and in fun shapes, such as a lego.

Nauts wants people to know help is available. It's important to be aware of your own bias and stigma, she said, especially given the high level of acceptance for the use of drugs, where substances like alcohol and marijuana are used with normalcy.

“It’s not about bad people,” she said. “It's about a medical condition that requires attention.”

AT A MEMORIAL service for Juniper last week, Julie Knapp, with help from the Greater Valley Health Center, gave out 100 doses of naloxone in an hour and a half.

Little cards that showcased Juniper’s art also were doled out, each containing a pouch with juniper seeds in them. They composted Juniper’s body at Recompose in Washington, allowing for the body’s transformation into soil.

Soil that one day juniper might sprout from.

Juniper was not ready to die, Julie said. One pill laced with fentanyl stole away her future.

“There’s no explaining why someone becomes an addict,” Julie said. “I just want to make sure that this doesn’t happen to anyone else.”

Reporter Kate Heston can be reached at kheston@dailyinterlake.com or 758-4459.