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(NEW YORK) — In the first 18 months of the COVID-19 pandemic, a record number of Americans died from drug overdoses. Although months of data is still incomplete, statistics show that most of the deaths involve the potent drug fentanyl.

According to the National Institute of Drug Abuse, fentanyl is 50 to 100 times more potent than morphine. In the new series “Poisoned,” which explores the devastation caused by fentanyl, ABC News Live examines how many parents are learning the deadly reality of the drug only after their children have suffered a fatal overdose.

Romello Marchman grew up in Nashville, Tennessee. His mother said that he was a typical 22-year-old man who loved video games and cars.

“He was a young man like so many others out there,” said Tanja Jacobs. “They are stressed, they are worried. The pandemic keeps them away from their friends. They can’t go to school.”

During the pandemic, Romello Marchman died from cocaine laced with fentanyl, according to Jacobs.

“He got it from his friends. And it’s the only reason why he took it, is because he did get it from his friends and he did trust them,” said Jacobs.

Last year, Tennessee had the third highest overdose death rate in the country, according to the National Institute of Drug Abuse.

“In the Nashville area, between 75% and 80% of our fatal overdoses will involve fentanyl at this point in time,” said Trevor Henderson, a public health analyst at the CDC Foundation.

That statistic accounts for the death of Frankita Davis.

Betty Davis said her daughter was diagnosed with cancer when she was 17 years old and that doctors had prescribed her pain medication. One day, a friend offered her daughter a pain-reliever pill that they did not know was laced with fentanyl, the mother said.

“She chose to take a pill, but she didn’t choose to die,” said Davis.

Fentanyl, which was originally made for sedation during surgery, is one of the most powerful opioids ever created. Fentanyl-related fatalities began to skyrocket nationwide after drug dealers and cartels began to lace the chemical into drugs that they were already selling, often targeting addicted users looking for a more powerful high, according to the United States Drug Enforcement Administration.

“A few grains of fentanyl will make you high. A couple more will kill you,” said Sam Quinones, who authored a book on the U.S. opioid crisis. “It’s just so potent and so profitable… Dealers are seeing that this is something they could sell in all manner of ways and to all manner of customers.”

Candice Sexton, a Nashville coroner, keeps a growing list of people dying with fentanyl in their systems. In 2016, her office noted 102 deaths related to fentanyl in middle Tennessee alone.

Every year since, those numbers have nearly doubled, Sexton said.

“It was just mind boggling,” she added.

In 2021, Sexton’s office reported nearly 1,200 fentanyl-related deaths. She said she expects 2022 to be even higher.

“We are on track for it to be worse,” said Sexton. “We have outgrown our cooler. We have a FEMA trailer that they’re allowing us to use as well for additional storage.”

Phil Bogard is a program administrator at Rock to Recovery, a recovery clinic in Nashville for women suffering from addiction.

”In 2018, I remember people coming in for heroin,” said Bogard. “Now nobody’s coming in saying, ‘I’m here for heroin.’ People are walking in the door saying ‘I’m here for fentanyl.’”

Naloxone, otherwise known as Narcan, reverses an opioid overdose. First responders said they are often administering multiple doses of Narcan just to resuscitate one person.

In Nashville, Henderson leads a small team of five people monitoring the fentanyl epidemic. One of their main goals is to distribute Narcan in parts of the city that have high numbers of overdoses.

“We can identify hotspots of activity. So we can look at ZIP codes that are hit particularly hard,” said Henderson.

Unfortunately, the growing number of fentanyl-related deaths is not unique to Nashville, but a scene playing out across the country. Like many other parents, Jacobs has been trying to spread the word about the dangers of fentanyl.

She said she is against the use of the word “overdose” and prefers to use the word “poison.”

“If you take too much of something, you overdose. You might or might not die,” she said. “But once that fentanyl is in there, if you get something you haven’t asked for and then you die from it – it’s poisoning, which makes it a murder.”

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(SAN DIEGO) — A 2-year-old girl who spent the first two years of her life in the hospital is back home with her parents and younger brother in California.

It was a joyous homecoming for Addy Smith, who left the hospital on April 5 after 848 days of treatment at two different San Diego hospitals.

Addy was born via cesarean section on Dec. 10, 2019, at 27 weeks and four days at Sharp Mary Birch Hospital for Women & Newborns in San Diego, where she first received treatment. She was small for her age and according to her parents, was diagnosed with intrauterine growth restriction while still in the womb. IUGR, also known as fetal growth restriction or FGR, is a condition where a baby doesn’t grow at a normal rate in the womb and can lead to a lower weight at birth, according to the American Academy of Family Physicians.

Addy’s parents, Aliesha and Chris Smith, had struggled for seven years with infertility, and at one point were told they weren’t able to have children. They tried several intrauterine insemination procedures that were unsuccessful but then got pregnant one month before they were supposed to begin the in vitro fertilization process.

“We had tried so long. It was never ever on the table, never an option to not see things through with her and not give her a chance,” Chris Smith, 36, recalled to ABC News’ Good Morning America. “The OB (obstetrician) had told us, she just painted a picture of what it would be like for the next, at least couple years, and the rest of her life and we were really like, ‘OK, let’s go. Let’s saddle up and this is what was meant to be.'”

At Sharp Mary Birch, Addy seemed to be making progress, despite her underdeveloped lungs, moving from a ventilator to a continuous positive airway pressure, or CPAP, machine to help her breathe. But three months after her birth, Addy took a turn for the worse, when she stopped breathing.

“The doctors did not think she was going to make it and we were getting ready to say our goodbyes,” Aliesha Smith, 35, recalled to GMA.

Doctors had to work on Addy for over an hour to resuscitate her, but the team at Sharp Mary Birch told Aliesha and Chris that in order to give Addy a fighting chance, she’d have to be transferred to Rady Children’s Hospital.

Addy was quickly admitted to Rady’s neonatal intensive care unit in March 2020, the same month when COVID-19 was declared a national emergency. Aliesha and Chris Smith also moved into a friend’s recreational vehicle so they could split up time with Addy after the hospital changed their protocols due to COVID-19 and only allowed one parent to stay at Addy’s bedside at a time.

“She was so critical, so critical, that we had a friend that let us use their RV. And so we parked on the street and that’s where one of us would be when one of us would be up by her room,” Aliesha explained, adding that Addy coded two more times on her first two days at Rady.

Dr. Sandeep Khanna, a pediatric intensivist and the medical director of the pediatric intensive care unit at Rady Children’s Hospital, treated Addy, who had chronic lung disease and had trouble breathing on her own, for over a year in the PICU.

“She was a challenge,” Khanna told GMA. “She was having periods when the air exchange was very difficult on her and we had to give her heavy amounts of sedation to relax her, and sometimes even the heavy, heavy amounts of sedation did not work.”

“The only thing which helped us through was that we had to give her a paralyzing medication after heavy sedation,” Khanna continued. “It was tricky because sometimes those episodes would resolve [after] maybe 30 minutes or an hour. But sometimes she would have periods of those episodes maybe 10 times a day and she would continue to have it for like seven to 10 days. And it was hard to wean her from heavy sedation and muscle relaxation medications. And that’s why she was stuck in the hospital.”

For months, Addy was on some form of paralytic drug, but the Smiths never gave up on Addy, even when her care team, like Khanna, didn’t have any clear answers or solutions.

“I was sitting with [Chris] in the room and I said, ‘Look, the way things are going, Chris, I don’t know when she will go home. I think this might take years. It might take decades, even,'” Khanna recalled. “We are not saying we’re quitting but I’m just telling you that you should be prepared for that. And he said, ‘Well, she’s driving the bus. Keep doing it.’ So we did it.”

“We were always on the same page,” Aliesha added. “We always knew what the end goal was, which was to get her home. And we always made an agreement, Addy is going to tell us when she’s not ready. And if we started questioning that and we would pray about it and say like, ‘God, please give me a sign, tell me if it’s time to stop or if it’s time to keep going.'”

Khanna said there were many factors in Addy’s case but letting her grow in the PICU under the care of her nurses and medical team seemed to help with her breathing episodes, as her lungs continued to develop. Physical therapy also helped with her muscle rigidity and her lungs seemed to improve as her muscles strengthened. By February and March 2022, Addy didn’t have any bronchoconstriction, or muscle spasms in the lungs, when she couldn’t breathe.

The last two years have been extremely difficult for the Smiths but one of their bright spots was finding out they were expecting again. The couple welcomed their second child, a healthy baby boy named Aiden, last year.

Aiden was able to join his parents and accompany his older sister home two weeks ago and they’re getting to know each other already.

“She starts cracking up when he’s laughing or when he’s screaming. She cracks up and it’s funny to see them interact,” Aliesha said. “We’ve taken them on walks together out in the neighborhood, which has been so fun to do.”

Even though Addy still needs to use a ventilator at home for now, Aliesha and Chris are full of hope for their oldest child and want to pass along their hope to others.

“It’s been miracle after miracle with her,” Chris said. “We’re both so excited to see where she goes and what she can do. And I know she’s always going to continue to blow us away and surprise us.”

“I’m hoping we can give another family hope. We felt very alone during this whole thing and if her story can give another family that may be going through something so similar … if we can give them that little peace, I know it would have meant everything to us, as well,” he added.

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