Overdose of fentanyl can not happen by simply touching the drug, experts say

DETROIT – The stories are scary: They say that cops across the country have overdosed by accidentally touching fentanyl while rummaging cars in traffic jams or providing first aid.

Except that toxicologists say that stories too are wrong – and that they create unnecessary panic. Touching a small amount of fentanyl will not cause an overdose, experts say.

"If you could absorb the drugs by touching them, why would people bother to inject them?" Said Dr. Andrew Stolbach, a toxicologist and emergency physician at Johns Hopkins Hospital in Baltimore. He is also an expert in fentanyl exposure.

"Medications like fentanyl and fentanyl analogues are not absorbed by the skin at all," said Stolbach. A brief and accidental contact will not cause a person to absorb a therapeutic dose, let alone a toxic dose.

So what is fentanyl, anyway?

Fentanyl is a synthetic opioid 50 times more potent than heroin and up to 100 times more potent than morphine. There are many varieties or the like. Carfentanil, intended for use as a tranquilizer for elephants, is one such analog. It's 100 times stronger than fentanyl.

Pharmaceutical fentanyl is used in hospitals, often as a patch, in patients with extreme pain. But even then, said Dr. Ryan Marino, an emergency physician and toxicologist at the University of Pittsburgh Medical Center, it's not easy to absorb.

"Fentanyl patches require placing fentanyl in special liquid vehicles so that it can be absorbed through the skin and then seal it against the skin for 72 hours at a time," said Marino.

"Patches have taken decades and millions of dollars to grow and are still incredibly slow and inefficient."

Illicit fentanyl is what is sold on the street and with which first responders come into contact. It is mixed with heroin or other drugs, often without the knowledge of the user.

Snorted, injected or sometimes swallowed in pills, the US Centers for Disease Prevention and Prevention and Preventinon claim that fentanyl is the country's deadliest drug, responsible for more deaths than any other drug.

In 2017, according to the CDC, more than 28,000 overdose deaths in the country involved synthetic opioids. In most cases, the opioid in question was fentanyl or one of its analogues.

Lemont Gore, who works with drug addicts as street coordinator for Unified HIV Health and Beyond in Ypsilanti, Michigan, said he was unaware that there would have been an overdose caused by fentanyl.

"The person who sells fentanyl (…) this person, for the most part, I doubt it's a chemist and they handle it," Gore said.

In addition to this, the experts said that involuntary inhalation overdose of fentanyl is difficult because the opioid is not found naturally in the air.

For this to happen, someone should scatter it in the air. Or, as Marino said, "you'd have to be in a kind of wind tunnel with massive amounts of fentanyl.

"It would not exist in the real world," he said.

The most likely unintentional exposure route would be: Someone who has fentanyl on their hands rubs it in their eyes or nose; the mucous membranes absorb fentanyl.

But being so reckless would be at odds with the universal precautions that first responders are trained to take, said Marino.

Police remember supposed fentanyl encounters

There are still reports of law enforcement officers becoming ill after touching fentanyl throughout the country, most recently in Iowa, Massachusetts, Rhode Island, and Arizona. In Michigan, two cases of accidental exposure were reported last month.

A Michigan state police officer fell ill after having a stuff on his hands during a roadside check in Lincoln Park mid-March, the agency said.

"We are pretty confident that it was fentanyl just the way he reacted," said First Lieutenant Mike Shaw's spokesman.

Signs of an overdose of fentanyl include slowing of breathing, wheezing or loss of consciousness, and pupils looking like sharp pins. The soldier had difficulty breathing and locating pupils, Shaw said.

When toxicologists said that it was impossible to overdose when touching fentanyl, Shaw said he would not argue with scientists.

"All I know is that the soldier was searching the car, exposed to something, got sick and received two doses of Narcan and was cured," said the door. -speak of the police. Narcan is an anti-opioid medicine.

Another officer fell ill while rummaging through a car during a roadside check in March in Saginaw. According to Lt. Jim Lang, an assistant commander in the area, the contents of a package entered the uniform of the soldier.

The rider has returned to his own car. After 10 or 15 minutes, he felt dizzy and dizzy, Lang said. He had a double vision. He felt the blood running to his head.

After two doses of Narcan – one that he administered himself – the soldier recovered. Laboratory results confirmed that the substance in question contained fentanyl, Lang said.

So what is really happening to the police?

The American College of Medical Toxicology and the American Academy of Clinical Toxicology have published an article in 2017 stating that the probabilities of overdose among first responders resulting from accidental contact with fenanyl in the workplace are "extremely weak".

So, what happens to these first responders?

"You can not overdose by accidentally touching fentanyl, the odds are zero," said Marino.

"The police are getting sick – in fact, sick – because of bad information, although they do not overdose, but the bad information is … have serious consequences. . "

He and other experts believe that the police response is fueled by panic.

"The vast majority of emergency responders surrounding fentanyl and fentanyl analogues have no symptoms," Stolbach said.

But for those who have symptoms, he said, "the anxiety associated with being involved in an exposure is probably responsible for many of these symptoms."

Overdose stories inadvertently create hysteria, which can lead to delays in the treatment of drug addicts.

"I've heard stories where people would wait and put on combinations of hazardous materials," Marino said. "And when people do not breathe, the weather is a bit critical."

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