The epidemic of opioids: you can not take an excessive dose of fentanyl by touching it

The latest horror story of the opioid epidemic in America: police officers would overdose simply by coming into contact with fentanyl synthetic opioid. In the most recent example, a soldier from the state of Vermont, the acting Sgt. Brett Flansburg reportedly fell ill last week and collapsed in a parking lot after being exposed to small amounts of drugs.

This is not the first time a similar story has been widely reported. This kind of story has really taken off with national reports that a police officer from east Liverpool, Ohio, had collapsed after clearing fentanyl residues from his uniform. And there have been similar reports in California, Massachusetts, Michigan, and Pennsylvania.

But there is a problem: it is extremely unlikely, if not impossible, to overdose fentanyl simply by touching or being close to it. However, contact overdose has been a persistent myth about fentanyl since it began to supplant heroin in much of the illicit opioid supply in the United States.

Yet these stories and the myth they perpetuate are of great importance. They suggest that helping drug users can be dangerous. This can result in unnecessary precautions or new requirements, such as requiring agents to put certain equipment when they respond to an overdose – which could then bring people in need of rapid emergency assistance and without hesitation to get hurt or killed in the meantime.

Fentanyl is dangerous, but touch will not kill you

Fentanyl is a dangerous drug. It's up to 100 times more powerful than morphine and several times more powerful than heroin. It is often mixed or sold as heroin, which means that a person who takes drugs may inadvertently take a much more potent dose than he or she expected. This is one of the main reasons why drug overdose deaths have exploded in recent years, the number of overdose deaths associated with fentanyl and other synthetic opioids (excluding methadone) has been multiplied by 10 since 2011.

But fentanyl is dangerous only when it is truly ingested – by smothering it or injecting it into the bloodstream. The American College of Medical Toxicology issued a position statement in which it was stated in 2017: "It is highly unlikely that a small unintentional exposure of the skin to tablets or powder causes a significant toxicity of opioids. , time for kidnapping. "

Maia Szalavitz also reported this myth for Tonic, quoting medical experts:

Jeremy Faust, an instructor at Harvard Medical School and an emergency physician at Brigham and Women's Hospital, treated many fentanyl victims in the emergency room. "It's just not a substance easily absorbed by the skin," pointing out that pharmaceutical companies have spent many years and millions of dollars developing a technology that allows a patch to deliver the drug through the skin.

If that does not convince you, Chad Sabora, a harm reduction activist in St. Louis, posted a video in which he had heroin cut with fentanyl and carfentanil (a more potent synthetic opioid). As you can see, he is fine:

A recurring theme in these stories is that police could not be resuscitated after multiple doses of naloxone, an antidote for opioid overdose, which is usually a way to suggest how serious the overdose was.

But there is another possibility: maybe naloxone could not revive the person because it was not overdose of opioids. Naloxone may, in some cases, require several doses to act, but it will eventually work; If this is not the case, it is probably not an overdose of opioids.

Why the myth of fentanyl is dangerous

So what's going on with these cops? It's hard to say and no one knows for sure. One possibility is panic attacks. While the media reports how dangerous fentanyl and other synthetic opioids are, some cops may have been convinced that the drug could cause an overdose if you touched it. They panic therefore, mainly under the nocebo effect. If this is true, the spread of this myth could hurt more police by potentially exposing them to unnecessary panic.

The good news is that until now, no policeman has died as a result of these clashes.

This myth, however, can be dangerous. If they believe in this myth, emergency response services may be required to require overdose personnel to wear safety equipment – gloves, masks, protective suits, and so on. But when you react to an overdose, every second counts. Inverting an overdose a few seconds or minutes earlier can prevent brain damage or death.

Thus, forcing emergency teams to put unnecessary equipment in seconds or minutes could put overdose victims in real danger, which could actually cause someone to die from overdose.

To learn more about fentanyl, read the Vox Exploder.