Fentanyl as Politically Motivated Scare-Lore

It all began on Twitter. I was reading an informative thread about the panic surrounding “contact-overdoses” from fentanyl (mainly among law enforcement officers). I noticed that some commenters were asking fair questions and being lambasted for politely daring to reveal their lack of expertise regarding the chemical properties of fentanyl and its effects on the human body, then having the audacity to express their desire for further clarification. “I fully RESENT these people's desire to better understand this subject!!” is what I’d probably be saying if I had the same awful attitude as those on the thread who, while correctly calling out fentanyl myths, were acting like total jerks. Rather than jump into the fray and fight literally everyone, I embarked upon a frenzied and messy voyage through the fraught seas of fentanyl fact and fiction. You see, I am a provider, and today I’m here to provide you with the clarity at least seven people were deprived of on that Twitter thread a few days ago. Put simply, contact overdoses (overdoses from short-term skin contact with fentanyl and other high potency synthetic opioids) simply do not happen. It’s not a real-life phenomenon. Despite these claims having been routinely debunked for years, they continue to persist now, in December of 2022, thanks to propagandist journalists, viral posts on social media, and news outlets that will continue to face no repercussions, and record viewership.

These tales of synthetic opioids are an example of a larger phenomenon known as Scarelore. Very similar to folklore, Scarelore is propagated with the motivation to cause fear that will drive people’s behavior and attitudes to an end desirable to those orchestrating the narrative. I’m currently mapping out a project with Scarelore as the central subject. Some notable examples include poisoned Halloween candy, kidney thieves, AIDS needles, and endless variations of incidents involving returned headlight flashing that results in your execution as a part of the other driver’s gang initiation. The knockout game. I need an ice cream scoop and pliers so I can fix my rolling eyes back into position.

Regardless of the strength, fentanyl doesn’t have the properties needed to cross the skin barrier into the bloodstream. Patients who are hospitalized and have extreme pain will typically receive fentanyl patches, which slowly release a therapeutic dose of the drug into the body through the skin. Dr. Ryan Marino, an emergency medicine physician and toxicologist at University of Pittsburgh Medical Center, says fentanyl patches contain a version of the drug that is specifically formulated to be absorbed by the skin, and even then the absorption is “incredibly slow and inefficient.” Dr. Marino can be found on Twitter using the hashtag #WTFentanyl to debunk myths about the drug.

So, what’s happening here? What has been causing the intense reactions experienced by LEOs after handling substances they believe to be fentanyl (even, in some cases, while wearing gloves)? We can start with the exceptionally poor training on the subject. Nearly 70% of LEOs had received so-called Fentanyl Training, which is a whole mess, identical to what you may hear cycling on Fox or Newsmax. This study assesses a training video issued by the DEA in 2016, Fentanyl: A Real Risk To Law Enforcement contained the specific claim that “exposure to an amount equivalent to a few grains of sand can kill you.”

 

Now, take this study  from the Health and Justice Journal. It surveyed more than 200 respondents in law enforcement about the dangers associated with handling fentanyl on a crime scene. Afterwards, they were given a 10 minute online training that clarified the risks (and non-risks) associated with fentanyl exposure. The respondents were asked to do a follow up survey on their own time so the researchers could assess the effectiveness of the quick training. The figure below shows the responses, before and after training, to the statement “First responders who encounter fentanyl are at great risk of overdose by touching it or inhaling it.” (I marked it up, because I have a problem. Let’s move on.)

The findings, in summary, were that more than 70% of officers agreed (SA 40.3%, A 32.6%) with this false statement, with about 15% correctly identifying it as untrue. After a corrective online training course done on the officers’ own time, those who answered correctly were just below 50%, and those who continued to err made up about 25%. The number of LEOs who changed their mind is not insignificant, but also not as many as I’d like to have seen. Let’s keep in mind, though, that this was established through a very quick online training that was intended to be corrective of prior misinformation. In my opinion, having this information as part of the training would much more thoroughly inform the officers, keeping them competent and protecting overdose victims from unnecessary apprehension due to unwarranted fears.

Another likely explanation for many of these crime scene incidents is a very simple one: panic attacks. Someone seeing on their hand a substance they’ve been taught is deadly to the touch is bound to freak out. This is further evidenced by the reported symptoms experienced on the crime scenes— like palpitations, heavy breathing, panicking , which are not consistent with the effects of opioid exposure (let alone an OD. If someone was found overdosing on something like fentanyl, they’d have a depressed heart rate, slow breathing, and would soon be unconsciousness or unresponsiveness at least).

Now, to be abundantly clear, no one should be goofing around with fentanyl like it’s nothing. It’s deadly in tiny amounts. A pinch of it, if ingested or in contact with one’s mucus membranes, can certainly kill someone. According to medical director of the New Jersey Poison Information and Education System, Dr. Diane Calello, “Handling an overdose victim is not going to entail a plume of aerosolized drug,” citing reports from medical toxicologists which say “At the highest airborne concentration encountered by workers”, in an industrial setting, “an unprotected individual would require nearly 200 minutes of exposure to reach a dose of 100 mcg of fentanyl”, which is a therapeutic dose, not a lethal one. However, fearmongering and spreading misinformation will only create more dangerous situations. Police and other first responders may hesitate to help an overdose victim, wasting time critical to their survival. Our lawmakers and extremist media would do well to give enough of a f*** about the safety of humans rather than cause a panic over innocent humans that are migrants, substance abusers, and/or unhoused.

When even Snopes has had enough of your s***, it’s probably time to give it up.