Dispatches from the Overdose Crisis: The fentanyl exposure overdose myth

Stories of first responders overdosing after coming into contact with fentanyl have popped up all over, including in Columbus. But the science doesn't add up, and the myth is damaging.

Jack Shuler
In this screenshot from an ABC 6 news story, Franklin County Sheriff Chief Deputy Jim Gilbert describes a recent incident in which a bag of fentanyl broke open in a cruiser. The story, columnist Jack Shuler argues, perpetuates the fentanyl exposure overdose myth.

At 2 a.m. on Jan. 16, a man was pulled over for an outstanding warrant at U.S. Rt. 23 and I-270. Video from a Franklin County Sheriff’s dashboard camera shows the suspect removing a bag from his body, after which the bag breaks open and the synthetic opioid fentanyl ends up everywhere — white powder on his lap, the floorboards, the seats.

Four days later, a post on the Franklin County Sheriff’s Facebook page read, “5-deputies on the scene narrowly avoided exposure and are safe…The list of scary ‘what ifs’ is long and the FCSO is thankful the deputies are safe and the poison is off the street.”

A story about the encounter ran on NBC 4’s website, and an anchor on ABC 6 described the incident as “a dangerous mess,” adding that “five deputies and that suspect are lucky to be alive tonight.” Chief Deputy Jim Gilbert told ABC 6 the incident “could have very well been bad for us. We’ve seen across the nation deputies and law enforcement officers who’ve been overcomed [sic] by these illegal narcotics.” According to Gilbert, the deputies and the suspect were checked for fentanyl exposure at a nearby hospital and cleared.

The traffic stop was certainly dangerous — cruisers were parked along a dark highway and six presumably healthy people were sent to a hospital in the middle of a pandemic. But here’s the thing: There was no real risk of overdose.

Fentanyl can indeed be lethal for those who consume it, especially unknowingly. More than 5,000 people died of an overdose in Ohio in 2020, and 81 percent of those deaths involved fentanyl, which has adulterated the drug supply.

But touching it or being near it will not lead to an overdose. The American College of Medical Toxicology and the American Academy of Clinical Toxicology say it’s not likely for someone to overdose from touching the drug because it doesn’t absorb well through the skin. (In some circumstances, a pair of nitrile gloves is all that’s needed for protection.) In fact, the phenomenon has never been scientifically confirmed.

Yet stories of first responders overdosing after coming into contact (by touch or inhalation) with an unknown powder believed to be fentanyl have popped up all over the United States, including in Arkansas, California, Texas and Florida, where six Orlando police officers were checked out in a hospital — three of whom drove there themselves.

These stories perpetuate the myth that first responders are in danger of overdose just by touching fentanyl or being near it. The more the story is shared, the more it’s believed, and the more real-world consequences accrue. For one, the myth can lead to unnecessary stress on first responders; some reported examples seem to share the symptoms of a panic attack.

Law enforcement agencies have fueled this anxiety. Beginning in 2016, a series of Drug Enforcement Agency press releases and videos fostered the idea that not only is fentanyl dangerous to someone who ingests it, but it’s also dangerous to anyone who comes near it. A September 2016 release claimed that it “can be absorbed through the skin or accidental inhalation of airborne powder.” This was a message shared with law enforcement agencies around the country.

These stories can also lead to calls for increased penalties for fentanyl possession. In 2017, an officer in East Liverpool, Ohio, said he overdosed after brushing fentanyl off his clothing, and the man who had possessed the drug was charged with assault. Last week, West Virginia’s House of Delegates passed a bill that would make “exposing” government employees or law enforcement to fentanyl a crime punishable by up to five years in prison.

Most immediately, the myth of fentanyl exposure overdose can slow response to an actual overdose. If people are concerned about fentanyl exposure, they might avoid touching a person who is overdosing and needs naloxone or rescue breaths.

Dr. Ryan Marino, medical director of toxicology and addiction at Case Western Reserve University School of Medicine, created a Twitter guide to address myths about fentanyl. He said fentanyl doesn’t act in the ways often described in these exposure stories, explaining that it’s more likely the perception of harm, known as the nocebo effect (the opposite of the placebo effect).

The myth, Marino said, also perpetuates the trope of dirty-versus-clean and implies that “people who use drugs — they’re the other, different from the rest of us.” Marino said he has seen the effects of this in real life when he arrived at a scene where a patient was experiencing a fentanyl overdose, and instead of resuscitating the patient, responders were sealing off the doors and trying to distance themselves because of fear of fentanyl exposure.

If law enforcement tells the story, Marino said, and media outlets repeat the narrative without questioning it, the myth will persist.

These exposure stories tend to get lots of clicks, and, as a team of researchers learned, they’re rarely corrected. The Franklin County Sheriff’s Office Facebook post was shared 576 times and had thousands of likes and hundreds of comments. The ABC 6 story was shared 112 times. Not exactly viral, but not a blip either.

Last summer, a group of doctors and journalists signed a letter encouraging outlets to issue retractions and refrain from telling stories like this in the future. (ABC 6 offered no comment for this story.)

In a follow-up interview, Franklin County Chief Deputy Rick Minerd said that deputies at the aforementioned traffic stop last month were sent to the hospital for precautionary reasons since fentanyl was all over the car. Besides, he said, “If you touch it, you might ingest it or inhale it.” Minerd also pointed out how deadly fentanyl can be. “Any exposure could be dangerous,” he said.

Taking precautions is prudent, but in this case, no one experienced symptoms. Yet the situation was perceived to be dangerous, and that perception was then amplified to the public, who was told that those on the scene were “lucky to be alive.”

“Everybody who has ever used fentanyl on purpose would be dead” if the opioid acted the way some law enforcement officers claim it does, said Shae Dalrymple, spokesperson for Harm Reduction Ohio, who added that fentanyl must be smoked, snorted or injected to have an effect; even a transdermal patch can take a while to begin working. “If you could get high from just touching it, why would someone inject it?”

Dalrymple, who identifies as a person in recovery, said that law enforcement officers are not experts on drug use, but because they are anxious about fentanyl, they spread this story. And because they are authority figures, people believe it.

The theory that fentanyl poses mortal danger if someone gets near it fosters the idea that we need to sequester the drug and the people who use it. It shifts our focus away from solutions and centers it on law enforcement officers, who then become the victims. It perpetuates the fear of fentanyl rather than an understanding of how the war on drugs helped bring this substance into our midst. Fear leads to panic, and panic leads to more jails, more prisons and more responses that only make matters worse.

Changing the Narrative, from the Health in Justice Action Lab at Northeastern University, is an excellent resource for learning more about the myth of fentanyl exposure overdose. Naloxone is available through Harm Reduction Ohio, Central Ohio Harm Reduction, Franklin County Health Department, Columbus Public Health and Safepoint. Support services are also available through Never Use Alone, Brave and Safepoint. For help with substance use disorder, contact SAMHSA National Helpline at 1-800-662-4357.