Cops Still Don’t Understand How Fentanyl Works

US drug overdoses reached another record high last month, with the CDC attributing nearly two thirds of overdose deaths to the synthetic opioid fentanyl. 

The increasing prominence of the drug, which can be lethal even in small doses when injected or snorted, has rightly generated alarm. But across the country, law enforcement responses to cases involving fentanyl shows that cops still don’t seem to understand anything about how the drug actually works.

Last month, the Orange County Sheriff’s Department deployed hazmat equipment while searching a vehicle that allegedly contained fentanyl, and called upon the fire department to cleanse their suits. Three deputies became “dizzy,” deployed the medicine Narcan on themselves and were taken to the hospital, according to the department’s Twitter. The post was quickly ratioed, with hundreds of accounts pointing out that this is not how fentanyl works. And last week, two Ashland County Sheriff deputies were given Narcan and taken to the hospital after experiencing an “overdose reaction” upon finding a bag of fentanyl that split open while searching a woman’s bra.    

The scientific consensus among toxicologists is that proximal exposure to fentanyl does not cause overdoses or other adverse health effects. While people can only get high from fentanyl by injecting, snorting and smoking the drug, about 80 percent of police officers surveyed in three separate studies believed they can overdose by touching it. 

The Ashland County Sheriff's Department did not respond to a request for comment. 

The Orange County Sheriff's Department declined to comment. “We do not have any other details to provide other than what we shared on our social media pages on March 29,” a spokesperson told Motherboard in an email, referring to the post that was called out for spreading disinformation.

Such false beliefs result in what some researchers call “fentanyl panic,” a phenomenon that can exacerbate stigma against people who use drugs, complicate overdose rescue procedures, and perpetuate anti-drug policies that are widely known to disproportionately harm the people of color, the unhoused, and other marginalized groups. 

The DEA is partially responsible for the panic. In June 2016, the department released a statement and video to all law enforcement personnel stating that a “small amount [of fentanyl] ingested, or absorbed through your skin can kill you.” (The agency has since removed the video and statement from the internet.) Last year, in a letter to President Biden, the organization Families Against Fentanyl asked for fentanyl to be declared a weapon of mass destruction, again inaccurately stating that “fentanyls can enter the body through ingestion, inhalation, and absorption through the skin and kill quickly, often before an antidote can be administered.”

“It is nothing more than anti-drug user propaganda that fentanyl exposure alone will result in any kind of harmful or potential overdose for someone who is just in the vicinity of fentanyl,” Mariah Francis, a resource associate for the National Harm Reduction Coalition, told Motherboard. “It's misinformation. And treating fentanyl like it's asbestos or black mold is really just a part of and a continuation of some of the harmful social racial repercussions of the war on drugs.” 

Police departments waste public resources when they deploy an excessive response to a perceived threat, activists say. In January, the Tennessee Highway Patrol flew in decontamination equipment by helicopter at an estimated cost of $3,800 while responding to a man who was overdosing. Then, after a deputy and EMS worker claimed to experience “symptoms of an overdose,” police and prosecutors criminally charged the man with two felonies for reckless endangerment, demonstrating how prosecutors can use fentanyl panic to accuse drug users of additional crimes. 

“Generally, as prosecutors, the more things you can charge somebody with, the more power you have,” Keith Humphreys, former senior policy adviser to the White House Office of National Drug Control Policy, told Buzzfeed News. “So even if they knew that this was mostly hysteria and hokum, they might still welcome the power. I don't know if you can change that.” 

Media outlets often contribute to the confusion around fentanyl by parroting law enforcement talking points. One study supported by the National Institutes of Health found that misinformed media reports about fentanyl exposure received approximately 450,000 Facebook shares, potentially reaching nearly 70,000,000 users from 2015-2019.

The American College of Medical Toxicology (ACMT) and the American Academy of Clinical Toxicology (AACT) attempted to set the record straight in a 2017 position statement on preventing fentanyl exposure to emergency responders. “[B]ased on our current understanding of the absorption of fentanyl and its analogs, it is very unlikely that small, unintentional skin exposures to tablets or powder would cause significant opioid toxicity,” they wrote. “[I]f toxicity were to occur, it would not develop rapidly, allowing time for removal.” 

Nitrile gloves provide sufficient protection during routine handling of the drug, according to the AACT and ACMT, and first responders can wear N95 respirators or P100 masks during rare situations that involve significant airborne suspension of powdered opioids.

But are police officers who claim to experience overdose symptoms misrepresenting the truth? Some experts say police are likely misattributing panic attack symptoms—dizziness, chest pains and even fainting—as overdose symptoms. Actual opioid overdoses involve a loss of consciousness, slow and shallow breathing, vomiting and blue or purplish black fingernails and lips.

Many harm reduction workers say police shouldn’t be handling drug-related matters in the first place. From a harm reductionist perspective, communities are safest and healthiest when people have their material needs met, are allowed to make their own choices, and have access to safety tools like fentanyl testing strips. Punishment has been shown to exacerbate unsafe drug use and movement of drugs, they say.   

“The War on Drugs was nothing more than an attack on Black and brown bodies and a way to demonize communities of color and blame the lack of a supportive, compassionate healthcare infrastructure on communities who do use drugs,” said Francis. “What we need to do is move away from carceral punishment for people who use drugs. You’re doing nothing to improve the tenable circumstances in a person’s life, you don’t have a place in the conversation to determine their choices.”

Advocates point to places like Portugal, which decriminalized drugs in 2001 alongside implementing harm reduction measures such as syringe distribution programs and increased outpatient services. Within the first five years of implementation, drug deaths dropped dramatically and drug use is at an all-time low in the country. Meanwhile, the United States has funneled billions of dollars into the War on Drugs, yet overdoses are at an all-time high.

“Decriminalize drugs in the United States, defund the police, take that money and issue it to public 24/7 Harm Reduction Centers,” Francis recommended. “So we can actually practically keep our community safe from dying.”