Severe toxicity from casual fentanyl exposure?

Yet another story about a law enforcement officer’s severe symptoms, purportedly from exposure to fentanyl.

There have been numerous accounts of this type, disputed by addiction experts who note that lots of people involved in handling and trafficking fentanyl aren’t suffering similar consequences.

“Fentanyl panic has real-world consequences. Professional responders and witnesses may delay overdose intervention to avoid perceived potential health risks to themselves (Nelson & Perrone, 2018). Inaccurate risk perception can contribute to unnecessary stress and other mental health issues. Misinformation can also engender counterproductive policies, including hyper-punitive responses, unnecessary expenditures, and pharmaceutical over-regulation ([Dasgupta et al., 2018]”

Are real hazards of casual fentanyl exposure being overlooked? Or do the news media have an obligation to report these stories more skeptically?

*noting that the FDA has warned of severe injury and death resulting from children getting ahold of medical fentanyl patches and putting them on their skin and in their mouths, which sounds like a more realistic risk.

It’s not even close.
-1 ABC News +1 PubMed

Don’t worry! The sheriff’s department has a highly convincing evidence-based response to all of the requests for more information: “We know what factually happened and our deputy almost died from a fentanyl exposure. This is a deadly substance!” They know, and that’s good enough for them and it’s good enough for all of the headline-writers. So there.

This article gives a clue as to what probably actually happened:

They trained this guy all the way into having a panic attack.

Maybe he pulled that TV cop move of licking his finger, sticking it in a baggie of unknown white powder then licking it off to identify the substance. Because with some types of fentanyl, that could absolutely give you a fatal dose. There’s plenty of cops stupid enough to try that move to look cool.

Which, IMHO, is how we end up with so many shootings by police. They are literally scared out of their senses, due to their training that tells them that everything and everyone is out to kill them all of the time every day 24/7/365.

Fentanyl is up to 100 times more powerful than morphine. Something the size of a grain of sand could kill you.

I would expect some kind of toxicology test to see if someone was exposed.

What is interesting, the use of Naloxone as a counter to a suspected overdose of opioids does not harm a person if they are NOT overdosing from opioids. So you wouldn’t know at the time of it’s use that there was a overdose in progress.

Skin exposure is not expected to lead to toxicity due to its extremely poor penetration of the skin barrier, and symptoms of intoxication from skin exposure are unlikely.

https://www.google.com/url?sa=t&source=web&rct=j&url=https://www.ncdhhs.gov/media/1740/download&ved=2ahUKEwjwldSZg7LyAhWpB50JHQcZBTkQFnoECAwQBg&usg=AOvVaw02AeAiMR-o98piOmRygDer

(PDF from NC Dept of Health and Human Services)

Yah, I would think it would need to be inhaled or ingested.

This one was so bad that an EMT had to take his gun away from him. After several minutes of increasing paranoia over an unseen and possibly nonexistent threat, he really comes unglued at about 5:30:

Not hard to imagine a cop, upon being told he was handling Fentanyl, could become so overwhelmed with anxiety and fear that he fainted dead away. That he recovered shortly after receiving Narcan is merely an annoying coincidence.

Not to be nitpicky, but the average grain of sand weighs about 0.05 mg, while a commonly accepted fatal dose of fentanyl for an individual who lacks tolerance is 2-3 mg. So (scratches head, carries a digit or two) a fatal dose is at least 40 grains of sand.

I’d only heard the “grain of sand” thing re: analogues like carfentanil, furanylfentanyl, etc., which are supposedly much more potent.

Looks like “it” may have happened again:

[ETA: though the circumstance of administering CPR could create a plausible scenario … I would guess]

Why did it ‘involve’ WP Cadets instead of involving them?

That’s an ‘excellent question.’

Alright … giving the benefit of the doubt here … this is from the above-linked article:

[bolding mine]

In a statement earlier, the U.S. Military Academy in West Point, N.Y. said it was “aware of the situation involving West Point cadets” that occurred in Wilton Manors on Thursday night.

So maybe snipping a particular word from a quote, as they did, justifies putting that word in quotes.

Maybe :wink: I’m not going to the APA or Strunk & White to check on this :slight_smile:

When I was in pharmacy school in the early 1990s, carfentanil was mentioned, only so we would know about scheduled veterinary drugs. It is literally “elephant tranquilizer”, because it is so potent, and it’s very, very hard to obtain legally.

Another take on the merely-touching-a-few-grains-of-fentanyl-can-kill-you meme:

FYI, here is an article (gift link) from The New York Times Magazine earlier this month about the myth of brief fentanyl exposure causing overdoses. It suggests that the fear might cause first responders not to aid people undergoing overdoses.

That story rightly points out that unfounded fears of exposure to first responders are potentially putting overdose victims at greater risk. But there is also a nasty little subtext of resentment at the idea of police officers being portrayed sympathetically.

“Hidden from view”? There’s been a ton of reporting on the spike in overdoses, including in the New York Times.

Has anyone claimed that it is?

“Suddenly”?

Police officers, like other humans, can be buffaloed into perceiving dangers that are nonexistent or way overhyped.

Coincidentally I just listened to the May 24, 2019 Radiolab episode about EMTs supposedly absorbing fentanyl through the skin.