Fentanyl, the deadly synthetic opioid driving the nation's high drug overdose rates, is also caught up in another serious problem: misinformation.
False and misleading narratives on social media, in news reports and even in popular television dramas suggesting people can overdose from touching fentanyl — rather than ingesting it — are now informing public policy and spending decisions.
Some state and local governments, for instance, are investing money from their share of the billions in opioid settlement funds in efforts to protect first responders from purported risks described in fentanyl misinformation.
In 2022 and 2023, 19 cities, towns, and counties across eight states used settlement funds to purchase drug detection devices for law enforcement agencies, spending just over $1 million altogether. Two mass spectrometers were purchased for at least $136,000 for the Greeley, Colorado, police department, "to protect those who are tasked with handling those substances."
But there is also almost no evidence that law enforcement personnel are at heightened risk of accidental overdoses due to such exposures. Although fentanyl-related deaths have drastically risen over the past decade, no evidence suggests any of these deaths have resulted from incidentally touching or inhaling it, and little to no evidence that any resulted from consuming it in marijuana products. Recent data indicates that fentanyl-related deaths have begun to drop.
Still, there is a steady stream of reports — which generally turn out to be false — of officers allegedly becoming ill after handling fentanyl. But experts say it's unlikely those episodes were caused by the fentanyl itself — more likely, officers' fear and anxiety resulted in panic attacks or similar symptoms.
Fentanyl is present in most illicit opioids found at the scene of an arrest, said Brandon del Pozo, a retired Burlington, Vermont, police chief who researches policing and public health policies and practices at Brown University. But that "doesn't mean you need to spend a lot of money on fentanyl detection for officer safety." If that spending decision is motivated by officer safety concerns, then it's "misspent money," del Pozo said.
Overdoses are most commonly caused by ingesting the drug illicitly as a pill or powder. And most accidental exposures occur when people who use drugs, even those who do not use opioids, unknowingly consume fentanyl because it is so often used to "cut" street drugs such as heroin and cocaine.
Fentanyl misinformation is affecting policy in other ways, too. Florida has a law on the books that makes it a second-degree felony to cause an overdose or bodily injury to a first responder through this kind of secondhand fentanyl exposure. Similar legislation has been considered by states such as Tennessee and West Virginia, the latter stipulating a penalty of 15 years to life imprisonment if the exposure results in death.
Public health advocates worry these laws will make people shy away from seeking help for people who are overdosing.
"A lot of people leave overdose scenes because they don't want to interact with police," said Erin Russell, a principal with Health Management Associates, a health care industry research and consulting firm. Florida does include a caveat in its statute that any person "acting in good faith" to seek medical assistance for someone they believe to be overdosing "may not" be arrested, charged, or prosecuted.
And even when public policy is crafted to protect first responders as well as regular people, misinformation can undermine a program's messaging.
Take Mississippi's One Pill Can Kill initiative. Led by the state attorney general, Lynn Fitch, the initiative aims to provide resources and education to Mississippi residents about fentanyl and its risks. While it promotes the availability and use of harm reduction tools, such as naloxone and fentanyl test strips, Fitch has also propped up misinformation.
At the 2024 Mississippi Coalition of Bail Sureties conference, Fitch said, "If you figure out that pill's got fentanyl, you better be ready to dispose of it, because you can get it through your fingers," based on the repeatedly debunked belief that a person can overdose by simply touching fentanyl.
Officers on the ground, meanwhile, sometimes are warned to proceed with caution in providing lifesaving interventions at overdose scenes because of these alleged accidental exposure risks. This caution is often evidenced in a push to provide first responders with masks and other personal protective equipment. Fitch told the crowd at the conference: "You can't just go out and give CPR like you did before." However, as with other secondhand exposures, the risk for a fentanyl overdose from applying mouth-to-mouth is negligible, with no clinical evidence to suggest it has occurred.
Her comments underscore growing concerns, often not supported by science, that officers and first responders increasingly face exposure risks during overdose responses.
Her office did not respond to questions about these comments.
Health care experts say they are not against providing first responders with protective equipment, but that fentanyl misinformation is clouding policy and risks delaying critical interventions such as CPR and rescue breathing.
"People are afraid to do rescue breathing because they're like, 'Well, what if there's fentanyl in the person's mouth,' " Russell said. Hesitating for even a moment because of fentanyl misinformation could delay a technique that "is incredibly important in an overdose response."
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