Congress is racing to address a problem toxicologists say probably doesn’t exist: the dangers to emergency responders of incidental exposure to the powerful drug fentanyl.
A bill introduced by Reps. Conor Lamb (D-Pa.), David Joyce (R-Ohio), and David Trone (D-Md.) would use federal money to fund local police purchases of portable drug screening devices. Front and center in much of the advocacy for the bill is the alleged risk of the synthetic opiate fentanyl to police and emergency medical responders who come in contact with it at drug busts and overdose scenes.
Thus the Toledo Blade editorial board calls for passing the bill at once, saying “police, firefighters, and other first responders are in jeopardy if they come into contact with even a minute trace of the drug.”
You can’t overdose on fentanyl simply by touching it.
An NPR station in upstate New York spoke to John Anton, police chief of DeWitt, New York, who is haunted by fears of his officers accidentally overdosing. “Fentanyl is just so deadly they’ll just go unconscious, and then CPR has to be administered,” Anton told NPR. “And I worry about them every day getting exposed to fentanyl, getting it on their clothes, bringing it home to their families, getting it on their boots and so forth.”
Anton’s worry is most likely misplaced. Fentanyl, a powerful drug, is at the center of a wave of thousands of overdose deaths. Even so, experts have been trying for years to calm fears that it poses any significant risk to first responders, notwithstanding viral stories to the contrary.
Perhaps the most-circulated story of this sort took place in 2017 after a fentanyl bust in which an officer in East Liverpool, Ohio, had used gloves to handle a white powder. Later, with ungloved hand, he absently brushed some dust off his shirt. Soon thereafter he lay unconscious. He described himself as “in total shock… No way I’m overdosing.” Colleagues attempted to revive him with naloxone, but he did not wake up until after four doses, a remarkable quantity. The terrifying story was widely publicized in national media.
Writing in Slate shortly thereafter, Harvard Medical School professor and emergency room physician Jeremy Samuel Faust offered a reason to be skeptical. Every toxicologist he spoke to agreed that skin contact from brushing a shirt, even if complicated by bringing fingers to mouth or some similar misstep afterward, would not cause such symptoms. The very detail that made the episode so riveting—that it took an enormous quantity of naloxone (four doses) before he woke up—undercuts rather than reinforces the story.
“When a medication with well-established and consistent efficacy such as naloxone does not work at its usual dose, it’s usually because we are treating the wrong illness—we’ve made a diagnostic error—not because the known treatment is flawed.” If a therapy that has been well established as reliably treating opiate overdose did not work, even at escalating dosages, it’s because opiate overdose is most likely not what he was suffering from.
Many of the bipartisan sponsors and supporters of H.R. 2070 seem unaware that any doubt lingers over the panic stories.
“We must make sure our first responders, who are on the front lines of this epidemic, are protected from exposure to deadly substances like fentanyl,” Trone declared in a press release. “Providing resources like screening devices to state and local entities is a no brainer.”
“Police officers, paramedics, and other first responders face tremendous danger when responding to scenes where fentanyl and other dangerous substances are present,” says another sponsor, Sen. Edward Markey (D-Mass.) “Shielding these brave men and women in Massachusetts and across the country from these dangers as they serve and protect our communities should be our top priority.”
Interestingly, while the Fraternal Order of Police union supports the bill, its letter of endorsement from national president Chuck Canterbury refrains from making any arguments based on officer safety. Instead, it advances other reasons for supporting the equipment bill, based on making drug investigations more effective.
Elected officials would do well to follow its lead. Unfounded fears of rescuer overdose can do real harm by fostering hesitation and needless preliminaries at overdose scenes where every moment counts in resuscitating a victim.