By Jonathan Jarry, McGill Office for Science and Society
On the fictional cop show Blue Bloods, in the appropriately titled episode “Pain Killers,” detective Maria Baez picks up a tray containing drug paraphernalia and a white powder and is soon seen on a gurney, fighting for her life, as a healthcare worker proclaims, “Fentanyl is a synthetic opioid, 50 to 100 times stronger than morphine. The slightest exposure can trigger an overdose.” As reported by Lindsey Ellefson for BuzzFeed News, the night the episode premiered, over eight million people watched it.
The belief that simply coming into contact with fentanyl can kill you is widespread within law enforcement. But is it true?
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Given the clear hazard posed by potent opioids like fentanyl, it’s no wonder that many first responders are afraid to be anywhere near them. This fear, though, is misplaced and can have dire consequences for the people in need of medical attention.
It started in Montreal. In April 2013, police conducted seven raids around Montreal and seized drug-making equipment and synthetic drugs, including a fentanyl derivative called desmethyl fentanyl. The clandestine labs making these drugs contained many chemicals, and the Montreal Gazette reported at the time that four police officers became ill from handling some of these drugs. One was hospitalized with heart problems, while three other cops, who were wearing masks and gloves, developed rashes on their arms. The link between touching fentanyl and getting sick was born.
But what really cemented the fear that merely touching fentanyl or one of its analogs causes instant harm was a case in Ohio four years later. A man who had just been released from jail on bond was driving and was pulled over by a police officer, who was joined by Chris Green, a local off-duty cop who happened to be nearby. The two officers found drugs in the car and the man admitted that the powder in his vehicle might include fentanyl. Green noticed some powder on his shirt and brushed it off with his naked hand.
An hour or so later, Green was sweaty, barely coherent, and not feeling well. He was taken to the hospital, where he was treated for an overdose. The man he had arrested was charged with drug trafficking and possession, yes, but also with assault on a peace officer because he had exposed Green to fentanyl. The attorney general for Ohio released a statement to the press during sentencing which would echo for years to come: “Fentanyl is so dangerous,” he said, “that even the slightest exposure can be deadly.” The news media was quick to repeat this memorable quote.
The belief that simply touching fentanyl will cause physical harm is very common among law enforcement officers. It is reinforced by media coverage, which often repeats this presumption with no pushback. Cops who survive their encounter with unknown white powders will tell journalists that “something as simple as the wind could expose you” or “I almost died.”
So, are there any reported cases of harm caused by touching fentanyl?
“No.” The man who gave me this unambiguous answer is Dr. Ryan Marino. He is a medical toxicologist and an associate professor at Case Western Reserve School of Medicine in Cleveland, Ohio. He is also one of a handful of experts frequently pushing back against opioid myths through the website WTFentanyl. His stance on this issue is backed up by the American College of Medical Toxicology (ACMT), which deems the risk to emergency responders as “extremely low,” and is echoed in the Journal of Emergency Medical Services, in which rescue specialist Simon Taxel reminds us that this position is unanimously agreed upon by physicians and toxicologists. “If there was a real hazard,” Taxel writes, “it would stand to reason that the people who produce fentanyl, distribute it, or use it would suffer similar exposures. This is simply not happening.” Same with carfentanyl, the extremely potent synthetic opioid. “It’s more potent,” told Dr. Joshua Radke, an ER doctor, to Emergency Medicine News, “but it’s not magically more dangerous.”
ou may be skeptical if you know that fentanyl patches exist, in which the opioid is allowed to seep through the skin and provide relief to patients dealing with chronic pain. But these transdermal patches were the fruit of significant investments to devise a technology that would allow fentanyl to be absorbed through the skin. Even with this patented delivery system, a patient will start to benefit from the fentanyl only three to 13 hours later. The effect is far from instantaneous. In fact, you can witness Chad Sabora on Facebook showing that a heroin powder tests positive for fentanyl and then holding it in his left hand for an extended period of time. “I’m experiencing no signs of toxicity, no overdose symptoms, nothing whatsoever,” he calmly states. “I don’t know what else to do.”
But what about the danger of accidentally inhaling fentanyl while conducting a drug bust? Reassuringly, the drug and its analogs are not easily airborne, with the ACMT referring to this hypothetical situation as “exceptional circumstances.” There would need to be large quantities aerosolized and breathed in for hours to get a meaningful amount in the bloodstream. The closest thing might have been the Moscow theatre hostage crisis of 2022, in which Chechen terrorists occupied a theatre. The Russian Federation responded by pumping in a gas that killed 129 of the more than 800 hostages, as well as at least 33 terrorists. The Russian government did not initially reveal the composition of the gas. An analysis by a British laboratory of the clothing worn by two British survivors and the urine from a third revealed the presence of carfentanyl and remifentanil. Even if those were indeed the gases used to subdue the terrorists, it is clear that this situation bears little resemblance to first responders arriving at the scene of a fentanyl overdose, or even to police officers raiding a fentanyl laboratory.
First responders who believe they are overdosing on fentanyl from simply touching it in fact exhibit the exact opposite of the symptoms we would expect. While fentanyl makes you euphoric and slows down your breathing, cops start breathing faster, sweat a lot, and become anxious. “I don’t want to discredit anyone or say they’re faking,” says Dr. Marino. “I do think people are having a true medical emergency when this happens. The symptoms seem most consistent with a panic attack or anxiety or a fear reaction.”
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This panic over accidentally touching fentanyl is causing actual harm. “I have seen this play out,” Dr. Marino tells me, “People are scared to resuscitate an overdosing person, because they’re worried about getting close to them.” Police departments spend unnecessary money on hazmat suits and special “fentanyl-resistant gloves.” Regular disposable nitrile gloves have been tested and are more than suitable; in fact, the human skin is already a pretty good barrier. But because of this dread, people are being charged with imaginary crimes for exposing a cop’s bare skin to fentanyl, and a coalition of attorneys general urged President Joe Biden to classify fentanyl, one of the most frequently used drugs in medicine, as a “weapon of mass destruction.” Fear spreads while science crawls.
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Blue Bloods may have fueled the fear over accidental fentanyl poisoning, but another cop show took a different approach. On an episode of Will Trent, a law enforcement officer starts panicking after believing he’s touched fentanyl. The show’s protagonist, Will Trent, replies, unphased: “Pretty sure that’s laundry detergent. Just wash your hands. Either way, you’ll be fine.” We need more scientifically accurate representations like this one.
Jonathan Jarry Bio:
Jonathan Jarry is a science communicator with the McGill Office for Science and Society, dedicated to separating sense from nonsense on the scientific stage. He has a Master’s degree in molecular biology and he brings his experience in cancer research, human genetics, rehabilitation research, and forensic biology to the work he does for the public. He was the creator, writer, and host of the YouTube show Cracked Science, which used a late-night deep-dive format to debunk pseudoscience and denounce bad science. With cardiologist Dr. Christopher Labos, he co-hosts the award-winning medical podcast The Body of Evidence, which aims to contextualize findings in the realm of health research and answer the public’s most pressing questions about the biomedical sciences while also being funny and entertaining.
Bruce Gerencser, 66, lives in rural Northwest Ohio with his wife of 45 years. He and his wife have six grown children and thirteen grandchildren. Bruce pastored Evangelical churches for twenty-five years in Ohio, Texas, and Michigan. Bruce left the ministry in 2005, and in 2008 he left Christianity. Bruce is now a humanist and an atheist.
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Another good reminder that TV shows are fiction, not factual
Is the fentanyl scare the modern version of “Reefer Madness?”