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Tag: Claire Zagorski

Liar, Liar, Pants on Fire: Will Touching Fentanyl Kill You?

liar liar pants on fire

By Claire Zagorski, MSc, LP, Salon

A dangerous myth about illicit fentanyl, the opioid largely behind the surge in overdose deaths, simply will not die. While addiction and drug policy experts have repeatedly refuted the idea that touching fentanyl alone can cause an overdose, like a stubborn weed, the lie keeps coming back. And now the myth has drifted upward to policymakers, who are ignoring the lack of evidence that mere exposure to fentanyl can be deadly.

At this moment, three bills — one in Florida (SB 718), one in West Virginia (HB 5319), and the other in Tennessee (SB 1754) — are making their way through their respective state legislatures.  All three will allow for a felony charge to be levied against people who expose a first responder to fentanyl or a fentanyl analog, such as carfentanil or remifentanil. But HB 5319 casts an even wider net, encompassing any opioid regardless of potency. 

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While fentanyl is easily absorbed through injection, pyrolyzing and inhaling its vapor, snorting it, or swallowing it, it isn’t good at passing through skin. When it hit the market in the 1990s, Duragesic, the trade name for the fentanyl skin patch, was a minor marvel of drug delivery innovation precisely for this reason. It took many years of effort to develop and refine a way to move fentanyl across the skin, much less in a controlled and predictable way. And even then, reaching a steady, pain-relieving blood concentration of fentanyl with the patch takes several hours, even with sustained contact. Fentanyl also does not aerosolize on its own, which is why people have to either snort (i.e., insufflate rather than inhale) or intentionally vaporize it.

If the science here is so straightforward, why is there still confusion? This myth of passive fentanyl overdose was first put forth in a 2016 bulletin from the Drug Enforcement Agency, which has since been updated, and the language softened. Other authoritative bodies like the CDC have repeated the myth, and despite changing their warnings to reflect the fact that there is no evidence this can happen or has ever happened, the agency still maintains a rather misleading guide under NIOSH’s website, which largely deals in hypothetical situations that are very unlikely to ever happen.

But if you’ve been following headlines, this all may be a surprise to you. Over the years, we’ve seen a steady drip of pieces on police encounters with fentanyl resulting in alleged overdoses. The more peripheral details vary, but the core remains strikingly consistent — an officer saw something that looked like a drug, or perhaps dusted some powdery grains off of their uniform. Someone mentions fentanyl. Suddenly they feel something — heart pounding, chest tightening, fingers tingling, light-headedness. Often, these officers are able to give themselves naloxone, the antidote to an opioid overdose. And while these experiences are certainly frightening, they aren’t opioid overdoses, which cause slow or absent breathing and a loss of consciousness.

Despite their viral spread in media and online, the smallest amount of scrutiny is able to disprove every single instance. The more likely explanation is an anxiety reaction or a similar psychosomatic response, like the “nocebo effect” (essentially the opposite of the placebo effect), where simply believing something can harm you will cause very real symptoms. We can, indeed, convince ourselves that boogeymen are real. Who among us hasn’t jumped at every small noise after watching a scary movie alone at night? But ultimately, we must separate myth from fact. Especially when, as is the case here, the myth actively harms others.

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Rampant and stubborn mythologies about the contact risks of fentanyl have already created confusion and anxiety in the American public. People need fact-based education about real risks, rather than worrying about fantastical narratives which only stir up panic. At the very least, we can choose not to codify this fiction into laws that will further harm people who use drugs, while protecting no one. 

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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Bruce Gerencser