Police are Dropping Left and Right from Fentanyl
But not from Overdoses
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As recently as December 14, 2022, a media story spread widely with the headline, “Florida cop treated for overdose after exposure to fentanyl during traffic stop.” Allie Griffin of the New York Post wrote that “shocking” video shows the officer receiving Narcan after somehow ingesting the “deadly drug” fentanyl. The officer purportedly found the drugs in a “rolled-up dollar bill,” which she apparently unfurled while wearing rubber gloves. Fellow officers reported that the affected officer “may have been exposed due to the wind blowing the drugs into her system.” Later, in reference to the event, the officer told media “I have done this 100 times before the same way. It only takes one time and a minimal amount.”
At least part of that statement is misleading.
Fentanyl is dangerous. On that there is no question. Tens of thousands of people overdose on it every year in the United States. It is a synthetic opioid that works by binding to the body’s opioid receptors. There are five of these, mu receptor (MOR), kappa receptor (KOR), delta receptor (DOR), nociception receptor (NOR) and zeta receptor (ZOR); with a variety of subtypes. Fentanyl binds to the mu receptor faster than heroin, which is among the reasons why it is referred to as “stronger.” Basically, it binds faster and holds that binding more firmly than heroin does. This can lead to irregular and slow breathing, and eventually to hypercapnia (too much CO2 in the bloodstream) and hypoxia (low levels of oxygen in the bloodstream). It also reduces the efficacy of Narcan compared to treatment of a heroin overdose. The concentration of the ingested fentanyl also effects the efficiency with which it conducts this binding process. This is another reason why it is dangerous as a street drug, because users cannot possibly know the composition of the drug they are ingesting.
So, why is the story outlined above misleading?
To begin with, it is nearly impossible to inadvertently consume enough fentanyl through touch or inhalation to even notice the effect, let alone overdose. This is true under virtually any conditions other than if the drug were purposefully weaponized. Weaponized fentanyl was used in the 2002 Moscow theater attacks, but the aerosol consisted of two types, carfentanil and remifentanil, and likely was produced through processes developed in Russian military research facilities still not available in the public domain (though, I am not willing to look, thank you very much).
Fentanyl as a prescribed drug is administered through touch all the time. This method of deployment is purposely designed for maximum dermal absorption. According to the American College of Medical Toxicology (ACMT) and American Academy of Clinical Toxicology (AACT), covering the palms of your hands with these patches would still take 14 minutes to receive 100 micrograms (mcg) of fentanyl. An overdose usually occurs around the ingestion of 2mg, or 2000 mcg. These organizations further note that dermal absorption of illicit fentanyl would take much longer than through patches because the drug must have enough exposure area and moisture to allow for absorption. Moreover, to reach the 100 mcg amount the drug must be delivered at a “steady” rate. And even if somehow it was sufficiently absorbed, the effects do not occur rapidly.
Inhalation-induced overdose is also nearly impossible in a street setting. At the highest airborne concentrations that workers who make the stuff are likely to face, it would require 200 minutes of exposure to reach the same 100 mcg threshold. There, the manufacturing process grinds the material to a much finer particulate size than fentanyl encountered on the street. Even still, if ground to the same levels as in the factory where its made, inhalation of the substance would not cause an acute reaction because it would take up to three and a half hours to consume enough to generate an adverse reaction.
The officer in the story probably wasn’t intending to mislead anyone…
Since 2016, first responders have been told through training, time and time again, that “Just touching fentanyl or accidentally inhaling the substance during enforcement activity or field testing” can kill you. The statement was from a warning issued by the DEA that was accompanied by a YouTube video. The DEA has since taken this media down. Nevertheless, this assertion continues to spread among the law enforcement community. The DEA’s 2016 claim has long been rebutted by a variety of medical and chemistry organizations for the simple reason that the odds of a fentanyl overdose in the field from an inadvertent exposure through touch or inhalation are all but zero. The DEA’s latest recommendation reads “Incidental skin contact may occur during daily activities but is not expected to lead to harmful effects if the contaminated skin is promptly washed off with water.” Alas, social media feeds on the extreme, which is rarely reflective of reality, and so the belief persists. Studies have shown that educating first responders on fentanyl encounters very effectively alters their perception and leads to better service in response situations where a fentanyl user is involved.
There are a lot of hypotheses about what is actually happening to the responders in the viral videos purporting to show a fentanyl overdose. These include panic attacks or conversion disorders followed by psychosomatic effects resulting from the “nocebo effect,” which is when inaccurate beliefs about a drug create a physical reaction in a person who believes they are exposed to that drug. But what is almost certainly not happening in nearly every viral video out there is an actual overdose of fentanyl. Medical doctors and other experts on the drug’s effects have observed that what occurs in the videos does not comport with the effects of a fentanyl overdose, though they very often are quite similar to the presentation of a panic attack or conversion disorder. The administration of Narcan in these videos is irrelevant because it can create a sort of placebo effect if the recipient truly believes they are experiencing an overdose. Narcan generally has no effect on a person who has not overdosed on opioids.
Police departments have been especially resistant to those questioning the circumstances of purported officer overdose events. In the case this article opened with, the police chief immediately came to the defense of the officer and tried to downplay the scientific consensus on the extreme unlikelihood that fentanyl caused the incident. First, she stated that her department “trusts” the officer. The issue, however, is not about “trust.” Even if the officer was fully confident that she overdosed on fentanyl, it is irrelevant to the question of whether she actually did. The chief then said, “Studies completed years ago do not accurately reflect the strength and risk of current street-level fentanyl.” This is simply either a misunderstanding of “the studies” or a blatant attempt to amplify the alleged dangers of fentanyl to police in furtherance of some other agenda.
Notably, the chief would not release the officer’s medical records about the incident, hinting that somehow doing so might impede their investigation. On this point, the chief’s position is logically inconsistent. It is hard to imagine how releasing an excerpted medical record that simply confirms or denies whether the officer overdosed on fentanyl is any more of an impediment to the investigation than the release of the body cam from the same incident. Normally, evidence is not released publicly during an investigation to avoid tainting a jury. In other instances, withholding is to prevent defendants further opportunity to hide their criminal acts. Publicly releasing a record confirming or denying the officer’s exposure to fentanyl seems only to potentially jeopardize a charge of fentanyl possession. If the substance was, in fact, fentanyl, then the charge will stick. If not, then it rightfully should be dropped (or changed based on the composition of the substance). Releasing the body cam video, however, seems far more likely to open the door for complicating the investigation. It almost certainly runs the risk of tainting the objectivity of a jury. And it creates a variety of other complications depending upon the circumstances.
There are plenty of reasons why some departments might take a position similar to this Florida chief. One is the very real—if wrongly held—belief that fentanyl is a dangerous substance for police exposed to it. Another is that alleged fentanyl overdoses by responding officers often lead to elevated charges such as assault or endangering officers. Still another might relate to funding for police departments where fentanyl is frequently encountered. The more dire a situation seems, the more money comes in.
Regardless of the reasons for why some police cling to the belief in their risks associated with fentanyl, there is one very important issue that has yet to be explained. There were at least 42,700 fentanyl overdoses in 2020. And the number for 2021 is likely even higher. In 2022, 14,700 pounds of fentanyl were seized by CBP alone. Yet in 2020, 2021, 2022, nor in any other year, has there been a single confirmed case of a death of a police officer from an inadvertent overdose of fentanyl in the midst of law enforcement activities. With all of this exposure to the drug, it is beyond belief that if fentanyl was as dangerous (by inadvertent exposure) as some continue to claim that not a single officer death would have occurred. Similarly, I could not find a single report of a firefighter or paramedic dying of an accidental overdose in the field. I also could not find a video purporting to show an overdose in the field involving either of those occupations. Moreover, if it were so easily consumed by touch, why would users ever employ any other method to ingest it, such as shooting up?
Perpetuating the myth of inadvertent fentanyl overdose risk hampers police agencies from effectively doing their job. It adds stress to officers who already undergo an inordinate amount of it in the first place. It needlessly consumes taxpayer dollars by the overreaction to the discovery of fentanyl by police, such as units who still use hazmat gear to remove the drug. And it leads to charging decisions that simply don’t meet any evidentiary standard (meaning, charging for endangering or assaulting officers merely by contact with the drug). At a time when the public view on policing in the United States remains mixed, promulgating easily disprovable myths does a disservice to the great number of departments that are performing a difficult job admirably.
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I am a Certified Forensic Computer Examiner, Certified Crime Analyst, Certified Fraud Examiner, and Certified Financial Crimes Investigator with a Juris Doctor and a Master’s degree in history. I spent 10 years working in the New York State Division of Criminal Justice as Senior Analyst and Investigator. Today, I teach Cybersecurity, Ethical Hacking, and Digital Forensics at Softwarica College of IT and E-Commerce in Nepal. In addition, I offer training on Financial Crime Prevention and Investigation. I am also Vice President of Digi Technology in Nepal, for which I have also created its sister company in the USA, Digi Technology America, LLC. We provide technology solutions for businesses or individuals, including cybersecurity, all across the globe. I was a firefighter before I joined law enforcement and now I currently run a non-profit that uses mobile applications and other technologies to create Early Alert Systems for natural disasters for people living in remote or poor areas.
