Fentanyl, a synthetic opioid, has stealthily infiltrated communities and left devastation in its wake. The potency of fentanyl increases the risk of overdose, which can lead to serious adverse effects and potentially life-threatening symptoms.
Unfortunately, because fentanyl is commonly mixed with other substances, someone doesn’t have to intentionally use fentanyl to be at risk for a fentanyl-involved overdose. Whether you’re a concerned citizen, a healthcare professional, or someone seeking knowledge, read on to unmask the hidden threat.
What is Fentanyl and What Makes it So Dangerous?
Fentanyl is a synthetic opioid that poses significant dangers due to its extreme potency. Here are the key points:
Fentanyl is up to 50 times stronger than heroin (another opioid) and a staggering 100 times stronger than morphine. Even a small dosage can be lethal.
There are two types of fentanyl:
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- Pharmaceutical fentanyl: Prescribed by doctors to manage severe pain (e.g., after surgery or for advanced cancer).
- Illegally-made fentanyl: Distributed through illegal drug markets for its heroin-like effect. Fentanyl is often mixed with other drugs, making them more powerful, addictive, and dangerous.
Synthetic opioids like fentanyl make up almost 70% of overdose deaths. Even tiny amounts can be deadly. Nonfatal and fatal overdoses involving fentanyl are also on the rise.
Detecting fentanyl in drugs without testing is very challenging. Fentanyl test strips can provide quick results, potentially saving lives. However, some potent fentanyl-like drugs may not be detectable by these strips.
How Does Fentanyl Exposure Happen?
Fentanyl can enter the human body through various routes. Here’s a breakdown of how exposure typically occurs:
- Inhalation: Fentanyl particles can be inhaled while airborne. This is particularly a risk when the substance is in powder form.
- Skin Contact: Fentanyl can be absorbed through your skin. This is more likely when the substance is in liquid form, but it can also occur with powder.
- Ingestion: Accidental ingestion can occur if fentanyl comes into contact with the mouth or is mistakenly consumed.
- Injection: This is less common in accidental exposure scenarios, but fentanyl can be injected by those who use it recreationally.
While fentanyl is highly potent, accidental exposure leading to harmful effects is relatively rare. Most cases of serious harm or fatality from fentanyl involve intentional ingestion or injection. However, given the potency of the substance, it’s crucial to take precautions when potential exposure is possible.
Debunking the Myths
There are two main myths that people ascribe to fentanyl:
Myth 1: Touching Fentanyl Can Be Fatal
Contrary to popular belief, casual skin contact with dry fentanyl products is unlikely to cause toxicity. Fentanyl must be absorbed into the body to produce harmful effects.
Myth 2: Touching Fentanyl Can Make You High or Overdose
Fentanyl’s potency necessitates absorption into the bloodstream. The real danger lies in inhaling airborne powder or aerosolized fentanyl, which can occur during drug handling or law enforcement encounters, though even this route of exposure requires prolonged contact.
What Are The Signs And Symptoms Of Fentanyl Exposure?
Like all opioids and narcotics, fentanyl exposure has a variety of symptoms that vary depending on the individual and how much fentanyl they have been exposed to. Below are some common indicators of fentanyl exposure:
These can include constricted pupils, severe respiratory depression (such as slow or shallow breathing), slower heart rate, difficulty focusing, inability to maintain normal posture, shaky or wandering eye movements, slurred speech, and muscle weakness.
Individuals exposed to fentanyl may exhibit unusual drowsiness or difficulty remaining awake, difficulty keeping their eyes open at unusual times of day, and episodes of significantly reduced hunger.
Fentanyl exposure can lead to poor decision-making or impulse control, hallucinations or delusions, and social isolation or detachment.
In case of a fentanyl overdose, symptoms can be more severe and life-threatening. These can include stupor, cold and clammy skin, pastiness, stiff or limp body, cyanosis (blue / purple tint to skin, lips or fingernails), and vomiting.
What Are the Long-Term Health Effects of Accidental Fentanyl Exposure?
Long-term health effects of accidental fentanyl exposure are not well-documented, primarily because accidental exposure typically involves a one-time, short-term contact with the drug. However, long-term use of fentanyl, whether intentional or accidental, can lead to several health issues.
Physical Health Effects
Long-term use of fentanyl can lead to chronic and severe constipation, which may result in serious health problems such as bowel obstruction. Other physical health effects can include breathing problems during sleep, heart attack, heart failure, and immune system suppression. Poor nutrition and weight loss are also possible.
Hormonal and Reproductive Issues
Fentanyl can cause hormonal and reproductive issues in both men and women. In men, it can lead to sexual problems. In women, it can cause irregular menstrual cycles.
Mental Health Effects
Long-term use of fentanyl can lead to unstable mood and reduced libido. These effects are usually associated with long-term use or misuse of the drug, rather than accidental exposure.
What Can I Do if I Have Been Exposed to Fentanyl?
If you suspect that you have been exposed to fentanyl, it’s important to take immediate action. Below are the steps you should follow:
Try not to touch your face (especially your eyes, nose, and mouth) until you have washed your hands.
If you think you might have touched fentanyl, wash your hands with soap and water as soon as possible. Avoid using alcohol-based hand sanitizers, bleach, or excessive sweating as these can increase skin absorption.
Anyone who experiences harmful effects from a suspected fentanyl exposure should be immediately removed from the scene and provided medical assistance. If fentanyl exposure results in the symptoms of opioid poisoning, naloxone may be a temporary antidote.
If you see powder or a crushed pill, do not touch it or attempt to remove it. Instead, leave the area immediately and seek help.
How Can Accidental Exposure to Fentanyl Occur in Public?
Accidental exposure to fentanyl in public settings can occur in several ways, but such incidents are extremely unlikely to cause an overdose. Those battling addiction should focus on avoiding their personal high-risk situations and preventing overdose.
- Inhalation of Fentanyl Smoke or Airborne Powder: The risk of overdose from secondhand fentanyl smoke or airborne powder is extremely low. Research shows that fentanyl use in public places does not produce enough contamination in the air to cause an overdose in passengers. However, if you see drug paraphernalia such as pipes, liquid, or powder, it’s advised to leave the area immediately and contact law enforcement.
- Touching Fentanyl: Touching fentanyl does not typically lead to an overdose. While fentanyl can be absorbed through the skin, this happens only with constant direct contact over hours and days. However, skin absorption can be increased by using alcohol-based hand sanitizers, bleach, and excessive sweating. If you think you might have touched fentanyl, it’s recommended to wash your hands with soap and water as soon as possible.
- Ingestion of Fentanyl: Ingestion is another potential route of exposure, but it’s less likely in public settings than skin contact.
- Exposure in the Workplace: For first responders and healthcare workers, exposure can occur during response situations, where powder-like forms of fentanyl can become easily airborne. Touching clothes or bedding, conducting triage, taking vital signs, and reviving or transferring a patient who has used the drug or has the drug in their possession could all lead to exposure risk through inhalation, ingestion, or skin contact.
How Can First Responders and Healthcare Workers Safely Handle Situations Involving Potential Fentanyl Exposure?
First responders and healthcare workers can encounter fentanyl in various forms during their work, including powder, tablet, and liquid. The potential exposure routes of greatest concern include inhalation, mucous membrane contact, ingestion, and percutaneous exposure. Here are some safety measures to take to handle situations involving potential fentanyl exposure:
- Personal Protective Equipment (PPE). Wearing appropriate PPE is crucial. This includes nitrile gloves, respiratory protection if powdered illicit drugs are visible or suspected, and eye protection. A properly-fitted, NIOSH-approved respirator can prevent inhalation of powders.
- Safe Work Practices. Avoid doing anything that can make powder become airborne. Avoid touching your eyes, nose, or mouth after touching any surface that may be contaminated, even if you are wearing gloves. Wash your hands with soap and water after working in a potentially contaminated area. Avoid using hand sanitizer or bleach.
- Training and Awareness. First responders should be aware of the risks of fentanyl exposure and know the signs of fentanyl intoxication. They should also take training on recommended safe operation procedures.
- Incident-Specific Plan. When arriving at a scene, responders should analyze the incident, determine if illicit drugs and/or other hazards may be present. Create an incident-specific plan to perform field testing.
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