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Fact or Fiction: Officer Overdoses on Dermal Fentanyl Exposure

In 2016 and 2017 multiple reports surfaced in the media depicting law enforcement and first responders becoming ill during routine arrests or while treating individuals abusing fentanyl. Much fear among the public ensued as the media interpreted these symptoms as being consistent with opioid overdose following a brief dermal exposure. 

In response to those worries, the National Institute for Occupational Safety and Health (NIOSH) recommended that law enforcement, public health care workers, and first responders wear a P100-rated respirator, nitrile gloves, and eye protection to protects themselves from fentanyl toxicity. They also advised to don coveralls and protective sleeves if performing tasks that may aerosolize fentanyl. The Drug Enforcement Administration (DEA) similarly released a statement that “just touching fentanyl or accidentally inhaling the substance during enforcement activity or field testing the substance can result in absorption through the skin.”

Local and national media sources cited such expert recommendations as evidence for and verification of the risk of severe opioid toxicity following dermal fentanyl exposures despite limited empirical evidence. The American College of Medical Toxicology (ACMT) and the American Academy of Clinical Toxicology (AACT) collaborated on a formal position statement using the best available evidence to ameliorate such concerns and revise those recommendations. Citing established pharmacokinetic literature on fentanyl patches, the position statement directly challenged the potential for severe toxicity from just touching fentanyl. Representatives from ACMT and AACT met with government officials on the issue. Partly as a result of these conversations, the White

House Office of National Drug Control Policy released recommendations that aligned with ACMT and AACT’s position. The NIOSH subsequently revised its recommendations. 

Additionally, popular media sources such as the Huffington Post, Snopes, local news stations, and twitter cited ACMT’S official position statement on multiple occasions. ACMT further disseminated this expert position statement by partnering with AACT in fireside TweetChat in November 2017. The collaboration of ACMT and AACT with the White House and other governmental agencies resulted in improved education of the public, government, law enforcement, and health care workers.

By: Theresa Kim, MD, ACMT Member