There has been some updated information regarding fentanyl exposures to first responders – namely, getting fentanyl just on your skin will not cause you to overdose. However, the risk is genuine, and overdoses happen when first responders accidentally ingest the drug into their body.
However, several physicians have spoken out about against the hysteria regarding fentanyl exposure, notably first responders are blowing fentanyl exposure out of proportion. These physicians have said what first responders have suffered from isn't fentanyl exposure, but from some other circumstance such as a panic attack. Some have gone so far and state there is no way someone can overdose from fentanyl by coming in contact with the drug. One such news story ran in USA Today this past summer, click on the story here.
We know first responders are not fabricating all of these overdoses. Some of these could be due to some form of anxiety, but certainly not all of these cases. There are several confirmed cases of law enforcement suffering from a confirmed accidental opiate overdose that was reversed by Narcan. There are also cases of police K9s suffering from opiate overdoses during a vehicle sniff, and the dogs were revived with Narcan. Yes, people can get anxiety or panic attacks knowing they can potentially overdose from fentanyl, but dogs don't.
However, just getting fentanyl on your skin isn't enough to kill you. The California Narcotics Officers Association and DEA Southwest Laboratory in Vista, CA, put on a very informative clandestine laboratory class. Chemists at the DEA advise you would need to sit in a bath of fentanyl for 2.3 hours to suffer from a transdermal overdose, and you would need to sit in a tub of the potent fentanyl analogue, carfentanyl, for 8.5 minutes to suffer from the same transdermal overdose.
Where most first responders get exposed is they somehow get the drug into their body. They inhale a powder, the drug gets on their skin and transferred into their body (introduced to nose or mouth), or some other type of exposure. Dr. Lisa Peters of the Fox Valley Animal Referral Center states if you Narcan a person or a working dog using a nasal applicator, be careful of a sneeze after administration. If fentanyl is still in the person or dog's nose, you could potentially have the contents of that sneeze come at you and put you at risk for exposure.
Having necessary Personal Protection Equipment (PPE) is essential to prevent a fentanyl overdose. Wearing an N95 mask, nitrile gloves, and safety glasses or goggles is a must. 3M Company, who manufactures popular PPE equipment, recommends a P100 mask for first responders. Never use hand sanitizer when decontaminating yourself as this opens up the pores on your skin and creates the risk of overdose. Use soap and water to decontaminate and remove any potential fentanyl on your skin. The above are the basic equipment and practices, and cases involving larger amounts will require better equipment and training.
Fentanyl exposures and overdoses are very real. Wear proper PPE equipment, especially when you are in situations when an opiate overdose is suspected. People in the medical community who state otherwise either don't know what they're talking about, don't work in the real world with clandestine laboratory-produced drugs or are influenced by some other motivator. Take precautions to take care of yourself, your coworkers, and your family.