Experts Warn Viral Police Video and Media Coverage of Fentanyl Could Cause More Harm

Drug policy and medical experts on Monday continued to criticize a "public safety" video released last week--featuring a patrol deputy who collapsed after being exposed to what the San Diego County Sheriff's Department said was the synthetic opioid fentanyl--and raise concerns about misinformation spread by law enforcement and news media.

The video focuses on Deputy David Faiivae, who collapsed at the scene of an arrest on July 3. Cpl. Scott Crane gave Faiivae Narcan, a nasal spray containing the drug naloxone, which is used as an emergency treatment for opioid overdoses. Faiivae was later taken to the hospital. The sheriff's department hasn't yet released a report confirming what he encountered.

"Despite anecdotal reports from nonmedical sources about overdose from 'exposure' to fentanyl, it is not possible to overdose on fentanyl or fentanyl analogues through accidental skin contact or from close proximity alone," Dr. Ryan Marino, a medical toxicologist and emergency physician at University Hospitals in Ohio, said Monday.

"Fentanyl and fentanyl analogues do not readily cross the skin barrier and do not aerosolize well. The only way to overdose on these substances is from injecting, snorting, or otherwise ingesting them, or in the case of the fentanyl patch, from mixing with an absorbable solvent and applying very large quantities for very long durations of time," he explained. "Furthermore, opioid overdose is a clinical syndrome with well-defined characteristics that do not align with these reports."

Another expert echoed those points to The New York Times on Saturday:

An opioid overdose tends to leave victims with shallow, almost undetectable breath, limp limbs, blue lips and fingertips, and gurgling sounds coming from the mouth, said Leo Beletsky, a professor of law and health sciences at Northeastern University in Boston.

He added that "it is not biologically possible" to experience overdose symptoms, or to die, from touching or being exposed to the drug, and that alternative explanations to Deputy Faiivae's reaction could be the enormous stress and panic among law enforcement officers around this issue.

Most opioids take 30 to 90 minutes to become fatal, and a fentanyl overdose can be fatal in 10 to 15 minutes, Professor Beletsky said. He clarified that the only way to get fentanyl into someone's system through their skin is by using medically prescribed fentanyl patches for pain, and those have led to very few, if any, fatal overdoses.

He added that reactions to fentanyl such as Deputy Faiivae's tend to be reported only by police departments or drug administrations, and rarely has a toxicology report or a medical follow-up shown that an officer, in fact, overdosed on fentanyl.

Like Beletsky, Marino pointed to law enforcement fears of the drug, and the potential consequences.

"This misinformation not only hinders appropriate responses to people who use drugs and resuscitations of people experiencing true overdose, but also worsens the stigma faced by people with substance use disorders and has been used to increase criminalization of this already vulnerable group," he said. "The fear and worry generated by these reports, too, is likely causing the symptoms of anxiety and panic that people are experiencing in these events."

The Los Angeles Timesnoted Sunday that a June study published in the International Journal of Drug Policy found that U.S. law enforcement agents "wrongly believed that dermal exposure to fentanyl was deadly and expressed fear about such exposure on scene. Officers had a lack of education about fentanyl exposure and faulty or dubious sources of information about it."

Marino said the Covid-19 pandemic "has sadly demonstrated all too well how medical misinformation harms everyone and knowing that more than 93,000 Americans died from overdose in 2020, we all have an obligation to ensure that everyone is better informed."

Kassandra Frederique, executive director of the nonprofit Drug Policy Alliance, said Monday that "it is unconscionable and completely irresponsible for law enforcement organizations to continue fabricating false narratives around fentanyl."

"Content like this simply creates more fear and irrational panic that fuels further punitive responses to the overdose crisis, instead of the public health approach we need," she said of the San Diego video. "We already know how this story goes, because we experienced it in the '80s and '90s with crack cocaine. Law enforcement-driven, media-perpetuated hysteria inevitably leads to extreme racially biased enforcement and mandatory minimum sentencing."

Media coverage, such as TIME's 1991 "Crack Kids" cover, "that drove extreme sentencing in the '90s has now been replaced with viral videos produced by local police departments purporting to show officers overdosing after barely coming in contact with fentanyl," Frederique continued. "Both have been proved false, but the devastating consequences of the policies they fueled unjustly remain."

Frederique warned that "it is incredibly dangerous to go back down this path, especially when the United States is experiencing the highest rate of overdose deaths in history and we have finally begun to make progress on reducing extreme sentencing."

"Rather, we must divest from our reliance on policing and punishment-first strategies that have consistently failed to save lives or reduce the supply of illicit fentanyl-related substances," she said. "And instead, we must prioritize forward-thinking, health- and evidence-based approaches--like what the STOP Fentanyl Act calls for--that address the root cause of fentanyl-related overdoses and other associated harms."

The Support, Treatment, and Overdose Prevention (STOP) of Fentanyl Act of 2021, sponsored by Rep. Annie Kuster (D-N.H.), aims to expand fentanyl research and education, enhance overdose prevention, support treatment programs, and improve public health data and training for law enforcement.

Along with urging Congress to urgently pass that bill, Frederique had a message for journalists.

"We call on media to think twice about amplifying these harmful narratives that have devastated Black, Latinx, and Indigenous communities over the last 50 years and led to more dire public health and societal consequences as a result," she said. "To that extent, we would encourage media to engage more public health experts who can actually speak to the science and solutions, rather than law enforcement, when covering public health crises such as these."