On Sunday afternoon, news broke that authorities responding to a car crash on Golden Gate Bridge were exposed to fentanyl, a potent opioid designed to treat pain. According to the California Highway Patrol, the four responding personnel — four CHP officers, a fire department employee, a bridge patrol officer and a tow truck driver — exhibited signs of overdose, and were rushed to the hospital. The Alexander Avenue off-ramp was closed and the scene was declared a hazmat situation.
It’s a sensational story, and for weekend reporters it was likely a welcome break from wildfire and COVID coverage. But it should be read with a highly critical eye. As studies have proven time and again, it’s nearly impossible to consume fentanyl just by being near it.
This rumor pops up every couple of years — so often, in fact, that several medical papers have been written addressing the misinformation. In 2017, the American College of Medical Toxicology and the American Academy of Clinical Toxicology co-published a paper on emergency responders and fentanyl exposure. In it, they state “for opioid toxicity to occur the [fentanyl] must enter the blood and brain from the environment. Toxicity cannot occur from simply being in proximity to the drug.”
The myth of accidental fentanyl exposure is usually associated with two methods: inhalation, or physically touching the drug. Both are unlikely. “At the highest airborne concentration encountered by workers, an unprotected individual would require nearly 200 minutes of exposure to reach a dose of 100 mcg of fentanyl,” the above paper said. The addition of masks to the situation — a requirement for all first responders due to the COVID-19 pandemic — makes the possibility of breathing in fentanyl even less likely in this scenario.
Furthermore, dermal absorption through the skin “is unlikely to cause opioid toxicity… even a high dose of fentanyl prepared for transdermal administration cannot rapidly deliver a high dose.”
Kristen Marshall from the Drug Overdose Prevention and Education Project, tells the Examiner that “Accidental exposure to fentanyl, like touching it or being in the same room as it, does not immediately lead to an overdose. That’s not how drugs work: They’re designed to interact with the body in certain ways, and fentanyl as we know it is not designed for transdermal absorption, and it doesn’t just magically float in the air in critical mass enough to be inhaled.”
Science aside, if fentanyl were so easily consumed, why would people smoke or inject it? And wouldn’t we see people collapsing all over The City just from being near fentanyl?
The validity of the Golden Gate Bridge story is also contingent on the white powder actually being fentanyl — which as of yet is unproven. As of Tuesday morning, the white powder discovered in the vehicle had not been tested by a toxicologist to determine that it was, in fact, fentanyl. CHP Officer Andrew Barclay told me that “passive tests were done at the scene that don’t give us exact names. There were differing results as to what was in the vehicle.”
So if it wasn’t a fentanyl overdose, why did so many people get sick? One common theory is that fentanyl hysteria gives first responders panic attacks. According to an article written by Eliza Wheeler and Savannah O’Neill for the National Harm Reduction Coalition, “Incidents where responders were treated for alleged ‘exposure’ were exhibiting symptoms of what appear to be anxiety or panic: dizziness, rapid heartbeat, sweating, even fainting – which are not symptoms of fentanyl overdose.” Other theories are that first responders are intentionally taking the drugs. It’s also possible the substance found inside the vehicle was a hazardous material other than fentanyl.
A recent example of the hysteria over fentanyl exposure in the Bay Area occurred in 2019, when nine sheriff deputies and five inmates at San Francisco’s Hall of Justice were hospitalized after an alleged fentanyl exposure. Each time these stories appear they’re shared widely, and the myths around fentanyl are further perpetuated. This can have longlasting harmful effects for people who use drugs. If a first responder responding to a drug overdose is terrified of accidentally consuming fentanyl, they may delay or avoid providing lifesaving CPR.
O’Neill and Wheeler liken the stigma around fentanyl users to that of the HIV epidemic. “We have been here before: In the late 1980s, doctors refused to treat HIV patients out of fear of contracting the disease, even once they knew contagion via casual contact was impossible,” they write. “This shameful history is now mirrored in the reports of cases where first responders are refusing to treat overdosing people before they secure hazmat suits. This is unnecessary, fear-based and should be considered criminal neglect.”
“This feels like just another opportunity for law enforcement to villainize people who use drugs and center themselves as victims of this country’s overdose crisis,” Marshall added. “By continuing to perpetuate this myth that people who use drugs are dangerous to themselves and others, they only contribute to more deaths and suffering.”
As part of the effort to educate first responders, Wheeler and Marshall wrote a guide on how to safely respond to fentanyl when it’s encountered.
It’s easy to take the information that authorities provide us at face value. But as our nation is slowly becoming more critical of police officers’ accounts — largely in the context of police violence — there must also be a healthy skepticism toward their portrayal of drugs, and the people who use them.
Welcome to Hard Pill to Swallow! In 2020, issues of public health are front and center. In this column, I’ll dig deep into the ways class, race, gender identity and income impact the equity of public health access in San Franciscans. Got a tip, or a story idea? Shoot me an email at firstname.lastname@example.org.