Thursday, June 29, 2017

Fentanyl Skin Exposure: An MD's View

 A story published in Slate magazine yesterday questions the assumptions behind the widely reported episode of the Ohio police officer who required four doses of Naloxone after brushing Fentanyl off his shirt.

The Viral Story About the Cop Who Overdosed by Touching Fentanyl Is Nonsense

Written by Jeremy Samuel Faust, an emergency physician at Boston’s Brigham Young Hospital, the story discusses the case with noted toxicologists, including Dr. Ed Boyer of the Harvard Medical School, who says,  “Fentanyl, applied dry to the skin, will not be absorbed. There is a reason that the fentanyl patches took years [for pharmaceutical companies] to develop.”

 
 

The story mentions that the widespread coverage of the Ohio episode and others has caused the American College of Medical Toxicology to speed up the publication of their forthcoming position paper on Fentanyl Exposure.

We should all welcome the toxicologists’ entrance into the debate before the viral stories of “life-threatening” encounters cause any more hysteria.  To date, we have had to rely on the DEA’s warnings, which while well-motivated to protect responders, do not appear to be fully medically vetted.  They overstate the danger of skin contact and advocate for administering frequent doses of Naloxone to exposed responders who are not in respiratory depression.

In the meantime, wear your PPE, use due caution, and follow your existing medical protocols when dealing with possible opioid overdoses.