Fentanyl Safety Resources for First Responders

Source: Vitaliy Vodolazskyy - 123RF

Fentanyl and its analogs pose a potential hazard to law enforcement, public health workers, and first responders who could unknowingly come into contact with these drugs in their different forms. Possible exposure routes vary based on the source of the fentanyl.

While dermal absorption of fentanyl commonly occurs through prescribed use of the drug, inhalation of powder is the most likely exposure route for illicitly-manufactured fentanyl. Inhalation exposure can quickly result in respiratory depression. Law enforcement personnel may come into contact with these drugs on the street during the course of law enforcement activities.

The DEA recommends that officers do not field test drugs if fentanyl is suspected. The substance should be collected and sent to a laboratory for analysis. Exposure via inhalation or skin absorption can be deadly.

First responders may also encounter violent behavior from the user when naloxone is used to reverse respiratory depression as it may put the user into withdrawal.

NIOSH has conducted Health Hazard Evaluations (HHEs) involving law enforcement and emergency responder exposure to hazardous substances at crime scenes.

Fentanyl is a powerful synthetic drug that is similar to morphine and heroin but is 50 to 100 times more potent. Fentanyl and its analogs are members of the class of drugs known as rapid-acting synthetic opioids that alleviate pain. Other drugs in this class include fentanyl analogs, such as acetylfentanyl, butyrfentanyl, carfentanil, alfentanil, sufentanil and remifentanil. Fentanyl acts quickly to depress central nervous system and respiratory function. Exposure to fentanyl may be fatal.

The U.S. Drug Enforcement Administration (DEA) classifies fentanyl and some of its analogs as schedule II prescription drugs, which are typically used to treat patients with severe pain or to manage pain after surgery. They are sometimes used to treat patients with chronic pain who are physically tolerant to other opioids; however per the CDC Guideline for Prescribing Opioids for Chronic Pain, only clinicians who are familiar with the dosing and absorption properties of fentanyl and are prepared to educate their patients about its use and risks should consider prescribing it for chronic pain.

According to NIOSH, standard safe work practices must be applied to all operations where fentanyl or its analogs are known to be present, just as they are applied to any law enforcement operation where narcotics (i.e. a meth lab or heroin) may be present. Do not eat, drink, or smoke while performing operations involving any narcotics; and wash your hands after performing your duties.

Depending on state and local laws, naloxone can potentially be administered effectively by emergency responders, law enforcement, and others trained in its use.