What’s Really Going on in Those Police Fentanyl Exposure Videos.

General General Discussion
1

https://www.nytimes.com/2022/07/13/magazine/police-fentanyl-exposure-videos.html

For the past five years, I’ve watched a bizarre news cycle play out on repeat. The most recent recurrence began on June 16, when KCTV5, a local news organization in Kansas City, Mo., published police body-camera footage under a dramatic headline: “ ‘I Knew I Was Dying’: How 5 Rounds of Narcan Possibly Saved KCK Police Officer’s Life.” The operative word in that sentence is “possibly.” The footage shows a police officer standing on a snowy lawn in what looks like a suburban neighborhood, wearing sunglasses and disposable gloves, inspecting pills stashed inside a crumpled piece of paper. “Seal it up — that’s fentanyl, dude,” another officer says. “Get that in a bag quick, so we don’t have an exposure.” The time stamp on the video then jumps to five minutes later. The officer who held the pills is now collapsed on the ground, limbs splayed as though making a snow angel. We hear another officer yell, “Narcan, Narcan, Narcan!” The fallen officer gasps rapidly as his fellow officers, with what seems like genuine panic, spray the opioid-overdose antidote up his nose several times.

The officer was taken to a nearby hospital and later released, and, like clockwork, the vivid footage began circulating. But there’s one major problem with all this: It’s nearly impossible for the symptoms depicted to have been caused by “fentanyl exposure.” The scientific literature shows, definitively, that brief contact with fentanyl is not sufficient for it to enter the bloodstream and cross the blood-brain barrier to cause such a rapid overdose. All the way back in 2017, America’s leading toxicological societies noticed the spread of these viral exposure stories and tried to put them to rest; there have since been countless fact-checks and scientific debunkings by major news outlets, including one from The Times’s editorial board. Last month, a 33-year-old clinical toxicologist and emergency-medicine pharmacist named Ryan Feldman co-published a case study about the time he accidentally spilled a mammoth dose of pure liquid fentanyl all over himself at work; he simply washed it off, with no adverse effects.

It’s not that the symptoms seen on video are feigned. Some psychologists suggest a kind of “mass psychogenic illness” is afoot, or a form of conversion disorder — neurological symptoms without a clear physical cause — or, potentially, simple panic attacks. Police officers have been told, by authorities including the Drug Enforcement Administration, that microscopic amounts of fentanyl can be deadly; they are taught to fear this substance. Their bodies may react accordingly, exhibiting symptoms, like rapid breathing, that are indicative of distress and panic. (Fentanyl produces the exact opposite effect; high doses result in slow and shallow breaths.)

2

Thinks it’s more like Carfentinil.

Look up Moscow theater hostage crisis. It was used a chemical weapon

3

“Gasping rapidly” does not sound like any opioid at all. Sounds exactly like a panic attack.

4

Carfentanyl, an ultra-potent synthetic opioid, is approved for use only in veterinary medicine as a tranquilizing agent. However, many cases of human poisoning with carfentanyl have recently appeared in the news with limited information given and scientific literature provides only 1 case of documented human exposure to carfentanyl.

Fifteen cases of death from drug overdoses with carfentanyl involvement are being presented. Fifteen blood and urine samples have been taken for alcohol and drug testing. Headspace gas chromatography was used for alcohol detection. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) and liquid chromatography–time-of-flight mass spectrometry (LC/MS TOF) system was used for drug detection.

Sixty-three cases of death from poisoning with drugs have been tested for carfentanyl in the State Forensic Medicine Service. Fifteen of them were positive for carfentanyl.

The cases mentioned above show that carfentanyl exposure causes signs and symptoms similar to other opioid toxicity. Carfentanyl intoxication may even be fatal if appropriate treatment is not available. Therefore, nowadays it is very important to draw forensic medicine expert’s attention to new substances in drug trade.

https://journals.lww.com/md-journal/fulltext/2018/11300/human_deaths_from_drug_overdoses_with_carfentanyl.85.aspx

5

Yes, I’m familiar, and its toxidrome is not what was described in the OP, not at all.

6

Definitely a panic attack, get nervous handling street grade carfentanyl sure.
[video=youtube_share;Jd76HxqCPf0]https://youtu.be/Jd76HxqCPf0[/video]

7

No opioid causes rapid, gasping ventilation - that does sound like a panic attack.

Also, rapid fire nasal Narcan doesn’t have the effect of a single dose followed by IV administration due to saturation of the vascular beds in the nasal cavity. Can it soak in some in the posterior oropharynx? Possibly, but that’s still not enough drug availability to counter a Carfentanyl overdose. Carfentanyl is a “one step” killer. The user is typically found at the location he or she used, falling off the toilet. Another telltale sign is the foam cone of froth that covers the face of the user, ante mortem. Onset of pulmonary congestion is rapid, and is the cause of all the frothy secretions from the airway. Conversely, fentanyl OD’s take around ten steps to bring the user down. You might not readily locate the point at which the user fixed, but the decedent is commonly found near water; kitchen, bathroom, etc. The hypotension brings on intense thirst. Remember getting hurt when you were a kid? (“I wanna drink of water!”) Same effect.

8

An explanation on how this works, for nerds, by nerds:https://elifesciences.org/articles/52694

9

Dealer bare handed bindles full of those pills all day, carried how many in his pocket? Users, same but less quantity. Cop touches one, while wearing gloves, and goes full on “OD”?

Nah, no psychosomatic factor at play here, not at all.

10

Easy way to get a free vacation and paid off by the tax payers for his sacrifice

11

Exactly what I was thinking.

12

Exactly what I was gonna say. If true, the opioid problem would solve itself.

https://www.ncdhhs.gov/media/1740/download

What are the risks of fentanyl exposure for first responders?

A first responder can be exposed to fentanyl in one of five ways: skin contact, inhalation, ingestion, contact with a mucous
membrane (eyes, nose, etc), or with a needlestick. The most likely way for a first responder to be exposed to fentanyl is through
brief skin exposure. For skin exposure, clinical toxicology experts6 state:

“The risk of clinically significant exposure to emergency responders is extremely low.”

Skin exposure is not expected to lead to toxicity due to its extremely poor penetration of the skin barrier, and symptoms of
intoxication from skin exposure are unlikely. If your skin is exposed to fentanyl, you should wash the area with water as quickly
as possible. Do not use alcohol based hand sanitizers or bleach; they do not effectively wash opioids off skin and may
increase skin absorption of fentanyl.

https://www.science.org/content/blog-post/fainting-fentanyl-exposure-nope

Let’s talk about fentanyl. It is a very powerful ligand for opioid receptors, and it has very powerful pharmacological activity. As the world knows, that activity includes a very real possibility for addiction, as with all pain-relieving opioid agonists, and it also comes with the other dangerous side effects such as respiratory depression. That’s how overdoses with such drugs typically kill people - they lose consciousness and stop breathing. This seems to be through loss of sensitivity to carbon dioxide levels - the “need a deep breath” reflex just does not kick in, and oxygen levels continue to drop. In opioid use for pain this effect tolerates out rather quickly, but a large dose can cause this effect even in people who have developed a high opioid tolerance in general. It’s thought that reduced sedation in such cases (another typical opioid side effect) makes that particular warning sign less effective. Another problem with overdoses is what’s called “wooden chest syndrome”, where the abdominal muscles became so rigid that breathing deeply becomes difficult or impossible. That one seems to only occur with the most potent synthetic ligands; it’s much less common with something like heroin.

For these reasons and others, opiods are dangerous substances to handle, and because of fentanyl’s potency it is even more dangerous than morphine or heroin (and those two are not exactly benign things to deal with). Fentanyl overdoses are also unpredictable because of side reactions with other drugs. Caution in being exposed to fentanyl is completely appropriate, and in light what I’ll be saying in the rest of the post, I want to make that part very clear. This is a dangerous drug and should be dealt with that way. But over the years an entire mythology has grown up around the drug because of these dangers, and this has had some rather odd consequences. Too many people now believe that they can be immediately killed by a fentanyl overdose from any sort of skin contact with the drug, and that’s just not true. It’s potent and toxic for sure, but you have to be dosed with it for that to happen.

This has come to more attention since the CDC recently removed a video from the NIOSH site that it says “mischaracterizes” the dangers of fentanyl exposure for police and first responders. There are many such videos of police officers quickly showing overt symptoms or even collapsing after exposure to minute quantities of fentanyl - or even just possible fentanyl - and these are just not pharmacologically possible. Fentanyl is not absorbed through the skin like this. Yes, there are indeed fentanyl skin patches for hospital pain relief, but these are formulated with other agents to make the skin more permeable under the patch (as are all such skin-patch dosage forms). Think about it: you do not see opioid addicts rubbing small bits of fentanyl on the backs of their hands for a quick hit. But this hysteria - which is what to call it - has spread to the point that random people are fainting when they think they’ve been exposed by (for example) picking up money off the floor.

13

I’ve had deputies fall out from fentynal and end up in the ER. Some of these posts seem like we’re in another realm. This level of alternate reality really is a reason to realign your BS meters.

For whats it worth none of the three ended up with paid vacations, they were off the rest of the day and the next and then returned to work. At the ER they all got IV’s. That’s the only thing right with this post is the IV is much more effective.

I think some of you should look into the soveriegn movement, you’ll fit right in.

14

What it reminds me of is those revivals where the preacher touches someone and they fall down and their limbs tighten up like you see in that video. Some, maybe most, people are hardcore suggestable and can fall victim to that kind of mass psychosis type stuff. You see the same thing in voodoo culture, where alleged priests claim to be able to control people with their mind and make them fall down and clench up like that. You’ll see the priest motion towards someone and they’ll fall down, and it’s claimed that they’re not paid shills but genuinely think they’re under his spell. Science has a hard time explaining both of those examples.

What’s also striking is that in both examples you have this induced high stress environment. In the revival example there’s a lot of yelling, there’s usually a choir or band, and a big crowd of people shouting. Same in the voodoo example. I could see the fear of the drug inducing that same kind of high stress environment.

15

I believe it if they somehow got dosed. It’s nasty shit if inhaled, they rub their eyes or otherwise introduce it to their system. But simply handling it aka brief skin contact, that is what most are calling BS on.

16

I won’t comment on shit I know nothing about.

17

You are doing the internet wrong.

18

We’ve had a few guys at work get exposed, but that was with powder. All the cases had them somehow get the powder puffed up into their face. Usually from being careless opening containers that they didn’t think would have the powder.

As far as the pills… I’ve handled thousands. Don’t eat them or smoke them and you’ll be fine.

19

IV Naloxone, or just “IVs”?

Sorry about your dudes.

20

Sounds like you need a lesson in Liberty and human nature.

Do you speak for all the police in the country and know that none of them received or were after taxpayer funded vacations?