No, you’re not going to overdose by accidentally touching a small amount of fentanyl, according to health experts.
There is a common misconception that if you touch fentanyl either by coming across a white powder or touching an object with fentanyl on it that you’ll overdose. Health experts are working to make it clear that this is not true.
“It is a common misconception that fentanyl can be absorbed through the skin, but it is not true for casual exposure. You can’t overdose on fentanyl by touching a doorknob or dollar bill. The one case in which fentanyl can be absorbed through the skin is with a special doctor-prescribed fentanyl skin patch, and even then, it takes hours of exposure,” said Daniel Colby, assistant professor and co-medical director for the Department of Emergency Medicine at UC Davis Health.
What is fentanyl? Fentanyl is a synthetic opioid that the DEA says is 50 to 100 times stronger than morphine. It was introduced in the 1960s. It is still legally prescribed and manufactured in the United States. It is used to treat chronic severe pain or severe pain after surgery.
According to the DEA, in the illegal drug market, it is often added to heroin to increase its potency or is disguised as heroin. Many people do not know that they are purchasing fentanyl, which can lead to overdose death.
You can be exposed to fentanyl through skin contact, inhalation, ingestion, or contact with mucous membranes (eyes, nose, etc . . .) or with a needle. Skin exposure is most likely to occur for first responders, but most experts believe the risk of significant exposure through skin contact is extremely low.
“If you walk into a space and find someone who has overdosed on fentanyl it is certainly safe to evaluate them, call 911 for help, administer naloxone, and even do CPR. While you should avoid intentionally touching any unidentified powder and then touch your mouth or nose, you do not need to hesitate when trying to save the life of someone who has overdosed,” Colby said.
Health experts have said that skin exposure is not expected to lead to an overdose because of extremely poor penetration of the skin barrier. They say the likeliness of someone feeling symptoms is very low.
“It is important that we clarify and let everyone know that fentanyl cannot really be absorbed through the skin because people who have overdosed on fentanyl may have only minutes to live. Pausing or waiting for other people to arrive means that person might die. They need our help and it is safe to help them,” Colby said.
In 2017, the American College of Medical Toxicology (ACMT) and American Academy of Clinical Toxicology (AACT) released a joint statement about exposure to fentanyl among first responders.
“Fentanyl and its analogs are potent opioid receptor agonists, but the risk of clinically significant exposure to emergency responders is extremely low. To date, we have not seen reports of emergency responders developing signs or symptoms consistent with opioid toxicity from incidental contact with opioids,” the statement reads. “Incidental dermal absorption is unlikely to cause opioid toxicity. For routine handling of drug, nitrile gloves provide sufficient dermal protection. In exceptional circumstances where there are drug particles or droplets suspended in the air, an N95 respirator provides sufficient protection.”
Alleged overdoses in first responders
In 2021, a video from a sheriff’s department in California claimed to show an officer overdosing from just touching fentanyl. The video was disputed by the Drug Policy Alliance.
“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. We already know how this story goes, because we experienced it in the 80′s and 90′s with crack cocaine. Law enforcement-driven, media-perpetuated hysteria inevitably leads to extreme racially-biased enforcement and mandatory minimum sentencing,” the Drug Policy Alliance said in a statement.
The Drug Policy Alliance said that it is not possible to overdose on fentanyl through accidental skin contact or from close proximity. They also said that fentanyl does not “readily cross the skin barrier and do not aerosolize well.”
Researchers believe that the reactions in these cases could be panic attacks caused by anxiety, or a range of other conditions from dehydration to ischemic strokes.
“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,” the Drug Policy Alliance said.
What to do if you touch fentanyl
If you touch fentanyl you should wash the area with soap and water as quickly as possible.
Do not use alcohol-based hand sanitizers or bleach. Those things do not wash opioids off the skin and could even increase skin absorption.
First responders should not eat, drink, smoke, or use the bathroom while working in an area with known or suspected fentanyl.
Be careful not to touch your eyes, mouth, or nose after touching a surface potentially contaminated with fentanyl. Avoid activities that could make the drug go airborne.
According to a DEA fact sheet, “Incidental skin contact may occur during daily activities but is not expected to lead to harmful effects if the contaminated skin is promptly washed off with water.”
The CDC and NIOSHA have more information online for what steps first responders should take.
What are the symptoms of an opioid overdose?
Call 911 and administer Narcan if someone you believe has used opioids has the following symptoms:
- Their face is extremely pale and/or feels clammy to the touch
- Their body goes limp
- Their fingernails or lips have a purple or blue color
- They start vomiting or making gurgling noises
- They cannot be awakened or are unable to speak
- Their breathing or heartbeat slows or stops
More information is available on the Substance Abuse and Mental Health Services Administration website, click here.
How to get Narcan in Michigan for free
Narcan (Generic name Naloxone) can be used to reverse the effects of an opioid overdose.
Its cost is usually covered by Medicaid and many other insurances. There are non-profit organizations that also give it away for free.
Click here to get Naloxone mailed to you for free. Click here to download a list of pharmacies approved to dispense Naloxone.
Read more: Michigan health officials to provide free naloxone to organizations, individuals
Testing drugs for fentanyl
It is nearly impossible to tell if drugs have been laced with fentanyl unless you test them with fentanyl test strips, according to the CDC.
The test strips were originally intended for urine drug tests, but they’re being used off-label to help reduce the harm that the drugs can cause.
Test strips are cheap and can provide results within five minutes. The CDC said to remain cautious even with a negative test, because test strips might not detect more potent fentanyl-like drugs, such as carfentanil. Test strips can also show false positives or false negatives.
Fentanyl has been found in heroin, cocaine, methamphetamine, counterfeit pills and other street drugs.
Learn more from these resources:
Safe syringe programs available in Michigan
There are programs that ensure people with substance use disorders have access to sterile syringes and safe disposal, as well as other harm reduction services.
Syringe services programs (SSPs) have never been shown to increase drug use. Studies have shown they have the opposite effect and reduce drug use. The programs also protect the public and first responders through safe syringe disposal.
“Nearly thirty years of research shows that comprehensive SSPs are safe, effective, and cost-saving, do not increase illegal drug use or crime, and play an important role in reducing the transmission of viral hepatitis, HIV, and other infections,” the CDC said.
Click here to learn more about safe syringe programs.
View: Map of syringe Service Programs in Michigan
Michigan laws about calling in an overdose
Michigan passed a Good Samaritan law in 2016. It prevents drug possession charges against those who seek medical assistance for an overdose in certain circumstances.
If you are struggling with opioids you can find nonjudgmental harm reduction services near you by clicking here and entering your zip code. You’ll be able to find sterile syringe providers, treatment, and naloxone, the drug that is used to reverse opioid overdoses.