Touching Fentanyl Can Kill You - Reality or Myth?

WRITTEN BY GERARD BULLEN

AUGUST 1, 2021

Edited by Editorial Team

Evan Leonard

MS, MMS, PA-C

Dr. Leonard is a Doctor of Medical Science and a clinical anatomist. He has practiced in both internal and emergency medicine and has published several, peer-reviewed articles and a medical book chapter.


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Medically Reviewed
This content has been medically reviewed by, Dr. Evan Leonard. Dr. Leonard is a Doctor of Medical Science and a clinical anatomist. He achieved his bachelor’s degree in human biology from the University of Miami. He received his Master of Science in anatomy from Barry University’s School of Podiatric Medicine, he then achieved his Master of Medical Science from Nova Southeastern University, and lastly, he achieved his doctor of medical science from Lincoln Memorial University’s DeBusk College of Osteopathic Medicine. He has practiced in both internal and emergency medicine at the University of Florida medical system. He has published several, peer-reviewed scientific articles, as well as a medical book chapter.

Touching Fentanyl Won’t Kill You

No, touching Fentanyl will probably not kill you. It is almost impossible for your skin to absorb enough Fentanyl to cause an overdose.

Fentanyl is a potent pain-relieving medication in the opioid class of drugs. It is similar in structure to morphine but is considered to be as much as 100 times more powerful. This medication is used to treat individuals with chronic severe pain or those dealing with pain following surgical procedures. In some cases, emergency medical personnel and first responders face coming into contact with this powerful medication. In recent times, the media has reported that coming into contact with this drug could potentially pose a serious hazard for these professionals. Can touching fentanyl kill you? This concept is becoming a commonly held belief that may make some professionals afraid to do their jobs, but is there any truth behind it?

What Does Fentanyl Look Like?

Powder fentanyl has varying levels of white to light brown coloration. When mixed with other white substances it can have a patchy brown look.

Fentanyl DEA light brown color

Fentanyl is hard to spot in pill form because it’s usually mixed with other drugs.

fentanyl pills

Reality or Myth: Touching Fentanyl Can Kill You

Following the huge rise in fatal opioid-related drug overdoses across the U.S. during 2020, resulting in yet more record-breaking mortality statistics attributed directly to the national opioid crisis, one particular opioid, a synthetic (man-made) substance, began grabbing the public’s attention as it began to feature more and more in newspaper and social media headlines – fentanyl, now fast-becoming as widely known as the humble aspirin.

Illicit Drug Fentanyl

The vast majority of these opioid overdoses were caused by the illicit form of fentanyl, either produced by native drug organizations using imported chemicals or manufactured and then trafficked into the U.S. by the powerful Mexican drug cartels, leading to the premature deaths of both recreational drug users and hardened drug addicts.

During the past couple of years, more and more criminal and medical research data has shown that this man-made, illegal opioid fentanyl is being actively “cut” (or mixed) into virtually every other form of illicit drug available from drug dealers across the U.S., such as heroin, cocaine, ecstasy, methamphetamine, and even counterfeit versions of prescription medications, like Xanax.

Prescription Drug Fentanyl

However, there is another form of fentanyl available in the U.S. –  fentanyl, the prescription medication – sold under the brand names of Actiq®, Duragesic®, and Sublimaze®. Fentanyl is a potent pain-relieving medication in the opioid class of drugs. It is similar in structure to morphine but is considered to be as much as 100 times more powerful. As a medication, it is used to treat individuals with chronic severe pain, or those dealing with post-surgery pain.

Emergency medical personnel and first responders face coming into contact with either form of the synthetic opioid fentanyl, either as the prescription medication or the illicit hard drug, during the course of their work. In recent times, the media has reported that coming into contact with this drug could potentially pose a serious hazard for these professionals.

So, can touching fentanyl actually kill you?

This concept is becoming a commonly held belief that may make some professionals afraid to do their jobs. Is there any truth behind it? To answer the question of whether fentanyl can kill you if you touch it, you need to look at the context of any situation where that might happen, but the real difference in possible outcomes lies with whether you’re dealing with the prescription version or the far more dangerous illicit one.

Why is Fentanyl Feared?

Fentanyl, in the form of medication, is still extremely potent and powerful. It is mostly used as a “breakthrough” drug when a patient has built up a tolerance to other pain-relieving medications. Like other opioid pain relievers, it works by binding to the opioid receptors in the brain. This results in a sharp and rapid increase in dopamine levels, which has a relaxing effect on the individual.

Where does the fear come into play with this type of medication? 

This is where the overriding factor of context comes firmly into focus. People can become fearful of medicinal fentanyl simply because they have read somewhere that “fentanyl” (although in its illicit form) has been involved in so many fatal drug overdoses during the pandemic. Additionally, they can become fearful because they are aware of the drug’s potency, and the various effects it can have on vital bodily functions. To explain, as this type of medication affects dopamine levels and produces a relaxed state, it can also affect an individual’s respiratory function – their breathing patterns. Therefore, using too much of it could cause respiratory depression severe enough to eventually lead to coma or death.

 

fentanyl

Can Touching Fentanyl Lead to an Accidental Overdose?

The many recent front-page news stories with their attention-grabbing headlines about deaths by fentanyl have created a commonly miss-held belief: “simply touching a drug as powerful as prescription fentanyl can kill you.”

One word… F-A-L-S-E.

Not true in the slightest, and such stories as these can create unnecessary worry or fear in people.

Let’s look at it from the point of view of our emergency personnel. They never know what type of scene they may be entering when they respond to various incidents, and it is only natural to expect that news items such as this may be upsetting and create fear in the minds of individuals who do this type of work.

Rest assured, it is virtually impossible for someone to absorb enough fentanyl through their skin to cause a serious overdose simply by touching it.

Medical professionals and scientists alike all confirm that not enough of the drug can be absorbed in this manner to create a life-threatening emergency such as an opioid overdose. Unfortunately, this is a myth that has circulated in the media for some time, and, unfortunately, continues to do so.

Medical professionals, emergency personnel, and the person on the street can be certain that simply touching fentanyl or other opioids will not result in any harm to the average individual. There is certainly no need for these individuals to be afraid of encountering these substances in the course of their normal work.

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Using Powerful Opioid Medications Safely

Potent pain-relieving medications, such as those of the opioid class, continue to have a use when it comes to treating severe pain, especially in those who no longer respond to weaker medications. However, these types of drugs are powerful and they must be administered in the proper setting with careful regard to using them correctly.

Proper education on using these medications safely and under the supervision of a medical professional can reduce the risk of dependency, misuse, and overdose in the vast majority of cases.

Due to the exceptionally powerful nature of the drug, many people have developed a fear of coming into contact with potent medications such as the one discussed here. However, can touching fentanyl really kill you?

Fortunately, research seems to indicate that the chances of this occurring are extremely small. While there is always a need to deal with these substances in a responsible manner, there is no need for first responders and other professionals to fear accidentally touching the drug. It is crucial that we continue to promote a solid understanding of potent medications and teach patients to use them responsibly to avoid injury or overdose.

The Real Reasons To Fear Fentanyl

Please understand that this does not mean that fentanyl should be considered harmless. Far from it. This drug is highly potent, and taking too much of it at one time can be extremely dangerous, even deadly. Therefore, people are right to want to steer clear of this drug. Although fentanyl will not harm you simply by touching it, it can hurt you in other ways. Here are the reasons you really should steer clear.

who is at risk for fentanyl overdose

In Arizona, Virtually All Illicit Drugs Now Laced With Fentanyl

Fentanyl is now being “cut into” (or mixed into) virtually every other illicit drug available, such as heroin and cocaine, in what could be seen as an attempt to make those drugs far more potent and give users a greater rush or high when using. Although this is true to a certain extent, it certainly isn’t the whole picture.

Illicit fentanyl, predominantly manufactured in large laboratories by the Mexican drug cartels, is, in fact, both cheaper and easier to produce when compared with the likes of heroin, cocaine, and methamphetamine, and, for these illegal organizations, it is far easier to traffick the drug into the U.S. and into other countries, as well. It is because of these vast cost savings that fentanyl is now being mixed with other illegal drugs.

Yes, it makes for a more powerful experience for the drug user (if, of course, it doesn’t kill them in the process), but, more importantly, it makes for far bigger profits for the cartels, and the U.S.’s own illegal drug organizations.

This is happening right here, right now in the whole of Arizona, as fentanyl and fentanyl analogs (substances that are chemically very similar in structure to fentanyl) are being trafficked across the Mexico-Arizona border all the time.

For example, according to an article published in “The Daily Courier,” U.S. Customs and Border Protection officers reported, in June of 2020, they seized close to 300,000 pills that had been laced with fentanyl, with the pills hidden in a pickup truck being driven by an American man through Nogales, Arizona. Additionally, they found cocaine and heroin, making the entire haul’s estimated street value around $1 million.

Sadly, this story is not an isolated incident – there have been numerous reports of authorities finding illicit fentanyl-laced drugs. Even worse, despite the best efforts of the FDA and police authorities, many of these shipments do make it through, finding their way, via local drug dealers, into the hands of consumers.

Fentanyl Pills in bags

Drug Cartels & Dealers Unfazed

In 2019, Maricopa County, Arizona reported a total of 1,078 drug overdose deaths. Obviously, this is just a single county, and, therefore, only a percentage of the overall overdose deaths in Arizona that year. What was important about this statistic that year was the clear, growing trend where the majority of the deaths were opioid-related, and fentanyl, in particular, was specifically involved in the majority of those.

Now, seeing as illicit drug manufacture and trafficking is a multi-billion dollar industry (albeit, a criminal one), you would think that drug cartels and dealers would be concerned about overdose deaths connected with their products. However, the reality is that the exact opposite is true.

Many dealers will deliberately cut some of their products with more dangerous substances for the very clear purpose of causing deaths by overdose. Their reason? They believe having overdose deaths associated with their products tells the consumer that they have a far more potent and powerful product than their competition.

This, in turn, gives their reputation what they consider a boost in “kudos” and gives their businesses a financial boost through increased revenue – a sobering thought, indeed, and one that should motivate more people into serious reflection and consideration about finally seeking treatment, and attending an Arizona drug rehab facility to find recovery if they are suffering with a substance use disorder (SUD) or a substance abuse issue.

Signs of an opioid overdose

Is Inhaling Fentanyl Dangerous?

There has been much unconfirmed “information” about the risks of inhaling fentanyl or one of its analogs, and much of this has originated from the DEA and first responders, such as paramedics, fire service, and police.

In fact, the DEA once released information publicly that served only to stir up public panic and concern with this substance. In one press release, they stated: “Fentanyl can be absorbed through the skin or accidental inhalation of airborne powder can also occur. DEA is concerned about law enforcement coming in contact with fentanyl on the streets during the course of enforcement, such as a buy-walk, or buy-bust operation.”

Their statement continued, “Just touching fentanyl or accidentally inhaling the substance during enforcement activity or field testing the substance can result in absorption through the skin and that is one of the biggest dangers of fentanyl.”

Because this is a highly potent drug, inhalation is never recommended, unless it is a prescription medicine, and those are the instructions for use. However, the accidental inhalation of fentanyl is normally nothing to be concerned about. The Northern New England Poison Center has this to say about fentanyl and carfentanil (a powerful fentanyl analog) exposure in first responders: “Even in circumstances involving manufacturing of fentanyl and analogs, nearly 200 minutes of exposure is required to reach a starting dose of fentanyl. It is extremely unlikely a significant exposure would occur in a first responder.”

Fentanyl-Laced Cocaine: How Opioids are Killing People with Cocaine Addiction

Can People Get Addicted to Fentanyl?

As fentanyl is an opioid, just like heroin and oxycodone, it is highly addictive, and, therefore, very possible to become dependent upon. People can either do so by using the drug recreationally, or through accidental exposure to the drug, eg. when it has been cut into other drugs. Because of its nature, those who do get addicted are usually people who have already formed addictions to other types of opioids.

It can only take one single-use before a person finds they are addicted to fentanyl. Once a person does become dependent upon the drug, it is important to consider professional addiction treatment for recovery.

Getting Treated for Fentanyl Addiction

There are many drug rehab programs well-versed in the best ways to treat fentanyl addiction across the country. Primarily, these require a combination of drug detox and addiction therapy – in order to treat the whole addiction and produce the best results.

Drug Rehab Service

Fentanyl Detox Programs

The drug detoxification process is critical for anyone who is addicted to fentanyl or any other form of opioid. When a person stops using this drug, they are very likely to go through the process of withdrawal, and withdrawal symptoms can quickly become severe and hard to manage.

Some of the more common fentanyl withdrawal symptoms include:

  • Significant pain in the muscles and bones
  • Problems with sleep
  • Vomiting and/or diarrhea
  • Goosebumps with cold flashes
  • Restless legs, which can make it hard to sleep or stay comfortable
  • Severe cravings for the drug

Professional detoxing can help by reducing the severity of these and other symptoms people may experience. It can also decrease their chance of any potential complications during the withdrawal period.

withdrawal-symptoms

Frequently Asked Questions

 

What is Fentanyl?

Fentanyl is classified as a synthetic opioid drug. It is 50 times stronger than heroin and as much as 100 times stronger than morphine. It comes in a lot of different forms, and people take it by injection, as a lozenge, by taking pills or by applying a patch to their skin.

Fentanyl is classified as a Schedule II prescription medication. Most of the time it is reserved for people who have severe pain that is not well-managed by other types of medications. It is also given to help control pain following surgical procedures.

Fentanyl is also manufactured for illegal distribution on the streets. It may be added to other drugs, such as heroin or cocaine, and it goes by several street names:

  • Apache
  • China Girl
  • Friend
  • China White
  • Murder 8
  • Goodfellas

Fentanyl street names

How Does Fentanyl Kill You?

Fentanyl can be fatal if an individual overdoses when they use the substance. A “drug overdose” can be defined as “taking too much of a substance, whether it’s prescription, over-the-counter, legal, or illegal, and can be either accidental or intentional, resulting in a severe and possibly fatal physical reaction.”

Individuals who die from a drug overdose involving fentanyl or another opioid do so because opioid use causes severe respiratory depression, where the individual’s ability to breathe either becomes very low (depressed) or stops working altogether, meaning their body becomes starved of oxygen.

This places a huge strain on the body’s vital organs – firstly, stopping the heart (cardiac arrest), and then shutting down the brain. Without immediate medical intervention, this leads to unconsciousness, coma, and then death. Additionally, after 3-5 minutes of zero oxygen entering the bloodstream, brain damage starts to occur and is soon followed by death.

With fentanyl and other opioid overdoses, surviving the overdose or dying from it depends entirely on the body receiving enough oxygen via the respiratory system. After taking opioids, respiratory depression doesn’t happen straight away – the process is usually a slow one, happening minutes or sometimes hours after the drug was used. This “window” provides the opportunity to save the life of the individual by emergency medical intervention.

The Critical Signs of Fentanyl Overdose

fentanyl-overdose

Signs of a fentanyl overdose, or any other drug overdose involving opioids, can include:

  • Pale and clammy skin
  • Purple or bluish hue to the lips or fingernails
  • Extremely small pupils
  • Inability to speak
  • Lack of coordination
  • Vomiting/making gurgling sounds
  • Physically limp
  • Slowed heart rate
  • Breathing problems (respiratory depression)
  • Trouble staying awake
  • Unconsciousness / Coma
Fentanyl size compared to a penny
Fentanyl size compared to a penny

What Should You Do in the Event of a Fentanyl Overdose?

  • STEP 1: CALL FOR HELP (DIAL 911) 

In the event of an opioid overdose, you should call 911 without delay. Be sure to give a  clear address and/or description of your location. 

  • STEP 2: CHECK FOR SIGNS OF OPIOID OVERDOSE 

The visible signs of an opioid overdose have been provided above, but if the person has clear breathing problems, it is a sure sign of overdose or overmedication.

  • STEP 3: SUPPORT THE PERSON’S  BREATHING  

“Rescue breathing” can be very effective in helping others breathe during overdose while waiting for the EMS. For adults, it involves the following steps: 

  • Be sure the person’s airway is clear
  • Place one hand on the person’s chin, tilt the head back and pinch the nose closed
  • Place your mouth over the person’s mouth to make a seal and give 2 slow breaths 
  • The person’s chest should rise (but not the stomach)
  • Follow up with one breath every 5 seconds
  • STEP 4: ADMINISTER NALOXONE  

If it is available, naloxone should be administered to anyone who shows signs of opioid overdose, or when an overdose is suspected. You should try to comfort the person, as the withdrawal triggered by naloxone can be unpleasant, and they need to stay calm.

How Much Fentanyl Can Kill You?

The amount of fentanyl that can lead to death is far, far less than you think, and the risk increases dramatically if you are a first-time user or one who hasn’t used the drug recently. To be precise, only 1,000mg (one thousand micrograms) is needed to stop your breathing and result in death, and even just half that amount can put your life in significant danger.

When anesthesiologists administer fentanyl during surgical procedures, they use far less than 1,000mg. For example, during multi-hour open heart surgery, patients usually receive only 250 to 500mg of fentanyl in total. In rare cases, this may rise to 700mg.

A “street dose” of fentanyl (mixed into heroin or not) is usually between 500 to 2,000mg. However, you should be wary of anything a drug dealer says about the product they are dealing with – in reality, doses can vary enormously, often far outside this range, and on both the lower and higher-end.

Estimated Fentanyl Overdose Risk By Dose (mg) in Users Without Opioid Tolerance

fentanyl kills

Source: www.harmreductionohio.org

Can Inhaling Fentanyl Cause an Overdose?

Medical toxicologists agree that in order for someone to overdose after inhaling fentanyl, they would need to be exposed to it for a significantly prolonged period of time. Some research indicates that in order to reach a dose of 100 mcg of the drug, a person would have to be exposed for around 200 minutes.

What are the Signs of an Opioid Overdose?

It is important for people to understand what the signs of an opioid overdose are. Knowing can help them protect themselves and their loved ones. Signs of an opioid overdose can include:

  • A pale skin tone
  • Skin that is clammy to the touch
  • A purple or blue hue to the lips or fingernails
  • Vomiting or making gurgling sounds
  • Becoming unconscious
  • Being unable to speak
  • A slower heart rate than normal
  • Slower or even stopped breathing
  • The body goes limp
  • Extremely small pupils
  • Trouble staying awake
  • Problems with walking and coordination

What Should You do if You Make Contact With Fentanyl?

If you do happen to come into physical contact with fentanyl, there is no need to panic. Simply coming into contact with the drug should not harm you unless you ingest it. Please take the following precaution: Wash your hands immediately after contact, and only with soap and water. Do not use bleach or hand sanitizer to clean contaminated skin. Doing so with hand sanitizer can actually increase the rate of absorption into the skin.

How Can You Tell if a Drug is Laced With Fentanyl?

You can now test recreational use drugs for possible fentanyl content with a fentanyl testing strip, and several U.S. states offer these freely to all residents along with naloxone, the opioid overdose reversal medication. Fentanyl testing strips are currently not provided by the state of Arizona.

How Long Does Fentanyl Stay in Your System?

The length of time a drug remains within an individual’s system is measured by assessing the “elimination half-life” of the substance (usually referred to as the “half-life”), which is the length of time it takes for half of the drug to exit the body.

The half-life of fentanyl can be affected by several factors, the primary one being the method of administration that was used:

  • When fentanyl is injected, it has a half-life of approximately 2-4 hours for adults, and, in total, it can take between 11 and 22 hours before your system has completely eliminated the substance
  • When fentanyl is used via either a lozenge or a patch, it has a half-life of approximately 7-17 hours for adults, and, in total, it can take around 36 hours before your system has completely eliminated the substance

Even so, it is also important to understand that fentanyl does leave traces behind, known as “metabolites” – formed when the body metabolizes a substance. These traces can be detected by extremely sensitive drug tests several days after the use of a drug has ended.

fentanyl in your system

Drug Rehab Centers

After detox, people suffering from a substance use disorder (SUD), such as opioid use disorder (OUD) should always be prepared to move on to drug rehab or another form of substance addiction treatment program.

This is because it is vital to understand the reasons behind addiction. Learning why you started using in the first place will aid greatly in the recovery process. Treating the root cause can significantly reduce the chances of relapse in the future as well. During drug rehab, people attend many types of therapy, including group and individual counseling sessions. They may also be treated for co-occurring disorders (where the use disorder or addiction is accompanied by a mental health disorder, like depression or anxiety) if one has been diagnosed. This further helps to reduce the chance of a relapse and promotes a long-term and sustainable recovery.

Sources:

  1. Daily Courier: https://www.dcourier.com/news/2020/jun/11/nearly-300000-fentanyl-pills-seized-arizona-mexico/
  2. Maricopa County Public Health: https://www.maricopa.gov/5079/Overdose-Deaths
  3. Northern New England Poison Center: https://www.healthvermont.gov/sites/default/files/AAA.Fentanyl-Fact-Sheet_NNEPC_FINAL.pdf
  4. National Institute on Drug Abuse: https://www.drugabuse.gov/drug-topics/fentanyl
  5. STAT: https://www.statnews.com/2017/08/09/fentanyl-falling-ill/
  6. Medline Plus: https://medlineplus.gov/opioidoverdose.html
  7. Canadian Centre for Occupational Health and Safety: https://www.ccohs.ca/oshanswers/hsprograms/fentanyl.html
  8. Substance Abuse and Mental Health Services Administration: https://www.samhsa.gov/sites/default/files/programs_campaigns/medication_assisted/dear_colleague_letters/2013-colleague-letter-fentanyl-analogues.pdf
  9. Drugs.com: https://www.drugs.com/medical-answers/what-do-you-mean-by-the-half-life-of-a-drug-458946/
  10. MedlinePlus: https://medlineplus.gov/lab-tests/drug-testing/
  11. Hard Reduction, Ohio www.harmreductionohio.org
  12. Carfentanil https://pubchem.ncbi.nlm.nih.gov/compound/Carfentanil
  13. Fentanyl testing strips https://www.sciencedirect.com/science/article/pii/S0955395918302135
  14. Arizona Department of Health Services https://www.azdhs.gov/prevention/womens-childrens-health/injury-prevention/opioid-prevention/index.php

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WRITTEN BY GERARD BULLEN
AUGUST 1, 2021

Gerard has been writing exclusively for the U.S. substance addiction treatment industry for many years, providing a range of medically-reviewed work, including white papers, long-form, and short-form content articles, and blog posts for accredited addiction treatment centers. A member of the American Medical Writers Association, Gerard’s specific focus is substance addiction (an area that has impacted Gerard’s personal life in several ways), and he is particularly drawn to the topics of professional, evidence-based treatment, new and alternative therapies, and enabling readers to find their own sustainable, long-term recovery. Gerard lives and works in Maryland, U.S., he’s happily married, and a proud father. His interests include hiking with the family, reading fiction (from the classics to virtually all of the current NYT bestseller list), American and British film classics, and his beloved dogs, Toby and Coco, both rescued from the local pound.

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