Gracie Lou, a Bernadoodle who lives in Spokane, was out for a walk on May 22nd when she spotted a fast food bag on her way home from the downtown post office. Like any pooch who breathes air, she nibbled at the bag. Neither Gracie Lou nor her owner, Bettie Kibala, expected its contents to be laced with fentanyl, an opioid that has become a fixture on the streets of Spokane.
Bettie Kibala, her owner, didn’t suspect the illicit drug either, and the two walked toward their West Central home.
“She started to wobble about a block away from the house,” Kibala told RANGE.
Kibala drove Gracie Lou straight to an emergency veterinarian who immediately administered Narcan, worried that waiting for labs would risk the dog’s life.
“It took eight hours for her to open her eyes, 12 hours for her to lift her head or even really look like she wanted to move,” Kibala said. “It was several days, probably three days, that she basically slept all day.”
Gracie Lou made a full recovery, but Kibala is still searching for more information about accidental fentanyl poisoning. She worries that activities she used to do all the time — like picking up litter — could expose her and her friends to fentanyl through skin contact.
“I never even considered that would happen, and let alone how fast and severe it ended up being.” Kibala said.
Like all opioids, fentanyl is a depressant that slows brain activity, relaxes muscles and can create a sedated effect in the body. It’s administered regularly in hospitals as lozenges or under-the-tongue tablets, and may be prescribed as a pain blocker for cancer patients. Signs of a fentanyl overdose include blue tinged skin, abnormal pupil size, a dazed state, and lowered ability to breathe — which can result in death.
It’s a powerful drug that’s responsible for much devastation, including on Spokane streets, and Kibala’s fears reflect broad societal concerns about it.
To read more about the effects of fentanyl, click here.
Such concerns are worsened by a range of myths, including some perpetuated by law enforcement. The most popular myths — for example that touching fentanyl can cause overdose, that hand sanitizer can cause the drug to enter the bloodstream through the skin and that being near fentanyl smoke can cause a contact high — play on a fear that a person can die of fentanyl without even realizing they’ve come into contact with it.
To separate fentanyl’s very real hazards from some truly absurd myths, RANGE reached out to Dr. Scott Phillips, Executive Director of Washington Poison Center, a nonprofit organization that runs a 24/7 hotline for poisoning, and offers community education programs by certified toxicology specialists.
He told us that, in general, fentanyl cannot affect people — or their furry companions — until it has entered the body through the nose or the mouth in smoke or powder form.
Fiction: Touching fentanyl causes an overdose
The idea that a person can overdose by simply touching fentanyl is a particularly widespread myth about the drug. But skin does not absorb the opioid without the use of a fentanyl patch, which functions similarly to a nicotine patch.
“I just tell people, ‘wash it off,’” Phillips said. “There's nothing to be afraid of.” But Phillips does warn that if someone touches fentanyl and then touches their mouth or nose, the drug can get into the body and take effect.
“Once it goes in your mouth, it can get absorbed through the lining of your mouth,” Phillips said.
Possible exposure to fentanyl through hand-mouth contact is a leading concern for medical experts throughout Washington state. Kids are more at risk for fentanyl poisoning than any other group, so the Washington Poison Center features a scowling, bright green mascot — Mr. Yuk — to engage with children and young adults.
“We really try to educate [kids], partly because they're a bit more at risk just because of the way this medication reacts,” Dr. Phillips says. Young people also may have a higher likelihood of poisoning because they tend to have lower tolerances for opiates like fentanyl.
Fiction: Hand sanitizer makes skin more absorbent
Another myth making the rounds is that fentanyl can be more readily absorbed through skin that has hand sanitizer on it.
Dr. Phillips said that’s also not true, and although he recommends soap and water as the most reliable way to wash off fentanyl contamination, he also says that hand sanitizer is not something to worry about.
“It’s a bit of a myth that hand sanitizer is a problem,” says Phillips. “Those alcohol components can make the skin soluble, [but] in this situation, it doesn’t work.”
Fiction: Passive exposure causes overdose
Smoking fentanyl causes concern for many people, as exposure to second-hand smoke of any kind can cause discomfort. But Phillips said that’s about as far as it goes. Smoking does not contaminate the air with fentanyl, and therefore does not risk intoxicating other people who are not smoking the drug.
“Fentanyl, when you inhale it from smoking, likes to stay in your body,” Phillips said. “It doesn't come out in the exhaled smoke to any sort of measurable quantity,” says Dr. Phillips. “It's in the parts per trillion. It's a teeny, tiny, nearly unmeasurable fraction.”
At such a small rate of exposure, people in the same area as someone smoking the drug are unlikely to experience an overdose or even intoxication from fentanyl smoke alone.
Mostly Fiction: Post-Narcan aggression
As overdoses have risen in recent years, so too have a raft of public programs educating people how to intervene. By far the most prominent method is administering Naloxone, known popularly as Narcan, usually in the form of an over-the-counter nasal spray that reverses the effect of overdose, shocking victims back into consciousness.
But with that education, many have worried that, if they administer a dose, the victim will become violent. Phillips said this fear is mostly unfounded.
“If people kind of wake up, who are mad, they get cravings, and they get anxious, that kind of thing. But it rarely turns into violence,” Phillips said.
It is possible to administer too much Narcan, which Phillips warns could send someone into withdrawals. In a scenario like this, he recommends giving them some space but continuing to provide aid by moving them into recovery position. He also said someone who administers Narcan should always call 911.
“Some people, they can get really wide awake and anxious,” Phillips said. “They might be vomiting, and they feel pretty crappy when they're withdrawing. So they don't really have a lot of fight in them in that situation.”
Phillips urges everyone to be ready to administer Narcan and have sympathy for the person coming out of an overdose, rather than preparing for a violent response.
“[Aggression is] not a very common thing, and that should absolutely not stop you from giving Narcan,” he said.
To learn more about how to safely administer Narcan, RANGE has an article here.
Don’t trust anything[?] on the internet
Phillips says the public normally finds information about fentanyl, opioids and other illicit drugs on the internet. He stressed they need to seek out trustworthy sources — which they often do. For the Washington Poison Center, this means that Phillips’ team spends as much time answering calls as they do responding to comments on social media.
According to Phillips, the number one way to find factual information about fentanyl and other drugs is to visit medical sources provided by health organizations rather than miscellaneous infographics or word-of-mouth. Phillips also recommends sites provided by health departments or treatment programs to find reliable information.
For more facts about fentanyl, Phillips suggests visiting StopOverdose.org, which provides resources on fentanyl’s effects, tips on responding to an opioid or fentanyl overdose and the laws surrounding overdose reversal medications.
