When you decide on a career as a first responder, be it police, fire, or medic, you understand the many dangers associated with this calling. Today there is a new danger to add to the list: Fentanyl. Fentanyl is a synthetic drug that is manufactured primarily in China and Mexico, and it is being used as an adulterant in other controlled substances such as heroin, cocaine, and methamphetamine. It is also being used in counterfeit pharmaceutical products, such as tablets that mimic oxycodone, hydrocodone, and alprazolam. In Ohio, there have been reports of it being used as an adulterant in marijuana as well.
The challenge with Fentanyl is that it is 50-100 times more potent than morphine and can be absorbed into the body by injection, oral ingestion, contact with mucous membranes, inhalation, and via transdermal transmission. Due to the many ways fentanyl can be absorbed into the body, accidental exposure by first responders is a possibility.
As with any new challenge facing first responders, agency responses can range from a “wait and see what happens” attitude, to going overboard and creating policy and procedures that cover all the bases but are operationally not practical.
The key to protecting yourself against this trend or any other developing issue is to educate yourself on the problem and learn how to protect you and your agency. Here are some great resources to help you get started:
In the DEA Fentanyl Briefing document, they recommend several levels of PPE when dealing with Fentanyl. For first responders who may encounter fentanyl or fentanyl-related substances, an individual (personal) PPE Kit should be maintained. This kit should include:
- Nitrile Gloves
- N-95 dust masks
- Sturdy eye protection
- Paper coveralls – shoe covers
- Naloxone Injector(s)
One issue that agencies are encountering is that under OSHA guidelines, the N-95 dust mask requires a yearly seal test fitting for each person issued a mask. This will not be an issue for smaller agencies, but keeping documentation for large agencies is an additional administrative task that will need to be assigned to someone in your organization.
So where do you go from here? If you are a first responder, educate yourself on the issue so that when you encounter Fentanyl in the field, you will know how to respond. If you are at the command level in your organization, it is time to review your policy and procedures to make sure this new threat is being addressed. You can start by asking yourself these questions:
- Do my employees have the proper PPE if they encounter Fentanyl in the field?
- Do we need to change the way we package and store suspected fentanyl or drugs adulterated with fentanyl, when they are collected as evidence?
- Are support personnel such as crime scene technicians and evidence custodians equipped and trained to handle fentanyl?
If you have not developed policy or procedures to address this issue, this will get you started.
Let those of us who have answered the call to be first responders make sure we are protecting ourselves and the people who work for us by making sure we are prepared for an encounter with Fentanyl.