18-03 - Dangers of Fentanyl
DANGERS OF FENTANYL
Scenarios
While conducting a traffic stop on a vehicle for a vehicle code violation, you approach the driver and immediately see a white powdery substance on the floor board of the passenger side of the vehicle. Could this be Fentanyl?
You respond to a single vehicle traffic collision where the vehicle has hit a tree. You approach the vehicle and notice the driver is unconscious, but breathing. You try to revive the driver without success. You start to evaluate the driver and notice his/her pupils are pinpoint as if they are under the influence of an opioid. Could the driver be under the influence of Fentanyl?
Background
Fentanyl is a prescription drug and a synthetic opioid 50 to100 times more potent than morphine and 30 to 50 times more potent than heroin. Its medical purpose is for pain management and is used in veterinary medicine to tranquilize large animals, such as elephants. Since the substance is readily available, it is used in the illegal drug trade as an additive to “cut” heroin and other controlled substances to amplify the effect of a less potent drug in an inexpensive manner.
Signs and Symptoms
Fentanyl works on the primary opioid receptors of the brain. The biological effects of Fentanyl are identical to those of heroin, such as pinpoint pupils, shallow breathing, dizziness, confusion, etc. Fentanyl is available in powder, tar, liquid, patch, and pill form, and can be smoked, snorted, inhaled, injected, or ingested. The user will generally achieve the drug’s peak effect in five to 15 minutes, and the effect will last one to two hours. Dependency on the drug usually develops within a few days.
Exposure
In most cases, the first responder will likely not know the drug they are handling may contain Fentanyl because it resembles just about every other narcotic a law enforcement officer is used to seeing. It can be readily absorbed through the skin, eyes, and mucous membrane. A person can also suffer an unintentional overdose of Fentanyl simply by touching the substance or by closing a bag and aerosolizing the fine powder in the air and breathing it in. One of the greatest risks of Fentanyl is through secondary exposure, such as touching the substance then touching the radio, pen, paper, etc. The Drug Enforcement Administration (DEA) reports as little as two (2) milligrams of illicitly available Fentanyl provides a lethal dose. It is possible as little as one-quarter (1/4) of a milligram can produce a lethal reaction to those with limited or no past exposure to the opioid. Exposure to the drug can cause respiratory depression sufficient enough to cause the person to stop breathing.
If you or someone around you has been exposed to Fentanyl, you should administer Narcan (Naloxone) immediately and notify paramedics for medical assistance. Due to the potency of Fentanyl, a second dose of Narcan may be required. Monitor breathing and perform CPR/Rescue Breathing utilizing a CPR mask or Bag Valve Mask (BVM), if necessary.
The procedure for overdose recognition and first aid is covered in Field Operations Directive 17-002, Deployment of Narcan Nasal Spray for Opioid Overdoses.
If you suspect the drug you are dealing with is Fentanyl, the following safety measures are recommended:
-
Wear two pairs of Nitrile gloves (preferably black in color to show any white powdery substance on them);
-
Wear a N95 mask (cup or flat style) and eye protection;
-
Handle the narcotic and immediately remove the first pair (outer pair) of gloves before touching anything else; and
-
Wash hands with soap and water after handling narcotic. Do not use hand sanitizers.
When packaging suspected Fentanyl, never remove it from the original packaging. The substance should be stored in a ziplock bag or heat-sealed bag. Double bagging the substance is recommended. Since Fentanyl is a potential hazard for all involved, label the outside of the bag as possible Fentanyl to warn others and prevent unnecessary exposure.
In the event you are sure you are dealing with Fentanyl, and depending on the circumstances, consideration should be given to contacting the Los Angeles County Fire Department for rescue/medical purposes, and the Department’s Narcotics Unit and/or the Los Angeles Interagency Metropolitan Police Apprehension Crime Team (LA IMPACT) Clandestine Laboratory Squad to assist in safely recovering the evidence. LA IMPACT may be contacted through the Department Operations Center (DOC), at [REDACTED TEXT]
If you have any questions, please call or email [REDACTED TEXT]
References
The California Commission on Peace Officer Standards and Training (POST) Video: Did you know? Series – “Fentanyl Exposure Risks”.
https://www.post.ca.gov/did-you-know-fentanyl.aspx
The Orange County District Attorney (OCDA) Appellate Training Unit Video: Fentanyl: A Toxic Opioid for Law Enforcement.
US Department of Justice, Drug Enforcement Administration (DEA) – Chemical Evaluation and other miscellaneous documents.