Explainer: You won't overdose on fentanyl just by accidentally touching it

Cassidy Morrison

July 18, 07:00 AM July 18, 07:01 AM

Frightening reports of fentanyl poisoning due to simple exposure to the substance have reinvigorated the dubious theory that a mere brush with the drug is enough to cause an overdose.

There have been several instances of people blaming skin contact with the highly potent opioid for severe reactions, but toxicologists say that such overdoses are unlikely or impossible.

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The most recent story involves a Kentucky woman, Renee Parsons, who picked up a $1 bill off the floor in a McDonald’s in Nashville, Tennessee, and, she said, immediately began to slur her speech, feel her body go numb, and lose consciousness.

“The police officer that came to take our report told us it was one of two things: Either the dollar bill was accidentally dropped and it had been used to cut and or store the drugs, or it was purposely left with drugs on it,” Parsons said.

But toxicology experts are skeptical about Parsons’s theory that touching a bill laced with fentanyl caused an immediate reaction.

“I think it is really unlikely the substance this lady got into her system is fentanyl based on the symptoms she had,” Dr. Rebecca Donald, a fentanyl expert at Vanderbilt University Medical Center, told WSMV News. “It is much more likely for her to have a reaction if she had inadvertently rubbed her nose and exposed that drug to some of the blood vessels in her nose or licked her fingers or rubbed her eyes.”

In fact, the dollar bill had no residue on it, and it was discarded by police when they found no evidence of a crime.

Another incident occurred in 2017 in which an Arkansas police department warned the public about fentanyl residue on Walmart shopping carts. The department warned people to wipe off shopping cart handles before using them while delivering a message on Facebook that said touching trace amounts of the substance could be poisonous. The original post has since been deleted, and the officer that wrote it issued an apology, saying he "should have checked into it further."

“You cannot overdose just by touching fentanyl or another opioid, and you cannot overdose just by being around it,” Dr. Ryan Marino, the medical director of toxicology and addiction at University Hospitals, Cleveland, told Reuters. “It will not get into the air and cause anyone to overdose.”

The report, coupled with widespread concern about the growing prevalence of the deadly drug, reinvigorated the debunked theory.

“The consensus of the scientific community remains that illness from unintentional exposures is extremely unlikely, because opioids are not efficiently absorbed through the skin and are unlikely to be carried in the air,” according to physicians at Johns Hopkins University.

The myth has gained traction due to reports from law enforcement, as well as warnings from the government. Public health officials only recently removed an advisory for first responders dealing with opioids about passive exposure to fentanyl. A video published by the National Institute for Occupational Safety & Health, an agency within the Centers for Disease Control and Prevention, was recently taken down because it erroneously claimed that first responders and drug enforcement officers are endangered by passive exposure to fentanyl.

“Reports of emergency responders developing symptoms after contact with these substances have described nonspecific findings such as ‘dizziness’ or ‘feeling like body shutting down,’ ‘dying’ without objective signs of opioid toxicity such as respiratory depression,” the American College of Medical Toxicology and the American Academy of Clinical Toxicology said in a joint statement.

Fentanyl is a synthetic opiate up to 100 times stronger than morphine and 50 times stronger than heroin. An infinitesimal dose can prove fatal, and drug users are often misled to believe the products they’re consuming are pure when, in fact, they are laced with the lethal opioid.

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Reported fentanyl-related deaths have increased by 56% from 2019 to 2020. Deaths linked to the synthetic opioid climbed a further 23% from 2020 to 2021, from about 58,000 deaths in 2020 to over 71,000 the year after.