Fentanyl Risk Assessment: 4 Ways to Protect Yourself

I originally wrote this article for PoliceOne.com. I'm reposting the article here in its entirety. 

There is no doubt that the word “fentanyl” creates some controversy in the law enforcement community. Some groups say the fentanyl threat is overblown, while other groups say the threat is an imminent threat to law enforcement. There has been hyperbole coming from both sides of the argument while the truth lays somewhere in the middle.

Fentanyl does, indeed, pose a threat to the law enforcement community. That doesn’t mean we should stop doing our jobs, however. We can still do our jobs safely by wearing proper personal protective equipment and proper scene management. All of this starts, though, with a proper on scene risk assessment.

We do risk assessment’s in everything we do on the job. You do it the minute you walk into a house on a domestic violence call. You look at threats at the scene and you make decisions based on the clues given to us. Some might do it through an official risk assessment form for tactical or crowd control situations. Law enforcement can do the same assessment of risk when it comes to drug crimes.

So, what happens if you don’t do a risk assessment? I received a call from a rural southern police administrator last year. He was at the scene of an overdose and wanted me to help identify some pills recovered near the decedent. Upon reviewing the picture, I could clearly tell that some gray powder near the pills looked like fentanyl that had been recovered in his area. Sure enough, it was later determined that the powder was a half-ounce of Carfentanil. One dose of Carfentanil, an analog of fentanyl, is equal to 10,000 morphine pills. At one point during the investigation, there were up to 8 people in the room with the dead body and the fentanyl. Thankfully, no one was harmed. But, not one person assessed the scene and no one was wearing personal protective equipment! To be clear, a lethal dose of carfentanil is generally regarded as 20 micrograms (depending on drug tolerance and other factors). That means that there were over 700,000 lethal doses in that room. We can all agree a risk assessment of the fatal overdose scene was needed. Here are some things you can do to assess the risk of fentanyl exposure.

INDICATORS OF DRUG USE/MAN DOWN CALLS

It is imperative to do a risk assessment in every case where fentanyl is suspected. First, you should evaluate the scene. Is there any information to suggest the method of potential exposure or hazard? An example of some indicators would be the type of drug paraphernalia or pills present. A good example would be a man down situation. If you arrive on scene to a man unconscious in a car and see a syringe in his hand, you should wear proper PPE when handling the call. Your risk for this call is heightened due to indications of a drug overdose. Conversely, your risk would not be as great as a man down call where the victim is 80 years old and appeared to have had a heart attack.

Presence of Large Volumes of Powder

If you have a scene where you recover large amounts of powdered drugs or pills pressed to look like pharmaceuticals, you should wear the proper PPE when handling the drugs. Large volumes of powdered drugs increases your risk of opioid toxicity. Fentanyl has been found in every drug we run across on a routine basis. Fentanyl is found in cocaine, methamphetamine, heroin and even in synthetic cannabinoids (“spice”) and synthetic cathinones (“bath salts”).

Background of the Location

What is the history of the location you are looking at? If the home has a history of drug use or drug sales, especially of opiate drugs, then your risk has increased. If the location has a history of being a tableting operation, your risk is even higher due to fentanyl pills being pressed into pills resembling pharmaceuticals and powders from the processing operation becoming airborn.

PPE IS KEY TO STAYING SAFE FROM FENTANYL

If you have an increased risk of fentanyl exposure at a call, you should use these four key pieces of PPE:

• There is information that shows fentanyl could go through latex gloves. Nitrile gloves should be worn, preferably two pairs.

• An N95 mask or a respirator with P100 filters. The biggest threat of exposure comes from inhaling fentanyl. Wearing a fit tested N95 mask or respirator will decrease your overall risk.

• Eye protection should be worn to protect exposure of the eyes.

• Wear long sleeves, like your patrol jacket, when handling drug evidence.

Fentanyl has raised the risk of first responders when working drug related calls. But, with a simple risk assessment and proper PPE, we should be able to mitigate that risk and continue to do our jobs safely.