Police, panic, and fentanyl
Police in the United States have told implausible stories about airborne fentanyl exposures for years. The real symptoms appear related to panic attacks and the psychological trauma of policing.
In July 2021, the San Diego Sheriff posted a video on “the dangers of fentanyl.” The video shows a police officer searching a car trunk, allegedly containing the opioid fentanyl. After reaching his hands into the trunk, the officer falls backward onto the ground and becomes nonresponsive until a partner administers naloxone, an opioid blocker. The official explanation was that the officer overdosed on fentanyl due to airborne or skin contact. However, within a few days, media outlets (even some that had credulously reported the initial claim) pointed out that medical experts nearly uniformly agree that airborne or skin-contact overdoses of fentanyl are impossible. Fentanyl is potent and dangerous, and the cause of a large number of overdose deaths, but it must be absorbed into the blood (dermal absorption is usually achieved through particularly receptive skin in the mouth or nose using special patches).
The unusual thing about the July incident is that it has been publicly debunked. In the past, outlets have been less critical of the years long pattern of police attributing collapses and loss of consciousness to airborne fentanyl exposure, as in the case of Alameda detectives who collapsed upon entering a hotel room in 2018, or Massachussetts officers who claimed airborne exposure during a raid in 2019. Massachusetts even banned bringing fentanyl to court as evidence out of fears of airborne exposure.
But as stories of police overdoses by airborne or dermal exposure to fentanyl have grown, so has medical skepticism. The AmericanCollege of Medical Toxicity and American Academy of Clinical Toxicology released a joint statement noting that “Fentanyl and its analogs are potent opioid receptor antagonists, but the risk of clinically significant exposure to emergency responders is extremely low….Incidental dermal absorption is unlikely to cause opioid toxicity.” A Johns Hopkins doctor noted that many of the symptoms of airborne or dermal contact stories “are nondescript, such as vague dizziness, that don’t concern opioid poisoning. And in a lot of the cases, the way that they were exposed doesn’t make much sense[.]” Recent research in the International Journal of Drug Policy concluded that even though nearly all of a sample of interviewed police leaders believed dermal fentanyl intoxication was possible, there were no substantiated cases.
Police maintain that they are at risk of airborne fentanyl exposure at great risk to their credibility. As awareness of the medical reality sets in amongst media outlets, these stories are less likely to be taken seriously (the July 2021 case received significant pushback within a week). However, perhaps more importantly, it is plausible that the reactions officers are experiencing in these cases are caused by a belief in the airborne potency of fentanyl.
In order to understand this connection, we need to understand the significance of the IJDP research concluding that police officials share and disseminate a widespread belief that airborne or incidental dermal intoxication is possible. Federal agencies such as the DEA reinforce this belief with ominous ‘safety recommendations’ that are widely distributed. Classic research on policing and front line workers shows how officers tell stories amongst themselves to reinforce a sense of identity and narrate the risks they face. If officers are receiving these stories from federal agencies or department leadership, they are probably circulating and amplifying them within department cultures (particularly in light of high-profile incidents like those discussed above).
This process creates the ideal scenario for what social psychologists Robert Bartholomew and Jeffrey Victor term “shared belief in a threat rumor” – a condition where the narrative processes within a particular culture or organization produce a shared reality where certain fears have become manifest and disproportionately shape reasoning. In such cases, they argue, the threat rumor can produce collective anxiety and panic attacks. And research on police demonstrates that anxiety is related to other possible psychiatric symptoms which police may face, including PTSD.
Another hypothesis emerges, one which is more plausible in light of medical knowledge than airborne transmission: the messaging police officers receive primes them to experience high levels of anxiety and fear when entering or searching areas containing fentanyl (activities which might ordinarily entail some level of anxiety or fear to begin with!). As a result, officers may be experiencing panic and anxiety attacks producing symptoms such as dizziness or brief loss of consciousness. In fact, the symptoms of panic attacks closely match police accounts of airborne fentanyl exposure.
There are several lessons to draw from the debunking of claims about airborne fentanyl. One of the most important is that inflating the dangers of narcotics serves no one, least of all the front line police officers who must deal with dangerous substances and require accurate, grounded information to support safe and sensible decision making. Beyond that, the credibility of the police increasingly comes under strain when they mask panic by insisting on the impossible.