Myth-Busting Monday

Myth #1 - You can overdose on fentanyl by being around it or touching it.

One persistent myth surrounding fentanyl suggests that merely being near or touching it can lead to overdose (also known as “passive exposure”). This notion is far from the truth.

Source of Myth:

This misconception gained traction from sensationalized news stories and dramatized portrayals in TV shows, beginning around 2016/2017. Reports surfaced of first responders allegedly experiencing highs or overdose symptoms from incidental exposure to powdered fentanyl.

Claims:

One anecdote claimed that a police officer overdosed simply by brushing fentanyl off his coat. Another story depicted a cop in Florida collapsing after coming into contact with street fentanyl. These stories in the US, at least, are common. These tales, although common, often lack any real evidence and symptoms may stem more from anxiety or fear of being around an opioid than actual overdose.

In a Season 3 episode of Chicago Med, the show depicts the hospital's response to the discovery of street fentanyl, highlighting the deployment of decontamination teams and a subsequent lockdown.

Facts:

While it's true that fentanyl can be absorbed through the skin, it typically requires large amounts and prolonged exposure, such as with fentanyl patches used for medical purposes. Additionally, fentanyl doesn't readily aerosolize, meaning it doesn't easily become airborne. Thus, the idea of experiencing a high or overdose from simply being near fentanyl is largely unfounded.

The Real Picture:

Claims of overdosing on fentanyl often focus on symptoms like anxiety and fast heart rate, which contradict the typical effects of opioids, known as "downers" for their tendency to slow heart rate and breathing. These stories contribute to a broader moral panic surrounding opioids, often used to justify punitive laws and restrictions on pain management treatments.

Myth #2- Prescription opioids will lead to a heroin addiction.

One prevalent yet damaging myth suggests that using pharmaceutical opioids in a medical context will inevitably lead to addiction, including heroin use.

Source of Myth:

Various sources, including the CDC and law enforcement agencies, have perpetuated this misconception:

Claims:

Some claims assert that prescription opioids are a gateway to heroin addiction or misuse of illicit substances like fentanyl. Additionally, there's a belief that the current overdose crisis is solely due to prescribed opioids, stemming first from OxyContin.

Myth Alert! 👇

Facts:

While misuse of opioids is possible, it's essential to differentiate between medical use and misuse. In Canada, only a small percentage of those using opioids for pain management develop problematic substance use.

Moreover, essential medicines recognized by the World Health Organization, including fentanyl, are deemed safe and effective for managing healthcare needs. Other opioids like codeine, morphine, hydromorphone, and oxycodone are also essential for pain relief and palliative care.

Contrary to popular belief, opioid prescriptions have been declining in both the US and Canada since the 2010s. However, fatal overdoses have continued to rise, indicating that the overdose crisis isn't solely attributed to pharmaceutical opioids.

The Real Picture:

Despite efforts to reduce opioid prescriptions due to concerns over the overdose crisis, overdose deaths persist. The rise in fatalities is primarily linked to the use of illicit drugs, which are often of unknown potency and mixed with other substances like nitazenes and benzodiazepines. Therefore, the root cause of the crisis lies more in illicit drug use than pharmaceuticals.

While caution is necessary regarding opioid prescribing practices, it's vital to recognize the unintended consequences of overly restrictive measures, such as undertreated chronic pain. The solution to the overdose crisis lies in addressing the complexities of illicit drug use rather than focusing on scaling back pharmaceutical opioids.

That’s it for this week’s newsletter!

👋 Mel, Policy on Drugs

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