Fentanyl exposure is the new “crack baby” myth

At the height of the 1980s crack epidemic, harrowing stories of so-called “crack babies”—infants born addicted to crack cocaine—were blasted across nightly news and newspaper headlines. Politicians on both sides of the aisle called for stricter drug policy, culminating in the Anti-Drug Abuse Act of 1986, a law that introduced mandatory minimum sentences for drug charges and created harsher sentencing for crack, which circulated primarily in lower-income Black communities, than for cocaine. The law led to increased policing of Black communities, drastic disparities in drug sentences between white people and people of color, and the mass incarceration of Black men and women.

Decades later, we now know that “crack babies” and arbitrary distinctions between crack and cocaine were little more than racist fictions perpetuated by political leaders and echoed by the media. As the nation is once again gripped by a drug crisis, this time in the form of opioid overdoses, viral stories about fentanyl exposure prove just how little we’ve learned about the dangers of drug myths.

The stories circulate every few months with the same blueprint: A person, frequently a police officer, touches something that they believe to have trace amounts of fentanyl on it. The person collapses, often hyperventilating, convinced that they are near death. These videos are usually debunked within minutes of being posted online as experts point out that incidental exposure to fentanyl cannot cause an overdose. But the stories persist, each more fantastical than the last. 

The myth that has taken hold among law enforcement appears to have originated in 2016 and 2017 when the Department of Justice distributed resources about the harms of fentanyl exposure to police departments around the country. Although the agency has since updated its training materials and removed most of the inaccurate resources, a video that is still on the Justice Department website and YouTube channel features a Drug Enforcement Administration representative stating that fentanyl is “extremely dangerous … to those who simply come into contact with it.” 

Hope Smiley-McDonald, a research sociologist at RTI International, found a clear line between the DOJ training resources and officers’ fears about fentanyl exposure. While interviewing officers about drug response programs, she and her colleagues kept encountering anecdotes about the allegedly terrifying effects of touching even trace amounts of fentanyl. “It all came back to that video,” she said. 

In a recent study examining perceptions of fentanyl exposure among law enforcement leadership, Smiley-McDonald found that most believed incorrectly that exposure to small amounts of fentanyl could cause a fatal overdose. A survey of Indiana police officers found that nearly 80 percent believed that first responders were at high risk of overdose from accidentally touching or inhaling fentanyl. But scientific and medical evidence tells us otherwise.

In 2017, the American College of Medical Toxicology and the American Academy of Clinical Toxicology released a joint statement confirming that the risk from incidental skin exposure to fentanyl is “extremely low” and ​​“very unlikely to cause opioid toxicity.” More recently, a case study described the accidental exposure to a large amount of fentanyl on unprotected skin with no reaction. So why are police departments and politicians telling people that accidental contact with minuscule amounts of fentanyl can cause a deadly overdose?

Zachery Siegel, a journalist and researcher who has written extensively about drug policy, thinks that this misinformation is driven by fear. “It’s like an urban myth now … these fears that micro fentanyl particles out in the world could cause you or your child to overdose.” Some might argue that the fear is rational. After all, fentanyl is a powerful opioid driving a very real overdose crisis. But when fears about drugs aren’t based in reality, they can have dangerous real-world consequences. 

Smiley-McDonald notes that fears about fentanyl exposure impact how people, including law enforcement, respond to potential overdoses. “The myth makes it harder to respond to overdose calls due to officer concern about possible exposure,” she says. “Every second matters … and if that fear is there, it can really impact the [overdose victim] if they’re not willing to immediately resuscitate that person.” 

Beyond the immediate risk to potential overdose victims, misinformation about fentanyl, especially fear-driven misinformation, increases stigma against people who use fentanyl and leads to ineffective and damaging drug policy. Colorado recently made possession of more than 1 gram of fentanyl a felony over the objections of drug and policy experts who assert that criminalization does little to decrease drug use or prevent overdoses. Earlier this year, Wisconsin and Kentucky introduced harsher fentanyl laws and Ohio congressman Tim Ryan proposed a federal bill to classify fentanyl as a weapon of mass destruction. “If everyone thinks of fentanyl as a WMD … , that can result in truly misguided and harmful policies and laws that will make the overdose crisis worse,” Siegel said. 

Decades of research show that investment in medication for opioid use disorder, overdose prevention and reversal, and other harm reduction initiatives is the type of drug policy that saves lives. But instead of laws to reduce fentanyl overdoses, much of the country is seeing an increase in policies that further criminalize fentanyl use. “We haven’t invested in a public health approach,” Siegel said. “We’re stuck in a law and order, criminalization approach.” These types of drug laws shift opioid use from being a public health issue to being one of public safety while doing little to reduce fentanyl-related deaths or end the opioid crisis.