Lab Matters Winter 2025 | Page 19

ENVIRONMENTAL HEALTH

By Kelsey Granger, MHS, specialist, Environmental Health

Fentanyl is a synthetic opioid that contributed to more than half of the 73,690 drug overdose deaths between April 2024 and April 2025 in the United States. However, misinformation on realworld risks posed by fentanyl continues to circulate. Here are a few facts on fentanyl:

Fact 1: Touching Fentanyl Will Not Cause an Overdose

A common myth is that an overdose can be caused by simply touching fentanyl, triggering unnecessary fear and stress in the workplace for those who encounter or handle fentanyl. However, there are no documented cases of overdose after dermal exposure to fentanyl. A 2024 statement from the American College of Medical Toxicology states“ there is essentially no risk of illness from incidental contact with fentanyl.” Fear fueled by misinformation can delay delivery of life-saving care like CPR or naloxone to those experiencing an overdose when time is of the essence. Having an accurate understanding of fentanyl and its risks enhances safety of those who may encounter fentanyl in the workplace, like first responders and laboratory scientists, by enabling selection of engineering controls, administrative controls and personal protective equipment that provide appropriate protections with limited interference to performing job duties.

Fact 2: Fentanyl is Not in“ Everything”

While fentanyl is widely detected in counterfeit oxycodone pills and drug products sold as heroin, claims that fentanyl is in“ everything” are unsubstantiated. Nationally, forensic laboratories did detect fentanyl in 50 % of heroin samples tested in 2023; however, for cocaine, methamphetamine and club drugs( ketamine and MDMA), fentanyl was detected in less than 4 %, 1 % and 5 % of samples, respectively, indicating

significantly less proliferation of fentanyl into non-opioid drug supplies. Further, fentanyl is not the only substance worthy of concern— laboratories have identified other harmful adulterants like xylazine and medetomidine, two sedatives posing significant health threats that emerged within the fentanyl supply. Beyond testing drug products, laboratory toxicology testing provides invaluable insight into which substances contribute to fatal and non-fatal overdoses. In 2023, fentanyl was implicated in 75 % of all fatal overdoses in the US while stimulants were also present in 62 % of all fatal overdoses. Overdose biosurveillance identifies substances implicated in non-fatal overdoses, and in South Carolina, fentanyl was detected in 16.8 % of all non-fatal overdose specimens, while methamphetamine was detected in 33.6 % and cocaine was detected in 20.8 % of specimens tested in 2023. Fentanyl’ s ubiquity in the opioid supply does warrant extreme concern but reports of rampant fentanyl contamination across all drug types are not supported, and many fatal and non-fatal overdoses cannot be solely attributed to fentanyl.

Fact 3: Cannabis Products Have Not Been Contaminated with Fentanyl

Viral news stories around overdoses caused by fentanyl-laced cannabis are common, often associated with use of THC products purchased from unregulated“ smoke shops.” Initial reports have stated that seized products tested positive for fentanyl on field devices, but such reports are often corrected after confirmatory laboratory testing. While even regulated cannabis products purchased from a dispensary can include trace amounts of substances like pesticides and heavy metals, there have not been verified cases of fentanyl contamination in regulated or unregulated cannabis products. Products from smoke shops are highly unlikely to contain fentanyl, but such retailers often do carry products with significant health risks, including 7-hydroxymitragynine, tianeptine, and THC products like Delta 8, for which symptoms of an acute overdose may be confused with a fentanyl overdose.

Laboratories play a crucial role in combating misinformation by providing accurate and reliable information. Misinformation about fentanyl can perpetuate harmful stigma toward people who use drugs, cause lifethreatening delays in providing care to individuals experiencing acute overdoses and overshadow awareness of other concerning substances. In a constantly changing drug supply, evidence-based approaches to risk assessment and safety, combined with reliable laboratory results are vital for swift public health intervention through identification of active health threats and transparent communication. g