Policy 248 - Synthetic Opioids: Preventing Exposure

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I. Purpose:

The purpose of this policy is to provide
first responding officers and other members of the
department with guidelines, instructions, and
procedures to prevent exposure to synthetic opioids
and related substances.

II. Discussion:

Synthetic opioids and related substances
are designed to be absorbed into the body by all
means, including injection, oral ingestion, contact
with mucous membranes, inhalation, and via transdermal
transmission (through the skin). As such, accidental
exposure by first responders is a real danger.

Accidental exposure can occur under a number of
circumstances, including during the execution of search
or arrest warrants, the purchase of synthetic opioids
during undercover operations, the processing of drug
evidence containing synthetic opioids or related
substances, or the processing of non-drug evidence
(e.g., drug proceeds, pill presses, scales, or drug
paraphernalia) which may be contaminated with these
substances.

Due to the high potency of synthetic opioids and related
substances, exposure to small quantities can cause
serious negative health effects, respiratory depression,
and even death.

However, synthetic opioids can be handled safely with
proper training and equipment to include hazard
recognition and use of personal protective equipment
(PPE).

III. The following job categories have been identified as
positions where responders might be exposed to
synthetic opioids or its analogues.

A. Pre-Hospital Patient Care: Includes emergency
medical services (EMS) providers, including first
responders, fire department, police officers, and
private companies who attend to individuals with
suspected synthetic opioids overdose. Responders
may encounter drugs or drug paraphernalia on or
near the patient.

B. Law Enforcement: Law enforcement officers who
perform day-to-day law enforcement duties. Law
enforcement officers may come into contact with
synthetic opioids during the course of their daily
activities such as traffic stops, apprehending and
searching subjects, and responding to synthetic
opioids overdose calls.

C. Investigation and Evidence Handling: Law
enforcement personnel who conduct investigations
related to synthetic opioids. Activities may
include executing search warrants and collecting,
transporting, and storing evidence. Evidence
collection activities in the field have the
potential to aerosolize powders. In addition, law
enforcement personnel who handle evidence in the
chain of custody have the potential to be exposed
to synthetic opioids unless controls are in place
to prevent exposures.

D. Special Operations and Decontamination: Workers who
conduct special operations where exposure to large
amounts of synthetic opioids are expected. Examples
include hazardous material incident response teams
at a release or spill, and law enforcement officers
executing search warrants on opioid processing or
distribution sites or participating in other
tactical operations. These activities may aerosolize
powders.

E. Jails and Booking Officers: Arrestees who are
transported to jails and booking stations pose a
threat to the officer if these arrestees have
been in contact with or using synthetic opioids.

IV. Procedures:

Due to the hazardous nature of the
synthetic opioids law enforcement personnel, jail and
correctional officers, or any first responders who
encounter synthetic opioids or related substances
should NOT take samples or otherwise disturb any
powdered substances without employing proper personal
protective equipment (PPE), as this could lead to
accidental exposure.

Officers should follow established work practices as well as the following recommendations when synthetic opioids or related
substances are known or suspected to be present.

If the presence of synthetic opioids is suspected,
personnel should immediately contact the appropriate
officials within this department who have been trained
to handle hazardous materials, or contact the nearest
DEA field office for assistance.

Having specially trained law enforcement professionals (or a hazardous materials "HAZMAT" incident response team) equipped
with the necessary equipment on-site, to include Level
"A" PPE, to assess the situation prior to exposure or
contamination is recommended.

This includes situations involving unknown powdered
substances and/or pill milling or encapsulating
operations.

When encountering unknown powders, personnel should use,
at the minimum, PPE to include nitrile gloves, N-95 dust
mask, eye protection, disposable paper suit, or paper
coveralls, and shoe covers. Naloxone should also be
readily available for administration. SEE Department
stand-alone Naloxone policy.
As matter of reference, it has been
determined that it would only take 2-3
milligrams of synthetic opioids to
induce respiratory depression, arrest,
and possibly death (see photo of
penny). When visually compared, 2 to 3
milligrams of synthetic opioids are
about the same as five to seven
individual grains of table salt1

V. General Precautions:

A. Do not eat, drink, smoke, or use the bathroom while
working in an area with known or suspected
synthetic opioids.

B. Do not touch the eyes, mouth, and nose after
touching any surface potentially contaminated
with synthetic opioids.

C. Field-testing of synthetic opioids or their
analogues is not recommended due to an increased
risk of exposure to responders performing field-testing. However, if detection and identification of synthetic opioids is critical to the incident response, develop an incident specific plan to
perform the field-testing in accordance with this
department's policies and procedures. Personnel
specifically trained to perform the field testing
should perform the field testing in the
appropriate PPE. Never handle synthetic opioids or
their analogues without the appropriate PPE.

D. Avoid performing tasks or operations that may
aerosolize synthetic opioids due to increased
exposure risks. Activities that aerosolize
synthetic opioids require higher levels of PPE,
should be conducted by appropriately trained
personnel, and completed in accordance with
department policies and procedures.

E. Wash hands with soap and water immediately after a
potential exposure and after leaving a scene where
synthetic opioids is known or suspected to be
present to avoid potential exposure and to avoid
cross contamination.

F. Do not use hand sanitizers or bleach solutions to
clean contaminated skin.

G. Officers who are exposed to synthetic opioids should
immediately use soap and water to thoroughly wash
and rinse contaminated skin. They should take care
not to break the skin during the decontamination
process and to cover all open wounds. Do not use
hand sanitizers or bleach solutions to clean
contaminated skin.

H. All contaminated clothing should be removed and
laundered, being careful not to disturb any
areas of contamination.

I. Shower immediately after a potential exposure.

J. Decontamination of reusable PPE and equipment
should be done according to the manufacturer's
recommendations.

K. Contaminated single use PPE should be placed in
labeled durable 6 mil polyethylene bags and disposed
of appropriately.1

VI. K-9 Working Dogs:

A. Police K-9s performing detection activities, are
also at risk of exposure to synthetic opioids and
its analogues. Working dogs should be removed from
an area where suspect synthetic opioids are
encountered. If exposed, residual drug powder might
remain on the dog's body; therefore, the proper
precautions and procedures mentioned above should
be employed by those handling the dog