“At Cheddi Jagan International Airport in Guyana, customs officers should not smell-test or touch an unknown powdery substance during baggage screening because synthetic opioids such as fentanyl can be lethal in microdoses.”

Skin contact is also a potential exposure route but is not likely to lead to overdose unless exposures are to liquid or to a powder over an extended period of time. Brief skin contact with illicit fentanyl is not expected to lead to toxic effects if any visible contamination is promptly removed. Potential exposure routes of greatest concern include inhalation of powders or aerosols, mucous membrane contact, ingestion, or exposure secondary to a break in the skin.

Do not touch the eyes, nose, or mouth after touching any surface that may be contaminated, even if wearing gloves. Wash hands with soap and water. Always wear nitrile gloves when illicit drugs may be present and change them properly when they become contaminated. Wear respiratory protection if powdered illicit drugs are visible or suspected.

Incidental dermal absorption is very unlikely to cause opioid toxicity. [...] based on our current understanding of the absorption of fentanyl and its analogs, it is very unlikely that small, unintentional skin exposures to tablets or powder would cause significant opioid toxicity, and if toxicity were to occur it would not develop rapidly, allowing time for removal. [...] Inhalation is an exposure route of concern if drug particles are suspended in the air.

Dermal exposure to fentanyl results in absorption over hours to days. [...] Absorption through the skin may contribute to whole-body (systemic) toxicity. [...] USERS may experience these symptoms: Restlessness; Drowsiness; Nausea; Visual disturbances; [...] Skin: IRritation, pain and local tissue death.

Experts told CBS News that touching fentanyl powder will not cause an overdose. In powder form, the way it's almost always found in the illicit drug supply, the drug cannot absorb through the skin, said Ryan Marino, a medical toxicologist. 'Fentanyl as a dry powder is not going to cross through your skin. It's the same reason you can touch sugar without your blood sugar going up,' said Marino. 'Solids don't cross through your skin.' In 2017, the American College of Medical Toxicology and the American Academy of Clinical Toxicology issued a joint position statement stating that 'incidental dermal absorption is unlikely to cause opioid toxicity.'

OSHA guidance for first responders and law enforcement emphasizes that fentanyl exposure through inhalation, skin absorption, or mucous membrane contact can cause acute overdose. Workers should not smell or taste unknown substances and must use nitrile gloves, eye protection, and respiratory protection when handling suspected fentanyl.

Based on our current understanding of the absorption of opioids, small unintentional skin exposures to fentanyl tablets or powder cannot cause significant opioid intoxication. [...] At the highest single airborne concentration measured (13 mcg/m^3), an individual exerting himself heavily for 20 minutes [...] would inhale 10.4 mcg of fentanyl. This dose of fentanyl is unlikely to produce any clinically significant effect.

The following table provides PPE recommendations for protection against potential exposure to illicit drugs. [...] NIOSH does not recommend that, in responding to a drug overdose, emergency responders enter the patient’s living or work environment without the baseline personal protective equipment (PPE) typically used when responding to any emergency. [...] Skin contact is not likely to cause overdose unless large volumes of concentrated powder are encountered over an extended period of time.

NIOSH recommends Level D when the contaminant is known and the concentration is below any exposure guidelines [...] For fentanyl work, Level D may be worn when the opioids are known and there is no likelihood of airborne or dermal exposure.

Experts say that the risk of overdose due to accidental exposure, such as skin contact, with fentanyl is very low. The ACMT and AACT note that it would take much longer and more surface area in contact with fentanyl to deliver a fatal dose. The ACMT and AACT also note that the inhalation risk of fentanyl is similarly low.

Fentanyl's extreme potency and multiple routes of absorption (inhalation, dermal, mucous membrane) create significant occupational hazards for law enforcement and customs personnel. Case reports document overdose symptoms in officers following brief exposure to fentanyl powder without protective equipment. Smell-testing or direct tactile contact with unknown powders is contraindicated.

Exposures by inhalation or incidental ingestion are most likely; however, other exposure routes (e.g., dermal contact) should be considered. [...] Any cleaning compounds that contain solvents (e.g., alcohols) could increase risk of dermal exposure to fentanyl. Do not use bleach solutions to clean skin that may have come into contact with fentanyl.

The risks of accidentally touching fentanyl or breathing it in through the air are very minimal. According to the American College of Medical Toxicology (ACMT) and American Academy of Clinical Toxicology (AACT), in the unusual circumstance of significant airborne suspension of powdered opioids, a properly fitted N95 respirator or P100 mask is likely to provide reasonable respiratory protection. ACMT and AACT also state that evaporation of fentanyl powder into a gaseous phase is not a practical concern, meaning that breathing air in a room where fentanyl powder is sitting undisturbed on a table is unlikely to harm you.

In 2016, the U.S. Drug Enforcement Administration (DEA) released an advisory and training video that warned: '[J]ust touching fentanyl or accidentally inhaling the substance… can result in absorption through the skin and that is one of the biggest dangers with fentanyl. The onset of adverse health effects, such as disorientation, coughing, sedation, respiratory distress or cardiac arrest is very rapid and profound, usually occurring within minutes of exposure (DEA, 2016).'

Skin contact is also a potential exposure route, but is not likely to lead to overdose unless large volumes of concentrated powder are encountered over an extended period of time. If visible contamination is promptly removed, brief skin contact is not expected to lead to toxic effects. Potential exposure routes include inhalation, mucous membrane contact (eyes/nose), ingestion and percutaneous (needlestick).

It is a common misconception that fentanyl can be absorbed through the skin, but it is not true for casual exposure. You can't overdose on fentanyl by touching a doorknob or dollar bill. The one case in which fentanyl can be absorbed through the skin is with a special doctor-prescribed fentanyl skin patch, and even then, it takes hours of exposure.

CBP officers used a nonintrusive imaging system and canine detection to identify 20.6 pounds of fentanyl powder concealed in vehicle doors, demonstrating safe detection protocols that avoid direct contact with the substance. The fentanyl quantity was noted as 'enough to kill nearly 7 million Americans,' underscoring extreme potency.

The ACGIH gave fentanyl a skin notation, indicating the chemical can contribute significantly to the overall exposure through the dermal (cutaneous) route. [...] One of the 78 air samples collected exceeded the Environmental Protection Agency (EPA) occupational exposure guideline for fentanyl in the air (0.1 micrograms).

Fentanyl can be injected, inhaled, ingested or absorbed through the skin. Because such a low dose of synthetic opioids can be lethal, first responders and receivers may be at risk when handling patients who have trace amounts of the drug on their skin, clothing or belongings. [...] Healthcare facility employees who are at risk of exposure to fentanyl or other synthetic opioids must be trained not to use alcohol-based hand sanitizer as it may facilitate dermal absorption.

A 2016 NIOSH alert warned first responders of potential exposure risks from fentanyl powder via inhalation or skin contact, leading to overdoses; however, subsequent studies and position statements from ACMT, AACT, and NIOSH clarified that incidental dermal or low-level inhalation exposures are unlikely to cause overdose, retracting some initial alarm. No specific guidelines found for Guyana's Cheddi Jagan Airport; general airport customs protocols emphasize PPE and avoiding direct contact with unknown substances.

A lethal dose of fentanyl is approximately 2 milligrams—equivalent to just 10-15 grains of table salt. Can you accidentally overdose from touching fentanyl? No, this is a common myth. Fentanyl cannot be readily absorbed through intact skin. You cannot overdose by touching fentanyl powder, handling a contaminated surface, or even giving CPR to someone who has overdosed.