Sheriff in California admits that he, not a physician, diagnosed video overdose
Sheriff Bill Gore of San Diego County, who has come under fire from health experts for a public service video purporting to show a deputy’s near-death experience due to fentanyl exposure, has now admitted that he, not a doctor, determined the deputy overdosed.
Following the dramatic four-minute video’s release last Thursday, experts strongly contested Mr Gore’s finding, claiming it fueled misunderstanding and unfounded fears about the danger posed by very limited contact with fentanyl.
Deputy David Faiivae reported that while searching a vehicle last month, his face came within about 15 centimetres of a white, powdery substance that tested positive for fentanyl, an opioid 50 times stronger than heroin.
Mr Faiivae is seen stagger backward, fall to the ground, and struggle for breath in the video from police body-worn cameras.
Mr Faiivae was wearing gloves and safety glasses but not a mask, according to an incident report released on Monday.
He recalled feeling dizzy just before collapsing.
Health experts have long stated that overdosing on fentanyl via skin contact or inhalation is extremely unlikely, which Mr Gore was unaware of.
According to the sheriff, the department assumed that such exposure could result in an overdose.
“Perhaps we were misinformed. We are attempting to rectify the situation,” he told the newspaper.
According to a study published last year in the Harm Reduction Journal, researchers who studied reported overdoses from fentanyl exposure among emergency responders concluded that the majority of cases can be attributed to the “nocebo effect,” a phenomenon in which individuals believe they have come into contact with a toxic substance and thus experience expected symptoms.
“When individuals are already under acute stress and have depleted mental health reserves, fear of overdose from contact with fentanyl may serve as an additional stressor,” the authors write.
Mr Gore, a former FBI official who will not seek re-election next year, stated that after viewing the body-worn camera footage, he concluded that the deputy displayed “classic signs of fentanyl overdose.”
“I apologize; my mind did not immediately jump to, ‘Oh, our deputy fainted.’ Our deputy suffered from a panic attack.’ It simply did not make the trip. What was the other logical explanation — to my mind, it was fentanyl overdose,” Mr Gore stated.
The sheriff promised to release the full, unedited video of the incident and to obtain the deputy’s medical records, which would likely reveal if he overdosed.
Mr Gore and Mr Faiivae were not available for interviews on Tuesday, according to the sheriff’s department.
Dr Ryan Marino, a toxicology expert and assistant professor at Case Western Reserve University School of Medicine, and Lucas Hill, a clinical assistant professor at the University of Texas at Austin College of Pharmacy, organized an online petition urging news organizations to correct what they claimed was the sheriff department’s inaccurate account.
They stated that it was signed by over 350 drug experts, including physicians.
“This is dangerous misinformation that has the potential to harm both opioid users and law enforcement personnel,” the petition states.
The Drug Policy Alliance, a group that advocates for decriminalization and safe drug use policies, condemned the video.
“Content like this breeds fear and irrational panic, which fuels even more punitive responses to the overdose crisis, rather than the public health approach that is required,” the group’s executive director, Kassandra Frederique, said.
Mr Faiivae, a trainee, approaches the white powder discovered in the back storage area of a Jeep in San Marcos, a San Diego suburb.
“This is not a joke. Corporal Scott Crane states before Mr Faiivae collapses, “It is extremely dangerous.”
After being shown on the ground, Mr Faiivae is given naloxone nasal spray, which reverses the effects of a drug overdose.
Mr Crane informs the deputy that he will not allow him to die.
Later, the deputy describes what it was like to be unable to breathe, gasping for air, and finally passing out.
“It’s an invisible killer,” Mr Crane says in a video interview following the incident.
“If he had been alone, he would have died in that parking lot.”
Mr Gore ended the public service announcement on a somber note, telling the camera that exposure to “just a few small grains of fentanyl” could have fatal consequences.
Two professional organizations — the American College of Medical Toxicology and the American Academy of Clinical Toxicology — stated jointly in 2017 that the risk of significant fentanyl exposure for emergency responders is “extremely low.”
The authors note that some responders reported feeling dizzy or as if their bodies were shutting down or dying, but conclude that “toxicity cannot occur simply from being in close proximity to the drug.”