Sheriff says he, not the doctor, diagnosed the deputy overdose

By Elliot Spagat | Associated Press

SAN DIEGO – San Diego County Sheriff Bill Gore faces strong criticism from health experts over a public service video that claims to show the near-death experience of a Member following exposure to fentanyl, admitted that he, and not a physician, concluded that the Member had overdosed.

Experts strongly disputed Gore’s findings after the four-minute dramatic video was released on Thursday, saying it fueled misunderstandings and unfounded fears about the danger posed by very limited contact with fentanyl.

During a vehicle search last month, Deputy David Faiivae reported that his face was about six inches from a white, powdery substance that tested positive for fentanyl, an opioid 50 times more potent than heroin. Police body-worn video shows Faiivae staggering backwards, falling to the ground and struggling to breathe.

According to an incident report released on Monday, Faiivae was wearing gloves and safety glasses but no mask. He remembered being stunned before collapsing.

Health experts have long said that an overdose by skin contact or inhalation of fentanyl was extremely unlikely, which was news for Gore. The sheriff told the San Diego Union-Tribune that the department suspected such exposure could lead to an overdose.

“If we have been misinformed, so be it. We are trying to fix it, ”he told the newspaper.

Researchers who studied reported overdoses of fentanyl exposure among emergency responders found that the cases can best be attributed to the “nocebo effect”, a phenomenon in which they believe they have encountered a toxic substance and therefore experience symptoms. expected, according to a study by medical experts published last year in the Harm Reduction Journal.

“When individuals are already functioning under acute stress and with few mental health reserves, the fear of overdosing upon touching fentanyl could be an additional stressor,” the authors state.

Gore, a former FBI official who is not running for a fourth term next year, said he concluded after seeing the camera footage worn on the body that the deputy exhibited “classic signs of overdose. fentanyl “.

“I’m sorry, my mind didn’t go, ‘Oh, our deputy is passed out. Our assistant had a panic attack. He just didn’t go. What was the other logical explanation – in my opinion it was drug overdose, fentanyl, “Gore said. The sheriff has vowed to post a full, unedited video of the incident and to search the deputy’s medical records which would presumably show if he had overdosed.

The sheriff’s department said neither Gore nor Faiivae were available for interviews on Tuesday.

An online petition organized by Dr Ryan Marino, toxicology expert and assistant professor at Case Western Reserve University School of Medicine, and Lucas Hill, clinical assistant professor at the University of Texas, Austin College of Pharmacy, urged news outlets to correct what he said was the erroneous account of the sheriff’s department. They said it had been signed by more than 350 drug experts, including medical professionals.

“This is dangerous misinformation that can harm both people who use opioids and members of the law enforcement community,” the petition says.

The Drug Policy Alliance, a group that advocates for decriminalization and safe drug use policies, called the video irresponsible.

“Content like this just creates more fear and irrational panic that fuels new punitive responses to the overdose crisis, instead of the public health approach we need,” said Kassandra Frederique, Executive Director of the group.

In the video, intern Faiivae approaches white powder found in the back storage area of ​​a Jeep on the San Diego suburb of San Marcos.

” This is not a joke. It’s super dangerous, ”said Cpl. Scott Crane said before Faiivae collapsed.

Faiivae is given a nasal spray of naloxone, which reverses the effects of a drug overdose, after being shown to the ground. Crane tells the deputy that he won’t let him die.

The MP later recounts what it was like, unable to breathe, gasping for breath and then passed out.

“He’s an invisible killer,” Crane said on video in an interview after the incident. “He would have died in that parking lot if he had been alone.

Gore struck a dark note at the end of the PSA to highlight the dangers of opioids, telling the camera that exposure “to a few small grains of fentanyl could have fatal consequences.”

Two professional groups – the American College of Medical Toxicology and the American Academy of Clinical Toxicology – said in a joint statement in 2017 that the risk of significant exposure to fentanyl is “extremely low” for emergency responders. The authors noted reports that responders felt dizzy or as if the body was shutting down or dying, but find that “toxicity cannot occur just by being near the drug.”

Associated Press writer Julie Watson contributed to this report.

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