SAN DIEGO (AP) - San Diego County Sheriff Bill Gore, facing sharp criticism from health experts over a public service video that purports to show a deputy's near-death experience from fentanyl exposure, acknowledged that he, not a doctor, concluded the deputy overdosed.
Experts strongly challenged Gore's finding after the dramatic, four-minute video was released Thursday, saying it fueled misunderstanding and unsubstantiated fears about the danger posed by very limited contact with fentanyl.
During the search of a vehicle last month, Deputy David Faiivae reported his face came within about 6 inches (15 centimeters) of a white, powdery substance that tested positive for fentanyl, an opioid that is 50 times more powerful than heroin. The video from police body-worn cameras shows Faiivae stagger backward, fall to the ground and struggle to breathe.
According to an incident report released Monday, Faiivae wore gloves and safety glasses but not a mask. He remembered feeling light-headed before collapsing.
Health experts have long said overdosing from skin contact or inhalation of fentanyl is extremely unlikely, which was news to Gore. The sheriff told The San Diego Union-Tribune that the department assumed such exposure could result in an overdose.
"If we were misinformed, so be it. We are trying to correct (it)," he told the newspaper.
Researchers who have studied reported overdoses from fentanyl exposure among emergency responders found cases can best be attributed to the "nocebo effect," a phenomenon in which they believe they encountered a toxic substance and therefore experience expected symptoms, according to a study by medical experts published last year in the Harm Reduction Journal.
"When individuals are already operating under acute stress and with few mental health reserves, fear of overdose from touching fentanyl could serve as an additional stressor," the authors state.
Gore, a former FBI official who is not seeking a fourth term next year, said he had concluded after seeing the body-worn camera footage that the deputy exhibited "classic signs of fentanyl overdose."
"I'm sorry, my mind didn't go to, ‘Oh, our deputy fainted. Our deputy had a panic attack.’ It just didn't go there. What was the other logical explanation — to my mind, it was overdose from the drug, from fentanyl," Gore said. The sheriff promised to release full, unedited video of the incident and to seek medical records of the deputy that presumably would show if he overdosed.
The sheriff's department said neither Gore nor Faiivae were available for interviews Tuesday.
An online petition organized by Dr. Ryan Marino, a 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 organizations to correct what it said was the sheriff department's erroneous account. They said it was signed by more than 350 drug experts, including health professionals.
"This is dangerous misinformation that can cause harm to both people who use opioids and to members of the law enforcement community," the petition reads.
The Drug Policy Alliance, a group that advocates for decriminalization and safe drug use policies, called the video irresponsible.
"Content like this simply creates more fear and irrational panic that fuels further punitive responses to the overdose crisis, instead of the public health approach we need," said Kassandra Frederique, the group’s executive director.
In the video, Faiivae, a trainee, approaches the white powder found in a Jeep's back storage area in the San Diego suburb of San Marcos.
"This stuff’s no joke. It is super-dangerous," Cpl. Scott Crane says before Faiivae collapses.
Faiivae is administered naloxone nasal spray, which reverses the effects of a drug overdose, after he is shown on the ground. Crane tells the deputy he won’t let him die.
The deputy later recounts what it was like, unable to breathe, gasping for air and then passing out.
"It’s an invisible killer," Crane says on the video during a sit-down interview after the incident. "He would have died in that parking lot if he was alone."
Gore struck a somber note at the end of the public service announcement to emphasize the dangers of opioids, saying to the camera that exposure "to just a few small grains of fentanyl could have deadly 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 of responders feeling dizzy or like the body was shutting down or dying, but finds, "Toxicity cannot occur from simply being in proximity to the drug."