Articles about fentanyl in dolphin blubber spark concern about medication disposal

Other posts discussed carfentanil and falsely suggested that SSPs increase syringe litter.

This past week, posts responded to several articles about fentanyl found in dolphin blubber, with some questioning how to properly dispose of unused opioids to avoid contaminating oceans. Plus, other posts discussed a recent CDC report on deaths from carfentanil—a powerful fentanyl derivative used to tranquilize large animals—and questioned whether syringe services programs contribute to syringe litter.

In light of these conversations, public health communicators may explain how to properly dispose of unused opioids and other medications, share information about carfentanil and overdose prevention, and highlight the benefits of SSPs.

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What’s trending nationally in conversations about opioids

On December 6, several articles reported on a study that found fentanyl in the blubber of dolphins from the Gulf of Mexico. Researchers speculated that drugs thrown overboard, agricultural runoff, or human wastewater could cause fentanyl to enter ocean water and then permeate dolphins’ blubber through the skin. Social media posts across multiple platforms discussed the study, with some receiving thousands of views. Most comments expressed concern about the health of marine life, and others demonstrated anti-immigrant sentiments. Some comments also questioned how to properly dispose of unused prescription opioids.

A recent CDC report found that while overdose deaths in the U.S. have slightly declined overall, overdose deaths involving carfentanil—which are rare—increased by roughly 720 percent between the first half of 2023 and the first half of 2024. Several social media posts discussed the report’s findings. A Facebook post from a local news program received approximately 32,400 views, 160 reactions, 160 shares, and 60 comments as of December 11. Comments expressed a variety of views, including distrust in the CDC, stigma toward people who use drugs, anti-immigrant sentiments, and confusion about what carfentanil is.

On December 4, a Reddit user shared a photo in a Portland, Maine, subreddit of syringes on the ground outside of a local business and asked if there is a “needle clean up team” they could contact. The post received approximately 85 upvotes and 180 comments as of December 11. Some comments stated that while they understand the benefits of harm reduction programs that provide sterile syringes, they are concerned that the programs lead to more syringe litter. Others questioned what they should do if they find syringes in public.

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Recommendations for public health professionals

Each week, the Infodemiology.com team will provide messaging recommendations in response to some of the trending narratives outlined above. These helpful tips can be used when creating content, updating web and FAQ pages, and developing strategy for messaging about opioids.

In response to concern about how to properly dispose of medications, messaging may emphasize that unused or expired prescription or over-the-counter medications can be dropped off at a drug take-back location. Find local, authorized drug take-back locations using this search tool. The FDA recommends removing personal information from medication bottles before disposal. Medication can also be mailed using a prepaid drug mail-back envelope, which may be available for free at some pharmacies. Alternatively, when there are no drug take-back locations nearby and drug mail-back envelopes are unavailable, some medications, including certain opioids, can be flushed down a toilet. Learn which medications can be flushed by reviewing the FDA’s flush list. However, flushing should be reserved as a backup plan after exhausting other options. Sharing safe trash disposal recommendations for medications that are not on the flush list is recommended.

Conversations about carfentanil provide an opportunity to educate the public about this drug. Messaging may explain that carfentanil is a dangerous synthetic opioid derived from fentanyl and that it is 100 times more potent than fentanyl. While carfentanil is not commonly found in the U.S. street drug supply, it has been linked to a growing number of overdose deaths. Fentanyl test strips, which help people determine whether their drugs contain fentanyl, may not be able to detect carfentanil, but using test strips to make educated decisions about drug use can still prevent a fentanyl-related overdose. Fentanyl test strips may be available for free through local harm reduction programs and can also be purchased online, but they are not legal everywhere, so communicators should stay informed about local drug checking equipment laws. Explaining that naloxone is effective at reversing an overdose from opioids, including carfentanil, is recommended. Multiple doses every two to three minutes may be required. Communicators may also recirculate information about the signs of an opioid overdose, where people can access naloxone, and how to use it.

In response to criticism of SSPs, messaging may explain that SSPs provide a wide range of services like vaccinations, HIV and hepatitis testing, referrals to care, and sterile syringes. These services have been shown to reduce the spread of infectious diseases, prevent overdose deaths, and reduce syringe litter in the communities they serve.