Persistent narratives about the HALT Fentanyl Act question whether fentanyl is ever safe

Plus, posts called attention to fentanyl-laced street drugs and highlighted barriers to substance use disorder treatment.

Discussions about the Halt All Lethal Trafficking of Fentanyl Act continued this week after the Senate Judiciary Committee voted to advance the legislation, with some social media posts questioning whether fentanyl is safe to prescribe or administer in medical settings. In other conversations, posts about a patrol deputy’s overdose noted that street drugs are often unknowingly laced with fentanyl, and a post about methadone sparked conversation about barriers to substance use disorder treatment.

In light of these discussions, communicators may outline the risks of prescription fentanyl and other opioids, share information about drug test strips, and explain how people can access SUD treatment.

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What’s trending nationally in conversations about opioids

On February 27, the Senate Judiciary Committee voted to advance the Halt All Lethal Trafficking of Fentanyl Act, which, if enacted, would permanently classify street versions of fentanyl as Schedule I substances and enact harsher penalties for people who transport or sell them. Several social media posts discussed the HALT Fentanyl Act in the days leading up to the vote. On February 26, Attorney General Pamela Bondi shared an X post calling the HALT Fentanyl Act “vital legislation in our fight against the drug traffickers who prey on addiction and profit from Americans’ despair.” Her post received approximately 1.4 million views, 33,000 likes, 6,400 reposts, and 7,400 comments as of March 5. Commenters debated whether the HALT Fentanyl Act would be effective at preventing overdose deaths and mentioned losing loved ones to fentanyl overdoses.  Other politicians posted in support of the bill, with commenters debating whether pharmaceutical fentanyl is safe.

Recent articles reported that a Sacramento County patrol deputy, who had allegedly been “exposed” to fentanyl while on duty in 2023 and was revived with naloxone, had actually experienced a fentanyl overdose after taking illegal drugs he had seized. The deputy allegedly believed that he was taking methamphetamine—which he had used in the past—and did not know that it was laced with fentanyl. Posts across platforms shared articles about the deputy. While some commenters expressed shock that the deputy had taken illegal drugs, many were unsurprised, and some expressed compassion and concern for people with SUD. Some comments also noted that fentanyl is often unknowingly mixed with other street drugs, stating that people who use drugs should “just assume” that “everything is laced.”

On February 24, a Facebook post shared the misleading claim that “methadone is free” for people in treatment for SUD and questioned why chemotherapy is not free for cancer patients. The post received approximately 49,000 views, 1,600 reactions, 690 shares, and 280 comments as of March 5. Some commenters argued that both treatments should be affordable or free. Several others correctly noted that methadone is rarely free and that many people struggle to access SUD treatment when they are uninsured or underinsured or live in rural areas.

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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 light of concerns about fentanyl, communicators may explain that fentanyl is a synthetic opioid that’s up to 50 times stronger than heroin and 100 times stronger than morphine. Synthetic opioids like fentanyl contribute to the majority of U.S. overdose deaths. Street fentanyl is different from pharmaceutical fentanyl, which health care providers can prescribe and administer to help patients manage severe pain or to cause drowsiness before a medical procedure. However, anyone can develop opioid use disorder, even when taking prescription fentanyl or other opioids. Some people face higher risk of developing OUD and overdosing, including people who have a history of SUD or health conditions like sleep apnea, people who use other substances in addition to opioids, and older adults. Patients who need prescription pain management should talk to their health care provider about their medical history and other medications they take to determine the best options for them. Outlining the signs of an opioid overdose and explaining where to access naloxone, which can reverse an opioid overdose, is recommended.

Conversations about fentanyl and fentanyl-laced street drugs provide an opportunity to explain that you cannot overdose on fentanyl by touching it or by accidentally inhaling a small amount. People who use drugs are at risk of fentanyl overdose because fentanyl is often unknowingly mixed with a variety of other street drugs. Communicators may note that fentanyl test strips prevent overdose deaths by helping people determine whether their drugs contain fentanyl so they can make educated decisions about drug use. Messaging may emphasize that fentanyl test strips can be purchased online and may be available for free through local harm reduction programs, but they are not legal everywhere. Communicators may ensure that messaging is up to date with local drug checking equipment laws. Additional messaging may outline how to use drug test strips and emphasize that testing the entire batch is the only way to know for sure if a drug contains fentanyl.

In response to conversations about the cost of drug treatment, messaging may explain that most health insurance plans—including Medicaid—cover some forms of drug treatment. Communicators may share local recovery groups, drug treatment centers, and SAMHSA’s National Helpline (1-800-662-HELP). Sharing grants that help people pay for SUD treatment is recommended.