Can folded dollar bills on the ground be deadly? What to know

Can I accidentally overdose by touching opioids?

(WJW) — There was a drug awareness story last month that got a lot of people talking — but for the wrong reasons, said a local doctor.

In April, a sheriff's office in western Kansas reported methamphetamine was found inside a folded $1 bill in a resident's yard, and issued what it deemed to be a public safety announcement. The report drew a lot of questions about whether it was common to simply encounter harmful drugs in public or even in your front yard.

FOX 8 News in Cleveland, Ohio, put that question to federal, state and local police or drug enforcement agencies — but none offered any evidence or even anecdotal reports that such a thing is happening with any regularity.

Moreover, it's not common for drug occurrences like these to even be happening. But could they happen?

Can you accidentally overdose by touching opioids?

Cases of drug-laden currency are not something the Ohio Narcotics Intelligence Center has looked into, the organization says. It's not a common means of transporting drugs, according to its analysts. Dollar bills are most often used to ingest drugs.

"While there are a number of ways civilians could become exposed to narcotics or other substances, it is unlikely any of these exposures would be done so nefariously or intentionally by individuals," center analysts wrote in an email to FOX 8.

University Hospitals' Dr. Ryan Marino, an emergency department toxicologist, is familiar with the story.

Similar reports cropped up last summer — except those dollar bills encountered contained fentanyl, a powerful synthetic opioid. A Kentucky woman claimed she accidentally came into contact with the drug in Nashville, leading to her hospitalization. Medical experts had their doubts.

"There's no evidence people are intentionally leaving drugs out," Marino told FOX 8 News.

Experts also doubted the 2017 case of an Ohio patrolman who claimed he overdosed after coming into contact with fentanyl during a traffic stop.

"You cannot overdose by touching any drugs — even fentanyl or carfentanil," Marino said.

The drug trafficker was sentenced to more than six years in prison on charges including assault. The officer, Chris Green, was fired four years later, after city officials determined he lied in an incident report on an entirely unrelated matter. He's since sued the city, FOX 8 sister station WKBN reported.

About a month after Green's reported overdose in 2017, academics came out to say that accidental skin exposure to a drug even as potent as fentanyl is unlikely to cause harm, and that first responders can adequately protect themselves with nitrile gloves and N95 masks.

" ... Based on our current understanding of the absorption of fentanyl and its analogs, it is very unlikely that small, unintentional skin exposures to tablets or powder would cause significant opioid toxicity, and if toxicity were to occur it would not develop rapidly, allowing time for removal," reads a position paper released by the American College of Medical Toxicology and the American Academy of Clinical Toxicology.

Even if you covered both your palms with transdermal patches specifically designed to deliver fentanyl for pain management, it would still take about 14 minutes for 0.1 milligram of the drug to enter your body. A lethal dose can be about 2 milligrams, depending on a person's size and tolerance.

So if a person were to accidentally come into contact with narcotics inside a folded dollar bill, there's no risk of it affecting them, unless they somehow ingest it, Marino said.

What are common means of accidental drug exposure?

According to center analysts, it's more likely for children living in homes where narcotics are used to be accidentally exposed, and Marino said those cases seem to be "on the rise."

It's also more likely that street-bought drugs have been cut with something like fentanyl, which is now so ubiquitous among street dealers that it's being found in the supplies of other illicit drugs. Even a college student buying Adderall to help them study might not know they're buying fentanyl, Marino said.

"The only thing [pill pressers] have available is fentanyl powder, so they're pressing it and passing it off as something else," he said. "You have to assume everything has fentanyl."

Inadvertently inhaling fentanyl that's been kicked up into the air is also a risk, according to the center — though it's not likely. A person could also accidentally prick themselves with a needle that wasn't property disposed and may still have drug residue on it.

These reports are a 'distraction'

Marino also works in addiction medicine. Outside of the emergency room, he also dispels misinformation on drugs and addiction — and he thinks Americans are poorly educated on drugs.

Marino said these scary reports from last year remind him of the HIV panic in the 1980s.

"There's this notion that people are dirty or malicious or out to get other people," he told FOX 8 News. "You get this moral panic where people are scared, and it hampers the actual public health response to fentanyl overdoses."

It can discourage people from stepping in to help save someone who is overdosing, Marino added. "If you think fentanyl is everywhere, you don't want to touch things."

Marino said these types of one-off reports that shock but offer little substance are more of a distraction from the real issue: An average 4,600 Ohio residents died of drug overdoses each year between from 2017 to 2021, and about three-quarters of those deaths involved synthetic opioids, according to Ohio Department of Health data.

"How many years are we into our opioid epidemic? ... These are all deaths that are entirely preventable. ... Every opioid overdose can be reversed."

What to do if you think someone is overdosing

People overdosing on opioids appear sleepy or struggle to stay conscious, according to the U.S. Centers for Disease Control and Prevention.

They may also be breathing slowly or making choking or gurgling sounds. Their pupils may be small and constricted to pinpoints. Their body may be limp. Their skin may be cold, clammy or discolored.

Anyone who thinks they may have been accidentally exposed to narcotics or believe they are overdosing should call 911 immediately.

Another person should give them naloxone, or Narcan, if available. It can't be self-administered. To get the potentially life-saving overdose remedy for free, visit naloxone.ohio.gov.

The CDC recommends keeping the person awake, laying them on their side to prevent choking, and waiting with them until first responders arrive.

The risk of overdose death is even greater for someone who uses drugs alone, without anyone to give them naloxone, Marino said.

"Be informed. Know the risks of drugs. Know what to do," he said. "If you're worried someone in your life is using substances, know what the risks are. Maybe they're not meaning to use fentanyl."