Evidence Management – The One About Fentanyl – Part 1

Posted on: Sep 09, 2021

Categories: Uncategorized

“The Evidence Show” is hosted by EMI Executive Director Shawn Henderson. Not to spoil the plot, but The Evidence Show is, well… a show about evidence management. In each episode, we will take a look at the unique issues that impact evidence managers, custodians, and the law enforcement community in general.

In Part 1 of this webinar, Shawn began by saying, “During the pandemic, I’ve had the benefit of getting acquainted with James Nalley at the Orange County Sheriff’s Office. We’ve worked together on some training in the past and we look forward to working together on training in the future. 

James has got a really deep background in dealing with fentanyl. And, that’s what we’re going to talk about today.

But first, I’d like to talk about how we’re able to pay the bills and get things done, especially when we’re not going out and training people. We’ve got a great partnership with Tracker Products. They’re an evidence management software company. And, because of our partnership with Tracker, we’re able to do what we do. So, I would encourage you to check them out. 

Okay… what we’re talking about today is: The One About Fentanyl. The goal here is to teach you about the things every evidence custodian needs to know about fentanyl. I’ve addressed this topic in the classes we teach, but the information comes from the things I’ve learned from other people about fentanyl.

Years ago, I retired from the law enforcement agency where I worked, right as fentanyl was becoming a huge problem for law enforcement and property rooms. To better understand the importance of becoming familiar with this problem, I’m going to introduce our two guests today. They’re both from beautiful Orange County. 

You might remember James Nalley from our past training episodes. He also does evidence training when there’s not a pandemic going on. James, will you introduce yourself real quick? And then, we’ll introduce Brian.”

guest panel

***Top Left – Brian, Top Right – Shawn, Bottom – James 

James said, “Absolutely. I’m James Nalley. A lot of folks know me already from our training class in California. The website is chainofcustodypro.com. Basically, we started the training out of necessity because we realized that California law is complex. There are a lot of things that we have to deal with in California that some other states don’t have to. Things like firearm laws, legislation on sexual assault evidence, legalizing marijuana, etc. Fentanyl is just another one of those things that we have to deal with in our unit. 

Unfortunately, it kind of blew up in Orange County. We know so much about it because it happened in our backyard. So, I’m glad to be here. Thank you Shawn for allowing me to come in and give some of my expertise on this subject. This topic is dear to my heart.”

Shawn said, “I am absolutely happy to have you here. I’ll also introduce Brian Quigley. Brian is a safety manager with the Orange County Sheriff’s Office. Brian, tell us a little about yourself?”

Brian said, “Of course. My name is Brian Quigley. I’m the safety specialist currently assigned to the Orange County Sheriff’s Department. My role is to provide information and guidance to the Orange County Sheriff’s department in regards to safety-related questions and programs; and to provide guidance on Cal/OSHA related material. 

As far as my background… I got my start in law enforcement back in ‘06 with the Orange County Sheriff’s Department. I moved up from their dispatch office to a non-sworn custody position. And then took on a sworn position as a Deputy Probation Officer in Riverside County where I stayed for another six years before coming back to Orange County as a safety specialist. 

So, I have had plenty of experience taking 911 calls, dealing with people in the jail, arresting people in the field, collecting evidence – including fentanyl – and dealing with the safety side of the house. Thank you for the invite.”

Shawn said, “Thank you for being here. I think you’re going to be able to provide us with some perspective and expertise that we don’t have, but people need to hear.”

Shawn passed the presentation over to James, who said, “This is our fentanyl safety in the property room (see the image above). We always like to remind people that the line staff is the foundation of a functioning evidence room, right? 

Today we’re going to talk about fentanyl. As if there’s not enough stuff to deal with in property and evidence; between the potential of loaded firearms, knives improperly packaged, loaded needles, marijuana aspergillus. It gets more and more complex all the time. But, fentanyl rates up towards the very top of the things that we handle. 

This is fentanyl. 

fe

This is it in its molecular structure. Doesn’t look very menacing here, but let’s talk a little bit about the problems with fentanyl. I’ll give you a little history and talk to you specifically about how toxic the drug actually is. 

Next, we’re going to talk about the proper methods for packaging and handling, and that actually starts in the field. So, this is something you can relay to your officers as well. I’m hoping that everyone in this audience has at least heard about fentanyl, and they’ve at least had some form of training. Because we’ve been seeing it come through since about 2016.

Some people might say, I haven’t seen any fentanyl come through my evidence stream. Chances are, your crime labs are probably not testing for it. If that’s the case, give your crime lab a ring and say, Hey, are we testing for fentanyl now? And if so, I need to be aware of it so that I can take the proper precautions for it. 

We need to know how to stay safe in the property room. And that’s all going to be about PPE and having proper procedures to keep us safe. 

Brian’s going to come in towards the end and talk about Naloxone, otherwise known as Narcan. Narcan is the antidote for an opioid overdose and that’s super important for us, right? 

fentanyl

So, let’s talk a little bit about the history of pharmaceutical-grade fentanyl, which is a man made synthetic opioid. It was introduced in 1959 for the purpose of pain management. It actually had a purpose; still does have a purpose. And that’s why fentanyl is still used by medical staff today.

In the 1960s, it was introduced as Sublimaze. Analogues were developed shortly thereafter. Analogues are just a similar drug that has the same molecular structure plus or minus atom, and they have different levels of toxicity. 

We’re going to talk about carfentanil, which is one of the deadliest opioids. A transdermal patch was created in the mid 1990s. It became widely used during the end of life phase. So, hospice patients and terminally ill patients were using that as pain medication. Obviously, it was a lot more potent than its predecessor morphine. 

One of the key points is that it was the first pain medication that used a transdermal delivery. For those of you that don’t know exactly what transdermal means, it means that it can absorb through the skin which is a big problem for us in the evidence management units. 

Let’s talk about illicit fentanyl… where it’s coming from, the toxicity levels of it, and so forth.

The biggest thing that I want to emphasize about fentanyl – and one of the reasons why it is so toxic and so dangerous – is that it’s super concentrated and super potent. It is measured in micrograms rather than milligrams. I’ll explain why that’s important…

Let’s say we took a packet of Sweet’N Low, tore it open, and spilled it out onto the table. That’s approximately one gram of Sweet’N Low. Now you’re going to take your favorite credit card and you’re going to make 10 individually equal lines out of that. Each one of those lines is basically a dose. If you were to measure heroin, cocaine, or some of the other narcotics that come in powder format, a gram is going to be one dose. 

By contrast, a couple grains in one of those lines equals a dose of fentanyl. So, you can see how concentrated it is. Anything more than that would be a fatal overdose. Just to give you an idea, it’s about 50 to a hundred times more powerful than morphine and 40 times more powerful than heroin. That’s why we’re having so many problems with it coming through our evidence stream. 

Some of the legal illegal analogues include carfentanil, which is extremely toxic. We’ll talk a little bit about carfentanil, furanyl, acryl, valeryl, and fentanyl. All of those are just analogues of fentanyl and they all do the same thing, just with different levels of toxicity. 

Let’s take a look at the lethal doses… 

If you notice in the top left corner of the image above, that’s a lethal dose of fentanyl next to the penny. Below it, those are ecstasy pills. Each one of those ecstasy pills contains a lethal dose of fentanyl. You might be thinking, I thought it was just powder format. Why is it in pills? 

We’re seeing fentanyl come through in everything. Powder format, counterfeit prescription medications, even Tar Heroin; like you see on the top right-hand coroner. If you look in the middle, you’ll see a lethal dose of heroin on the left hand side of the black and white image. The middle is fentanyl, and the right side of it is carfentanil. And we’ll talk about the toxicity levels of that. 

So, let’s talk about packaging and handling, because that’s where we live, right? That’s the important stuff about what we have to do to ensure that we stay safe in our units. Our agency has created some very specific packaging guidelines based on the fact that we had so much fentanyl coming in the very beginning.

fentanyl

How did we discover that we were getting fentanyl in our evidence room? Because honestly, it’s a cutting agent. So, you’ve got heroin, you’ve got methamphetamine, you’ve got cocaine coming in with fentanyl in it. It wasn’t until our crime lab discovered that we had a rash of overdoses that they started to take a deeper look into the narcotics that were coming in from these coroner cases.

Upon reviewing those coroner cases, and finding the narcotics on scene, they identified different types of fentanyl that were coming in. Which led to these massive overdoses, especially when the people manufacturing the drugs don’t necessarily have a specific formula. It’s kind of like trial and error for their recipes. 

First and foremost, we’re hoping desperately that all agencies have stopped field testing. It’s just so incredibly dangerous to do field tests because your officers are risking their health and safety. We’ve worked with the district attorney’s office and forensics community to forego field testing. I know the DA’s office wanted to have that field test done, the NIK kit, and the Presumptive so that it would help their probable cause in court. But it’s just way too dangerous to do that in the field. 

Now, as our officers come in, we require them to dawn two pairs of nitrile gloves. You might think, Can they be latex? The answer is no. Latex doesn’t protect as well as nitrile gloves. So, we’re asking that they place two pairs of nitrile gloves on, plus safety glasses. 

There are different levels and threat assessments for needing other types of PPE. Obviously, if you go to a scene with a lot of unconscious people and narcotics everywhere, you’d really want to just back out of that scene and let your contingency responders handle it. It could be a mass overdose of fentanyl. It could be a pill, manufacturing facility, etc. So, in the field, at least wear an N95 respirator and the gloves. 

All narcotics must be packaged in Ziploc or heat seal bags. Some people have asked me, Hey, is there fentanyl in marijuana? And actually we have seen fentanyl in marijuana too. It’s a little bit rare, but we do see it. So, you want to make sure you treat all of the narcotics the same way.

Now, when the officer comes in, he’s got his original packaging that he collected in the field. It could be all the different formats of how narcotics are packaged for sales or for possession. So you have bindles; pieces of paper that are folded up with the narcotics inside. You could have balloons. You can have small baggies. Those items are called the primary packaging. 

We’re talking about narcotics that are coming into your unit that are under 400 grams. 400 grams or more is a completely different process. We’re talking about the small quantities that come in. So… you have your primary packaging, you have your double gloves on, and then your PPE. You want to put that into another sealed plastic baggie.

These could be Ziploc baggies, or the preferred method is a heat seal bag. Primary packaging goes into secondary packaging. The reason I think it’s important to use heat sealed bags is that most people push a Ziploc bag up against their body to push the air out. When you push that air out, where’s all the powder going to go? Right up in your face. Now you have exposure. So, it’s always better, in my opinion, as a standard to heat seal. You’re just eliminating some of that risk.

Once you’ve got your primary packaging and your secondary packaging, now you can place your secondary packaging into your standard envelopes or however you would store evidence at your unit. We like to put them in either the 6 x 9 or 9 x 12 manila or craft style envelopes. 

Get that all sealed up, with the initials, and get it booked in. If you suspect it to be fentanyl, make sure you either write on the outside – or if your agency has some fentanyl stickers – you’d want to place that on the property, next to your evidence tag. 

So, talking about 400 grams or more, including kilos, obviously, you can’t stuff two kilos into a manila envelope, so you should use a containment bucket. I’m going to show you examples of a containment bucket in the next slide. Make sure you write on the envelope, or on the bucket, that you have a potential fentanyl threat. 

Here’s exactly what I was talking about…. 

fentanyl

You’ve got your double nitrile gloves. 

I apologize… I missed a really critical step. I want to go back and talk about that real quick. 

Once you take your primary packaging, and you put your primary packaging into your secondary packaging, and you seal that, just before you put that into your envelope, you definitely want to strip your outer layer of nitrile gloves. 

At the beginning, we had talked about putting on two pairs of nitrile gloves. The reason for that is, we don’t want to contaminate the outside of our evidence with any residue from your original packaging. So once again, primary packaging goes into your secondary packaging, heat seal, or Ziploc with a seal on top of that. And just before you take your secondary packaging and place it into your evidence envelope, strip the outer layer of gloves, and dispose of those immediately. 

Now you have your evidence all booked in. You’re ready to go. The image above is just an example of what I was talking about: bindles, baggies, balloons, narcotics, including prescription medication. You have a syringe there, and then there’s your red line bags or your heat sealer. 

Again, for fentanyl or narcotics coming in over 400 grams, you definitely want to use something a little more robust, like heavier duty bags. And then, of course, putting it into a containment bucket where you would seal it. 

To dispose of the gloves, we’ve set up little specialty trash cans. When those gloves go into the specialty trash can, you tie it off and go with you to the narcotics burn. Maybe that’s overkill, but there’s really no specific information about how to destroy fentanyl. We’re still doing it the conventional way, at the incineration facility. Until we get word that that’s a no-go, we’re just going to continue down that path. 

BTW, it’s always a good idea to turn your gloves inside out as you take them off, put them into your waste receptacle, and then save that waste receptacle to go on the burn. 

Just to reiterate… put on a double pair of nitrile gloves and then take the outer layer off after you’ve placed the primary package in the secondary package. I can’t stress that enough. If you’re able, wash your hands immediately after handling narcotics with cold water and avoid using alcohol based hand sanitizer. 

The ways of getting accidental exposures to fentanyl… you can accidentally ingest it, inhale it through your nose, or it can be absorbed through the skin. And trust me, we’ve had a couple of exposures at our agency already.

Luckily none of them have been fatal. I’m sure Brian will get into that a little bit more at the end. Exposure happens so quick. Exposure through the skin is not going to be as quick as if you got it in the mucus membranes of your nose, your eyes, and so forth. But, it happens very fast and sometimes folks don’t even have an opportunity to get help beforehand. So, always keep an eye on your partner. 

We’ll talk about how to handle this. Like how to handle your intake areas, how to handle your lab runs, how to have Narcan in your storage areas, close to your vaults, and so forth. If you don’t have Narcan in your agency, now’s the time to really push for it. 

Like I said, the onset after exposure happens very, very rapidly. Symptoms can include: difficulty breathing, drowsiness, sedation, disorientation, pinpoint pupils, skin rash, and clammy skin. If your partner drops out after handling narcotics or been in an area where there are narcotics, you have a pretty good shot in knowing what it is. 

Primary treatment is a Naloxone or more commonly known as Narcan. Always, always, always have Narcan available. Like I said before, it should be available in your intake area,  narcotic storage, and your lab runs. 

You may even have to take a look at how you do lab runs and the type of containers that you transport in. We’ve modified the way we handle our products a lot in our unit. We’ve created some specific fentanyl bins that we use. During the transportation process, we always put them on a cart.

Luckily for us, our lab is across the hallway. I feel for folks that have to drive somewhere with fentanyl, especially by yourself. You want to do everything you can to keep yourself safe. Put that in a unit like in a tote, make sure the tote’s sealed. Put the tote in the trunk. Anything you can do to distance yourself from that, but yet still maintain a proper chain of custody and control over that item. It could potentially be a lifesaver.”   

Tracker Products and The Evidence Management Institute want to give you something productive to think about during this time of uncertainty… a series of free evidence management training and panel discussions. Watch and comment on the webinars here. Or – to get in on the discussion, with nearly 600 other evidence custodians – join the Evidence Management Community Forum on Facebook.