Recently, an older adult was referred to me with a question about an alleged food allergy. The story was that he was eating a chicken sandwich at a local fast-food restaurant. A very disheveled man entered the restaurant and used the restroom for about 20 minutes. He then emerged and went up to the drink station next to my patient, who was refilling his drink. The man was delirious and constantly rubbing himself.
My patient left the restaurant and drove 10 miles home. Within a few minutes, he began to itch and then developed blurred vision and difficulty breathing. Luckily, he made it home and called the paramedics, who transported him to the hospital, where he was treated for anaphylaxis. Narcan, which reverses opioid poisoning, would have been better.
This man did not suddenly develop an allergy to chicken. He was most likely poisoned by exposure to aerosolized fentanyl. Fortunately, the patient made it home safely; the toxic exposure did not occur in a 30-pound child, or the results could have been fatal. This event happened only a few weeks after two police officers were overcome by fentanyl exposure at Home Slice Pizza.
Fentanyl is becoming a serious public health issue for the general population. The Department of Homeland Security is developing aerosolized fentanyl detectors for first responders, but one wonders whether they should be deployed in public places, such as smoke alarms.
W. Donald Cooke MD
Durango
