2.5. Active Monitoring for Illicit Compounds

Emergency responders, law enforcement, emergency medical services, firefighters, and healthcare personnel are all at risk of exposure to fentanyl and other illicit drugs in the course of their work. NIOSH is working to provide guidance for preventing workplace exposure and developing methods to facilitate opioid detection and decontamination. Recently, handheld detectors for narcotics (including opiates, cocaine, and amphetamines) have come to market. However, until their ability to accurately detect small amounts of illicit compounds is much improved, their detection time is immediate, and their use is widespread, syndromic surveillance (e.g., opioid toxidrome) followed by laboratory confirmation from blood and/or urine samples remains the most likely route to recognizing illicit drug exposures. Although it does little to protect these workers from on-the-job exposures, laboratory analysis of pharmaceutical ingredients in samples taken by first responders can also identify drug exposures.