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In 2018, more than 48,000 Americans died from opioid overdose, with synthetic opioids such as fentanyl contributing to more than half [[1]]. In a rare case report of law enforcement officer opioid exposure in a peer-reviewed literature, clinical manifestations were not consistent with opioids, and none of the law enforcement officers tested was positive for opioid metabolites [[9]]. The symptoms were not consistent with opioid poisoning (neither heart racing nor rashes are symptoms of opioid toxicity), and no confirmatory testing was described. We considered that a reporter not familiar with opioid terminology may erroneously substitute the word "opiate" for "opioid", but fentanyl immunoassays were not commercially available for clinical use in 2016, so it is unlikely that a test was used that could have found fentanyl [[13]]. [Extracted from the article]