This page provides information for child welfare workers to help reduce risk and harm and educate parents and caregivers on drug residue. A client’s failure to follow all or part of these practices should not be taken as the sole reason to separate a child from their family.
Residue left over from drug use can linger on surfaces and create health risks, especially to babies and young children who spend time on the floor and put things in their mouths.
It’s important to help parents and caregivers understand how to clean residue from areas where drug use may have occurred. Parents and caregivers should also be informed of ways to reduce risks in the Public Health Guidance on High-Potency Synthetic Opioids (PDF), especially in spaces shared with children. Reducing Your Family’s Contact with Drug Residue at Home (PDF) is a resource for you to give to caregivers. This guide provides information on both methamphetamine and fentanyl residue because they are often found together.
What is Drug Residue?
Methamphetamine or fentanyl used indoors can leave residue behind that exposes people to these substances.
Residue means any form of methamphetamine or fentanyl leftover from use, whether visible or not, including pills, powder, vapor or smoke build-up, liquid, skin patches, and drug paraphernalia.
Drug residue may be left on furniture, walls, ceilings, floors, and even within an HVAC system.
Levels of drug residue can be high even when it’s not visible. Learn more from our Drug Residue webpage.
Who is Most At-Risk of Health Effects Caused by Drug Residue?
Infants and young children, who are often on the floor and putting things in their mouths, are most at risk for health effects from drug residue. Young children may swallow pills or powder left behind, causing overdose. Naloxone (often known by the brand name NARCAN®) is safe and should be given to a child experiencing an overdose due to drug residue exposure. You should keep naloxone on hand if possible. You can learn more about naloxone on the Overdose Education and Naloxone Distribution webpage.
Unintentional exposure to drug residue has never been reported to cause death in adults, but other health effects, such as rashes and headaches, have been reported where methamphetamine use occurred. These effects are temporary and go away once the affected person leaves the exposure area. Similar health effects have been reported by non-drug-users who were exposed to fentanyl. The health effects of living or working in spaces with exposure to methamphetamine and fentanyl residue for extended periods of time have not been studied. If you’re feeling unwell, leave the area. Consult your trusted health care provider if you are concerned.
People might breathe in leftover smoke or particles in the air, but this exposure has never been reported to cause an overdose. We recommend people, especially pregnant people and children, avoid exposure to all forms of vapor or smoke because it is unhealthy to inhale. You can find more information on health effects from drug residue in our Health Effects from Exposure to Meth and Fentanyl Residue (PDF) document.
Fentanyl is not well absorbed through the skin. Prescribed fentanyl patches, which are specifically designed to deliver medication through the skin, are an exception. Unfortunately, there have been rare instances where fentanyl patches have accidentally become stuck to children, causing an overdose. Young children could overdose from fentanyl due to hand-to-mouth and other behaviors that lead to accidentally swallowing it.
How Can We Reduce Exposure to Drug Residue?
The primary ways to reduce exposure to drug residue in the home are to seek substance use disorder treatment or use away from areas shared by children. It’s important for your clients to clean their homes frequently, reducing drug residue left behind from use. Note that while we have recommendations for how to clean drug residue, none of the cleaning products remove or break down all drug residue completely, especially from textiles or porous surfaces like wood and drywall.
Caregivers who are cleaning areas that have drug residue should use protective clothing such as gloves and an N95 mask if possible. We recommend anyone cleaning use gloves because this can stop them from touching drug residue and accidentally touching their mouths or eyes; we are not worried about skin absorbing these drugs. Alcohol-based sanitizers do not remove or break down drug residue, and alcohol increases your skin’s ability to absorb these drugs. Therefore, we recommend cleaning your hands with soap and water rather than using hand sanitizers. There are no reports of overdose from brief skin contact with fentanyl or methamphetamine. You can find more information on fentanyl at 6 Facts About Fentanyl (PDF).
Masks protect you and your clients from the rare occurrence of drug particles going into the air and being breathed in. Various cleaning products may also recommend wearing gloves and/or a mask. Always check the label requirements on all cleaning products. While cleaning, remind everyone to wash their hands, avoid touching their face, and not to drink or eat food.
Transient accommodations, such as temporary housing, affected by high levels of methamphetamine residue may require professional decontamination. Decontamination uses certified contractors, and your local health officer will decide if this is required. You can call your local health department to learn more.
A Note on Cleaning Products
When cleaning an area where drug use may have occurred, it’s important to know that while general household cleaners, sometimes just soap and water, can remove drugs from surfaces, they don’t break down the drugs completely. This means that the active drug may be in wastewater or on the used paper towel or cleaning cloth. The cleaning fluid should be wiped up before it dries, or it will leave behind drug residue.
Encourage caregivers to follow the product instructions for personal protective equipment (PPE), watering down, and how long to let the product sit before wiping off (sometimes called “dwell time”).
There are neutralizing solutions that can break down methamphetamine or fentanyl, but most of them aren’t available to the public because they aren’t safe or easy to use. One neutralizing solution caregivers likely have access to is household bleach. Full-strength bleach and other bleach-containing products are effective at breaking down fentanyl and methamphetamine residue.
Provide your clients with information on using bleach because it is one of the few neutralizing solutions people have access to in their homes and is also effective at life-threatening. This mixing often happens when people use multiple cleaners on the same surface. Visit Dangers of Mixing Bleach with Cleaners for more information.
What Cleaning Guidance Can I Offer?
Cleaning Smaller Areas
It is most important to clean areas that small children have access to or where their food is prepared. Here are some tips for cleaning smaller areas:
- Before mixing baby formula or preparing other food, use a paper towel to clean the counter with a household cleaner, rinse, and wipe clean. Throw cleaning materials in the household trash or wash reusable cloths or sponges in a washing machine or dishwasher.
- Store trash in an area that is not accessible to young children. This helps protect them from exposure to skin patches and drug residue on used cleaning materials.
- Place babies and toddlers on a clean, washable blanket to avoid exposing them to surfaces that are more difficult to clean such as carpets or upholstered furniture. Other textiles that may have drug residue, such as clothes and toys, should be cleaned in a washing machine.
- Routinely clean floors and low surfaces, such as coffee tables, that children have access to. Consider what surfaces are accessible at the child’s eyesight level to know what to clean.
Cleaning Larger Areas
The steps below are for larger living areas, such as an entire room or a home, but can also be followed for a smaller area. Make sure children are supervised by someone else and not in the area while cleaning.
- Turn off the heating, ventilation, and air conditioning (HVAC), if possible, to prevent the spread of drug residue. Close off the area to prevent exposure to other people. In a multi-unit building, you may need to work with building maintenance staff to turn off the HVAC. If the cleaning product says not to use it in an enclosed space, you can open windows for ventilation after step 2. Keep the HVAC turned off until all cleaning is done.
- Prewet or mist all surfaces with water to prevent drug particles from going into the air and being breathed in. Wear an N95 mask when possible.
- Clean the area from top to bottom, focusing extra attention on frequently touched areas.
- Consider replacing items that were in contact with drug residue that cannot be cleaned, including items frequently used by children that are difficult to remove residue from (e.g., porous items like wooden or fabric furniture).
- Clean textile materials like fabrics, baby clothing, fabric toys, and rugs in a washing machine. If not machine-washable, clean fabrics by spraying a cleaner and letting it sit according to label instructions to ensure the cleaner is effective. Pressure wash it, then wet vacuum, if possible, or scrub the material with more cleaner and hot water.
- To clean porous materials like wood and drywall, wash surfaces, rinse well, and repeat. If possible, use a wet vacuum to dry the material to reduce moisture and prevent mold growth.
- For non-porous substances like glass and metal, wash surfaces and rinse well.
- Wet vacuum or wipe up wastewater on surfaces before it dries.
- Follow all scrubbing of surfaces with HEPA-equipped vacuuming, if possible, once materials are dry. Do not vacuum with a non-HEPA-equipped vacuum.
- Wash reusable cleaning cloths and sponges in a washing machine or dishwasher. Throw away all other items, including disposable cleaning materials and PPE, according to local waste regulations. Parents and caregivers can put materials into their usual household waste.