More states are allowing fentanyl test strips as a tool to prevent overdoses


An amendment was suddenly added to the House version of the bill, although the new wording had nothing to do with dairy products. The language called for legalizing the use of drug test strips for fentanyl, a powerful synthetic opioid fueling a wave of fatal overdoses across Georgia and the United States.
The amendment, said Sen. Jen Jordan, an Atlanta Democrat who sponsored it, was “a common sense, life-saving solution.”

The revised Milk Bill passed overwhelmingly on the last day of the General Assembly session. If the bill does not attract Republican Gov. Brian Kemp’s veto, Georgia will join a growing list of states decriminalizing the use of fentanyl test strips as the drug scourge has spread across the country. country.

The governors of New Mexico and Wisconsin this year signed bills allowing test strips in those states, and the legislatures of Tennessee and Alabama recently passed similar legislation. In Pennsylvania, although state law bans test strips, the mayors of Philadelphia and Pittsburgh have ordered bans on prosecuting those in possession. The state’s attorney general said he won’t charge people to have the test strips. Alaska state health officials, horrified by a spate of overdose deaths, have begun handing out free test strips. A vending machine in Ohio offers the fentanyl detection devices alongside naloxone, a drug to reverse overdoses.

But the Florida legislature balked this year at a bill that would decriminalize test strips. Fentanyl testing devices — banned by drug paraphernalia laws passed decades ago — remain illegal in about half of the states, drug policy experts say.

Many public health and addiction experts, however, promote rapid test devices as a so-called “harm reduction” tactic to help prevent illicit drug overdose deaths that users may not know about. be not that they contain fentanyl.

“We hope that all states will realize that the dangers of contamination are so high and that fentanyl test strips allow a person who takes drugs to know if they have fentanyl,” said Dr. Nora Volkow , director of the National Institute on Drug Abuse at the National Institutes of Health.
Street versions of fentanyl, an approved painkiller that is produced illegally, largely come to the United States from Mexico. Fentanyl is up to 100 times more potent than morphine. It is commonly found in what is sold as heroin – often taking its place entirely. It can also be mixed with cocaine, methamphetamine and counterfeit street pills sold as opioid drugs – substances that many buyers do not expect to contain fentanyl.
The spread of fentanyl has contributed to a dramatic increase in drug overdose deaths. Synthetic opioids — including fentanyl — were implicated in about two-thirds of drug overdose deaths in the United States in the 12-month period ending November 2021. And three-quarters of deaths by cocaine overdose last year were associated with fentanyl, Volkow said.

“Fentanyl is so potent that it can stop your breathing at very low doses,” she said.

The fentanyl epidemic “has also exacerbated racial inequalities,” Volkow added. From 2019 to 2021, fentanyl overdose deaths more than tripled among teens — and quintupled among black teens, according to an analysis of Centers for Disease Control and Prevention data produced by the Families Against Fentanyl Advocacy Group. .
This month, the Drug Enforcement Administration sent a letter to federal, state and local law enforcement authorities warning them of a nationwide spike in massive overdose events related to fentanyl. “Fentanyl is killing Americans at an unprecedented rate,” said DEA Administrator Anne Milgram. “Already this year, numerous mass overdose events have resulted in dozens of overdoses and deaths.”

Test strips are inexpensive, costing around $1. An addict can take a small amount of the substance, add water, and briefly dip a strip into the solution. If a red band appears on the strip, fentanyl is present; two bands mean that no part of this drug was found.

One downside is that the test strips don’t measure the amount of fentanyl in the drug.

Still, the strips are good at detecting “very small amounts of fentanyl,” said Brown University epidemiologist Brandon Marshall, part of a team that studied illicit drug users and devices in Rhode Island. . Many participants who tried the strips, Marshall said, discarded the substance if fentanyl was present, used the drug with someone else present, or had naloxone available during use.
A similar study of intravenous drug abusers in North Carolina found that 3 out of 4 people indicated that fentanyl strips helped them feel better able to protect themselves against an overdose.
In South Carolina, which has made fentanyl test strips available, the state sends an anonymous survey to anyone who receives them. Sara Goldsby, director of South Carolina’s Department of Alcohol and Other Drug Services, said survey responses indicate people who use the strips report using fewer drugs, with some choosing not to use drugs completely, and feel safer to prevent overdoses. .

Test strips, Brown’s Marshall added, “will not be a silver bullet to solving the overdose crisis. But they can be an important tool in helping people stay safe.”

In Georgia, where the testing bill awaits governor’s approval, public health officials said fentanyl-related overdose deaths jumped after the onset of the covid-19 pandemic, doubling between the May 1, 2020 and April 30, 2021, over the same duration. in 2019 and 2020.

And fentanyl-related overdoses have recently increased in Savannah, Georgia, according to Dr. Jay Goldstein, medical director of Memorial Health’s emergency department. He said many overdose patients said they were surprised by the potency of the drug they had taken, but he fears giving them the strips will not stop its use.

“It’s sad to say, but some users want fentanyl in their drugs because it gives them a more intense high, even though the risk of crashing and burning is much worse,” he said.

Current drug paraphernalia laws may discourage states or organizations from applying for grants to purchase test strips or creating programs to distribute them, said Jon Woodruff, senior legislative counsel at Legislative Analysis and Public. Policy Association. But in many states that haven’t decriminalized gangs, people who have the papers aren’t prosecuted.
In Georgia, “people can be charged, but it’s usually not prosecuted, especially if it’s about those test strips,” said Pete Skandalakis, executive director of the Georgia Board of Attorneys, which has supported the amendment on test strips.
Despite Georgia’s current ban, the Atlanta Harm Reduction Coalition said it distributes the strips to individual drug users and other members of the community.

Meanwhile, families in Georgia who have seen loved ones die of a fentanyl overdose are supporting the availability of test strips.

Doreen Barr of Fayette County in suburban Atlanta lost a son to a combined dose of heroin and fentanyl seven years ago. She started a nonprofit foundation in Ryan Barr’s name to educate people about addiction.

Barr said she believes the test strips can save lives.

“Why don’t we have the fentanyl strips? ” she says. “Cocaine or a fake pill could have fentanyl in it. One time could kill you. If they had a test strip, maybe they wouldn’t take it.”

KHN South Carolina correspondent Lauren Sausser contributed to this article.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Along with policy analysis and polls, KHN is one of the three main operating programs of the KFF (Kaiser Family Foundation). KFF is an endowed non-profit organization providing information on health issues to the nation.


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