As Overdoses Soar, More States Decriminalize Fentanyl Testing Strips

With time operating out within the 2022 legislative session, Georgia lawmakers took up a invoice to manage uncooked milk.

An modification immediately received tacked onto the House version of the bill, though the brand new wording had nothing to do with dairy. The language known as for legalizing using strips that take a look at medication for fentanyl, a potent artificial opioid fueling a wave of deadly overdoses throughout Georgia and the U.S.

The modification, mentioned Sen. Jen Jordan, an Atlanta Democrat who sponsored it, was “a commonsense resolution to save lots of lives.”

The revised milk invoice handed overwhelmingly on the final day of the Common Meeting session. If the invoice doesn’t draw a veto from Republican Gov. Brian Kemp, Georgia will be a part of a rising checklist of states decriminalizing using fentanyl testing strips because the drug’s scourge has unfold throughout the nation.

Governors in New Mexico and Wisconsin this yr signed payments permitting take a look at strips in these states, and legislatures in Tennessee and Alabama not too long ago handed related laws. In Pennsylvania, though a state legislation prohibits take a look at strips, the mayors of Philadelphia and Pittsburgh have ordered bans on prosecuting folks possessing them. The state’s lawyer basic mentioned he received’t cost folks for having the take a look at strips. Alaska state well being officers, horrified by a surge of overdose deaths, have began giving out free take a look at strips. A merchandising machine in Ohio gives the fentanyl-detecting units alongside naloxone, a medicine for reversing overdoses.

However the Florida legislature balked this year at a invoice that will decriminalize the testing strips. Fentanyl take a look at units — prohibited below drug paraphernalia legal guidelines adopted many years in the past — stay unlawful in about half of states, drug coverage consultants say.

Many public well being and dependancy consultants, although, promote the speedy testing units as what’s generally known as a “hurt discount” tactic to assist stop overdose deaths from illicit medication that customers might not know are laced with fentanyl.

“We hope all of the states would come to understand the risks of contamination are so excessive and that fentanyl take a look at strips empower an individual taking medication to know whether or not they have fentanyl,” mentioned Dr. Nora Volkow, director of the Nationwide Institute on Drug Abuse on the Nationwide Institutes of Well being.

Road variations of fentanyl, an authorized painkiller that’s being produced illegally, largely come into the U.S. from Mexico. Fentanyl is up to 100 times as highly effective as morphine. It’s generally present in what’s bought as heroin — typically taking its place completely. It can also be mixed into cocaine, methamphetamine, and counterfeit avenue capsules bought as opioid medicines — substances that many patrons are usually not anticipating to include fentanyl.

The unfold of fentanyl has helped result in a surprising rise in drug overdose deaths. Artificial opioids — together with fentanyl — had been concerned in about two-thirds of U.S. drug overdose deaths within the 12-month interval that resulted in November 2021. And three-quarters of overdose deaths from cocaine final yr had been related to fentanyl, Volkow mentioned.

“Fentanyl is so potent that it could actually cease your respiratory at very low doses,” she mentioned.

The fentanyl epidemic additionally “has exacerbated racial inequities,” Volkow added. From 2019 to 2021, fentanyl overdose deaths greater than tripled amongst youngsters — and surged fivefold among Black teens, in accordance with an evaluation of Facilities for Illness Management and Prevention information produced by the advocacy group Households Towards Fentanyl.

Final month, the Drug Enforcement Administration sent a letter to federal, state, and native legislation enforcement officers warning of a nationwide spike in fentanyl-related mass-overdose occasions. “Fentanyl is killing People at an unprecedented fee,” mentioned DEA Administrator Anne Milgram. “Already this yr, quite a few mass-overdose occasions have resulted in dozens of overdoses and deaths.”

The testing strips are cheap, costing about $1. A drug consumer can take a small amount of the substance, add water, and dip a strip briefly into the answer. If one crimson stripe seems on the strip, fentanyl is current; two stripes imply none of that drug is discovered.

A draw back is that the take a look at strips don’t gauge the quantity of fentanyl within the drug.

Nonetheless, the strips are efficient in detecting “very small quantities of fentanyl,” mentioned Brown College epidemiologist Brandon Marshall, a part of a staff that has studied illicit drug users and the devices in Rhode Island. Lots of the individuals who tried the strips, Marshall mentioned, discarded the substance if fentanyl was current, used the drug with another person current, or had naloxone out there throughout use.

A similar study of North Carolina intravenous drug users discovered 3 in 4 folks indicated that fentanyl strips made them really feel higher capable of defend themselves from overdose.

In South Carolina, which has made fentanyl take a look at strips out there, the state sends an nameless survey to anybody who receives them. Sara Goldsby, director of the South Carolina Division of Alcohol and Different Drug Abuse Companies, mentioned survey responses point out that individuals who use the strips report utilizing fewer medication, with some selecting to not use the medication altogether, and that they really feel safer in stopping overdoses.

The testing strips, Brown’s Marshall added, “are usually not going to be a silver bullet to handle the overdose disaster, however they are often an essential software to assist folks keep protected.”

In Georgia, the place the testing invoice awaits the governor’s approval, public well being officers mentioned fentanyl-related overdose deaths jumped after the beginning of the covid-19 pandemic, doubling between Might 1, 2020, and April 30, 2021, in contrast with the identical span in 2019 and 2020.

And fentanyl-related overdoses not too long ago spiked in Savannah, Georgia, in accordance with Dr. Jay Goldstein, medical director of the emergency division at Memorial Well being. He mentioned that many overdose sufferers mentioned they had been stunned on the efficiency of the drug they’d consumed, however he fears that giving them strips received’t stem its use.

“Unhappy to say, however some customers need fentanyl of their medication as a result of it provides them a extra intense excessive, although the danger of crashing and burning is way worse,” he mentioned.

Present drug paraphernalia legal guidelines might discourage states or organizations from making use of for grants to purchase take a look at strips or creating applications to distribute them, mentioned Jon Woodruff, senior legislative lawyer for the Legislative Analysis and Public Policy Association. However in lots of states that haven’t decriminalized the strips, individuals who possess the papers aren’t being prosecuted.

In Georgia, “folks could be charged, however it’s usually not prosecuted, significantly if it’s these testing strips,” mentioned Pete Skandalakis, government director of the Prosecuting Attorneys’ Council of Georgia, which supported the testing strips modification.

Regardless of the present Georgia prohibition, the Atlanta Harm Reduction Coalition group mentioned it distributes the strips to particular person drug customers and different group members.

In the meantime, households in Georgia who’ve seen family members die from fentanyl overdoses help making the testing strips extra out there.

Doreen Barr of Fayette County in suburban Atlanta misplaced a son to a mixture dose of heroin and fentanyl seven years in the past. She has arrange a nonprofit foundation in Ryan Barr’s identify to teach folks about dependancy.

Barr mentioned she believes testing strips can save lives.

“Why not have the fentanyl strips?” she mentioned. “Cocaine or a pretend tablet can have fentanyl in it. One time may kill you. If they’d a take a look at strip, perhaps they wouldn’t take it.”

KHN South Carolina correspondent Lauren Sausser contributed to this text.

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