Advocates: Legalize fentanyl test strips, save lives

Jan. 12—Fentanyl test strips cost about $1. Accidental drug overdoses cost more than 5,000 Pennsylvanians their lives in 2020.

Addiction recovery advocates promote fentanyl test strips as a harm reduction measure along the lines of naloxone, the life-saving medication — widely available as a nasal spray — that reverses the effects of an opioid overdose.

Naloxone is legal. Fentanyl test strips are not. They're grouped into Pennsylvania's drug paraphernalia law. A proposal in the state House calls for the strips to be legalized for personal use.

Rep. James Struzzi, R-Indiana, proposed the bill. His brother, Michael, died of a fatal drug overdose in 2014.

Struzzi's bill was the subject of a public hearing at the Capitol on Monday. It remains in the House Judiciary Committee. That's where a prior version expired in the last Legislative Session. Struzzi said Tuesday he thinks support for the measure is building but he's uncertain when it might be considered to move forward.

"It needs to occur sooner rather than later," Struzzi said specifically of the test strips proposal. "I don't condone drug use, but these measures do work to help get people into treatment and ultimately get them into recovery."

Struzzi said he also plans to introduce a bill to legalize syringe services, allowing users to exchange used needles for new ones. It's another harm reduction measure — a similar proposal is in a Senate committee — intended to save lives, connect drug users with recovery specialists and potentially get them enrolled in addiction treatment. The needle exchange is also viewed as a way to stymie the increase of HIV and Hepatitis among intravenous drug users.

Could save livesFentanyl strips aren't medication and don't reverse an overdose. They can prevent one, allowing users to test their drugs for the presence of fentanyl before ingesting the substance.

According to manufacturer BTNX of Canada, the strips were developed for urine drug screening. To test for fentanyl, they're dipped into water combined with drug residue and in seconds, can indicate the presence of the synthetic opioid and its analogs.

BTNX cites an external study by Johns Hopkins researchers that found results to be upwards of 100% accurate. The results won't show the potency, however.

According to the state Department of Health, 5,075 fatal overdoses occurred in Pennsylvania in 2020. Figures for 2021 aren't yet available, however, estimates predict that figure will rise.

Preliminary death estimates from the Centers for Disease Control and Prevention predict 100,255 fatal drug overdoses occurred across the U.S. in the 12-month period ending in May 2021. About 75% of those deaths are attributed to opioids and, by and large, fentanyl.

For Pennsylvania, the predicted total fatal overdose count is 5,494 over that same period. That tops the recorded high of 5,403 in the calendar year 2017.

About 85% of overdose deaths in Pennsylvania involve opioids, the Department of Health found.

Pennsylvania's Physician Gen. Dr. Denise Johnson testified Monday that fatal drug overdose is the leading cause of accidental deaths in the state.

The Drug Enforcement Administration points to the rise of illicit fentanyl trafficked into the U.S. and cut into heroin, cocaine or pressed into counterfeit prescription pills. Fentanyl is 50 times stronger than heroin, 100 times stronger than morphine.

Its presence in a particular drug isn't always known to, or sought by, a user.

Johnson advocated for the legalization of fentanyl test strips. She noted the House proposal is bipartisan and that states that approved similar measures have varied political majorities: Arizona, Maryland, Washington, for example.

"We've lost a lot of loved ones and this does not have to continue to be so," Johnson said. "The bottom line is you have to save the life first in order to treat it."

'A no-brainer'

Philadelphia and Pittsburgh each took measures independently of the General Assembly to decriminalize possession of the test strips. And, the CDC and the Substance Abuse and Mental Health Services Administration announced last April that federal grant money could be used to buy the strips.

Alice Bell of Prevention Point Pittsburgh, a nonprofit engaged in harm reduction advocacy, said the group distributed 17,000 test strips since 2019 and another 5,000 in partnership with a similar organization, NEXT Distro, a mail-based harm reduction service.

At the outset of the effort, Bell said nearly 9 in 10 people who took test strips indicated they'd changed their usage behavior after learning fentanyl was in their drug.

"It's a no-brainer," Bell said of legalizing possession of the test strips. She added that the effort should be broadened to include other potential technologies and drugs to be tested for.

"The law that makes it illegal for people to be in possession of any kind of equipment to test drugs is part of an archaic war on drugs-era law that has served no good purpose," Bell said.

Kami Anderson and Mike Krafick of the Armstrong-Indiana-Clarion Drug & Alcohol Commission both testified about the strips. Anderson cited separate studies indicating most drug users would use the strips and many might alter their usage depending on the test results.

Anderson posited that the strips could be distributed in tandem with naloxone through community events, hospital emergency rooms and ambulance services.

"We know that effort is working, having an impact and saving people's lives," Krafick said of naloxone distributions.