February 15, 2023 – In December, Texas Governor Greg Abbott made a U-turn on a difficulty that has been a flashpoint in the controversy over decriminalizing drug paraphernalia: using test strips that may detect fentanyl, the synthetic opioid. Abbott had previously opposed laws to legalize the test strips, but cited a staggering 89% increase in fentanyl deaths in Texas the previous 12 months.
“It is an extraordinarily deadly problem,” Abbott said in a press conference explaining his change of heart.
From September 2021 to September 2022, greater than 100,000 people died of drug overdoses within the United States. according to CDCNearly 70% of those were resulting from fentanyl and other synthetic opioids. The death toll is now causing lawmakers across the country to vary their minds.
A change in policy
Fentanyl test strips have been developed in 2011 to check drug use in urine by the police, for fogeys who need to know what their children are taking, and for users who need to know what's within the drugs they've previously taken. Study by Johns Hopkins University In 2018, it was found that the test strips could accurately detect fentanyl in drug residues. Soon after, California and Oregon were among the many first states to offer their health departments with free test strips to distribute at needle exchange centers.
The test strips are easy to make use of and effective. When dipped in water containing dissolved drug residue, the strips immediately indicate whether trace elements are present in a substance reminiscent of heroin, cocaine or ecstasy. Depending on an individual's weight, tolerance and former use, as little as 2 milligrams of fentanyl could be fatal.
In the U.S., states have legalized fentanyl strips within the hope of saving lives. Georgia passed a law in July. Alabama, Tennessee, Pennsylvania, Wisconsin, South Carolina and New Mexico have done the identical. An analogous bill has been introduced within the Florida legislature. These states join about 30 others which have decriminalized the strips and made them available to drug users.
When the strips first got here available on the market, they were used to completely remove fentanyl from the drug supply. But today, that isn't any longer as true because it once was because fentanyl is now so widely available, says Aaron Ferguson of Austin, Texas, who advocates for safer drug use with the Urban Survivors Union. The organization distributes strips to people who find themselves believed to be more prone to take some form of precaution to stop a fentanyl overdose. For example, he recently distributed the strips and naloxone, a drug commonly used to treat opioid overdoses, to a mother who knew her son was using opioids and wanted him to be secure.
A poisoned supply
“We are in a drug poisoning crisis,” says Jacqueline Goldman, a research fellow at Brown University School of Public Health. The crisis has not necessarily worsened because more persons are using drugs, says Goldman, but relatively because “more people are dying from them because they are so powerful.”
Compared to other Western countries, the United States has all the time had a “puritanical” view of harm reduction strategies in coping with drug use and abuse. says Dr. John McIlveen, chief opioid treatment officer for the Oregon Health Authority. “Now is an excellent opportunity to change the narrative,” he says, “because the drug supply is no longer just contaminated with fentanyl, it is fentanyl.”
Because fentanyl is instantly available and so powerful, people from all walks of life are vulnerable to overdose. “If there is a silver lining, it is that attitudes are changing and we are finally seeing greater acceptance of the test strips and other harm reduction methods that are saving lives,” he says.
Losing the fight
Even though the test strips are increasingly decriminalized, they're still not an ideal solution. Although they'll accurately detect fentanyl and its analogues, they don't provide information concerning the amount of the substance contained.
According to Ferguson, the high cost of the drugs and the legal risk of obtaining them mean that users are unlikely to be willing to throw away a supply of medication even when a test strip shows signs of fentanyl. And there's also the danger of a false positive result. A study published in May 2020 in International Journal of Drug Policy found that the strips produced a false positive end in 10% of cases, meaning that the test was positive though it didn't contain fentanyl.
More worrying is the danger of false negative results, especially with pressed pills. The CDC calls it the “Chocolate chip cookie effect.” Fentanyl clumps in pill form, so in the event you cut the pill open to check the drug, it is feasible that a part of it is freed from fentanyl, though the pill incorporates fentanyl. The International Journal of Drug Policy The study found that false negative results occurred in 3.7% of cases.
In addition, the potency of fentanyl implies that some users grow to be hooked on the high it produces and should seek it out relatively than avoid it, McIlveen says. The more fentanyl there's within the drug, the more users grow to be addicted since it is 50 times stronger than heroin.
The range of medication can also be always changing, and test strips can hardly sustain. New contaminants reminiscent of xylazine, a robust sedative used on cattle and horses, have recently entered the opioid market. Xylazine can't be detected with the test strips.
Nora D. VolkowMD, director of the National Institute on Drug Abuse, believes fentanyl test strips should be available freed from charge across the country, together with a gentle supply of other harm reduction agents, especially naloxone.
“Currently, an opioid user may see someone overdosing and not have enough naloxone on hand to prevent it,” she says.
Other medications, reminiscent of buprenorphine and methadone, help patients wean themselves off fentanyl and other opioids, but are unavailable in lots of parts of the country. Patients may get a prescription from their doctor, but their local pharmacy may not have the option to fill it because they don't have the medication in stock.
There are some effective treatments to avoid wasting people, reminiscent of fentanyl test strips, Naxolone, syringe service programs, buprenorphine and methadone, but states don't consistently offer them. In West Virginia, for instance, 62% of convictions were for drugs and the state also had the highest number of drug overdoses deaths within the country. There is hope that in the longer term more resources will likely be directed towards harm reduction relatively than incarceration.
“Discrimination and stigma have led to laws that affect the survival of drug users,” says Volkow.