Testing for fentanyl

MYRNA BROWN, HOST: Coming up next on The World and Everything in It: the opioid epidemic, specifically, fentanyl.

The opioid is a powerful synthetic. It’s been responsible for two-thirds of the total overdose deaths from opioids.

MARY REICHARD, HOST: Drug users don't always know when they take fentanyl. Dealers often mix it in with other drugs to increase potency. Lawmakers are pushing to make it easier for people to test drugs for fentanyl. And this opens up questions of whether this crosses a line, into feeding addiction.

WORLD’s compassion beat reporter, Addie Offereins, is here to talk about it.

BROWN: Welcome Addie!

ADDIE OFFEREINS, REPORTER: Thanks for having me.

BROWN: Tell me more about fentanyl test strips.

OFFEREINS: The only way for users to know if their drug contains fentanyl is to use a fentanyl test strip. This is just a paper strip that users will dip in water that has been dissolved with the residue of the illicit drug that they're testing. As you mentioned, users taking illicit drugs like cocaine or heroin often risk consuming fentanyl along with them. This is because fentanyl is cheap and potent so it increases the high of a drug and dealers will often mix it in to other illicit drugs to make them go further. Dealers will also press fentanyl into pills that resemble legitimate prescription opioids. And not only is fentanyl cheap and potent, it can be fatal at a two milligram dose for some people.

BROWN: In your article you report that some states ban the strips. For example, Texas fines those who possess the strips $500 for committing a Class C misdemeanor. But now some states are rethinking these bans. Why?

OFFEREINS: Well, as deaths keep climbing and the opioid epidemic is getting worse, lawmakers are getting desperate and reconsidering decriminalizing these strips. Republican Governor Greg Abbott is making a legislative push to save more lives and is urging the new Texas legislature to reconsider decriminalizing the strips. Other Republican and Democratic governors around the country in places like Arizona, Pennsylvania and Georgia are making similar pushes. In Arizona the state seized 1,200 pounds of illegal fentanyl last year by the month of October. Most of this was found at or near the southern border. And to combat this influx of illicit fentanyl, the state began distributing these test strips to different counties around the state.

BROWN: Those who want to decriminalize test strips say that making them more widely available will reduce the number of overdose deaths. But others say making the strips more available will actually incentivize drug use. What about those concerns?

OFFEREINS: Yeah, so they say that distributing the strips or opening safe consumption sites will make illicit drugs more socially acceptable, and they aren't likely to get addicts into rehab. Paul Burke is a former addict and current pastor. He says harm reduction strategies don't change people's lives. He used methamphetamines—among other drugs—for about 18 years and now he's the executive director of Brooklyn Teen Challenge, which is a residential rehab program in Brooklyn, New York. He's not sure that users will throw out their next high even if they do detect fentanyl in a drug. He did emphasize when talking with me that he doesn't minimize saving a life. But he's worried that fentanyl test strips will encourage more people to experiment with illicit drugs. Instead his program focuses on life transformation, bringing people out of addiction, and introducing them to Jesus Christ.

BROWN: Some people in favor of the strips also advocate for other harm reduction measures like safe consumption sites. Are all harm reduction measures equal? Can we make distinctions here?

OFFEREINS: Yeah, so addiction psychiatrist Dr. Mark Duncan wouldn't put fentanyl test strips in the same category as safe consumption sites. He says the strips are essential in his home state of Washington as fentanyl has become the most common drug on the street. But when it comes to safe consumption sites, he says it's less clear, because some addicts may never interact with the treatment provider outside of a safe consumption site. Critics of the sites point to places like San Francisco which recently closed its Tenderloin Center. This was a site aimed at preventing overdoses and connecting people to rehab. And while it did reverse more than 300 overdoses, fewer than 1% of visits resulted in addicts entering treatment. So the question is, do these sites actually provide effective compassion for people in their addiction or enable them to continue using drugs in the long term?

BROWN: That’s a good question. And Addie goes into much more detail in her roundups article at wng.org. We’ve included a link to it in today’s transcript. Addie Offereins is WORLD’s reporter on the Compassion beat. Thanks for joining us today, Addie.

OFFEREINS: Thanks for having me, Myrna.

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