In 2017, 5,614 people in Pennsylvania died from a drug overdose. County coroner and medical examiner reports show that fentanyl, a synethic opioid, was present in 64.8 percent of these fatalities.
Many of these deaths were accidential as people often ingest or inject fentanyl without knowing it.
Public health workers say test strips can help a person determine if fentanyl, which is up to 100 times more powerful than morphine, is present in an illicit substance. Knowing this can help a person make safer decisions.
“If we could legally hand out test strips, we’d do it in a heartbeat,” said Dave Lettrich, executive director of Bridge to the Mountains, a street outreach organization connects people to resources like housing. The Pittsburgh-based organization also distributes naloxone, commonly known as Narcan, the medication that can revive someone from an opioid overdose.
“I see a lot of people that are suffering with a lot of different things, and substances are part of their lives because of that suffering,” said Lettrich. “That suffering isn’t necessarily in their lives because of the substance.”
Lettrich said if fentanyl test strips were legal, lives could be saved. He said test strips would have been especially useful five years ago when fentanyl first started permeating Pittsburgh’s heroin supply.
Now that fentanyl is being found in the cocaine, non-opioid users are exposed to the drug. These people have little to no tolerance to opioids, which puts them at particularly high risk of overdosing.
To use a test strip, you dilute a very small amount of the drug into a cup of water, and then dip a strip into the cup. If fentanyl is present, two lines appear.
Like naloxone or clean needle exchanges, critics of fentanyl test strips say that these tools waste resources and enable people’s addictions.
Proponents of harm reduction measures argue that people know drugs are dangerous, and that doesn’t stop them from using, so at least a test strip -- like a clean needle or naloxone -- can help someone stay alive. In the case of test strips, this might mean taking a smaller amount, not using that drug alone, or making sure naloxone is nearby.
“In doing things like providing naloxone or giving out these fentanyl test strips, we’ll be able to reach a population of people that are not walking into the doors of our offices, because they’re not necessarily ready to seek out treatment services yet,” said Mike Krafick, a certified recovery specialist, for the Armstrong-Clarion-Indiana Drug and Alcohol Commission, a nonprofit that provides substance use and addiction treatment to residents of those counties.
It’s unclear if anyone has been charged by a Pennsylvania law enforcement agency with a paraphernalia possession for having a test strip. But Krafick’s organization covers many municipalities in three rural Pennsylvania counties, so he said he's not willing to risk ending up on the wrong side of the law by handing out test strips.
“Especially because public officials change over time,” said Krafick. “What if there is a change in the top law enforcement officer in that town, you know, six months or a year down the road?”
In Allegheny County, people can get the strips from Prevention Point Pittsburgh for free, and in Philadelphia, one business owner stocks a small supply at her store.
“The drug epidemic in Philly is so, so intense in certain parts of the city, that I think this kind of falls in the lower end of the scale of [law enforcement's] interest,” said Keri Girmindl, co-owner Common Beat Music, a record shop in west Philadelphia.
Girmindl started keeping test strips at her shop after someone she knew fatally overdosed.
“[The store] is on a pretty busy strip of bars and show spaces, so I’ve kind of been using my shop as a home base,” said Girmindl. “People can come in, and if they need a Narcan [naloxone] kit … if they want to get the fentanyl test strips … they can stop at the store.”
More people might soon be joining Girmindl in supplying fentanyl test strips. Last month, Republican State Rep. James Struzzi, of Indiana County, introduced legislation to make test strips legal.
Struzzi wrote in his sponsorship memo that because the opioid epidemic has reached catastrophic levels, “allowing those who are in the grip of addiction to possess and use test strips" will save lives.
*This post was updated at 11:52 a.m. on 8/15/2019.