Louisville health department offers fentanyl strips to safeguard drug users; fentanyl responsible for more than half of 2017 ODs

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As a way to protect drug users from deadly fentanyl, Louisville's health department has started passing out test strips, Beth Warren reports for the Louisville Courier Journal.

Fentanyl was initially added to heroin, but has increasingly been hidden in many other drugs, including methamphetamine and pills that are made to look like legal ones, Warren reports.

Fentanyl is a synthetic opioid that can be up to 50 times more potent than heroin. It was responsible for more than half of the 1,565 overdose deaths in 2017, according to the annual Kentucky Office of Drug Control Policy report.

That number could be even higher in this year's report, preliminary numbers in Louisville suggest. An analysis by the Courier Journal found that fentanyl and its derivatives were responsible for 210, or two-thirds, of the 313 overdose deaths last year in Jefferson County. The analysis found that 46 of the deaths were from heroin and 103 were from methamphetamine.

The test strips are controversial, Warren reports, but a growing number of states are using them, including California, Rhode Island, Massachusetts, Delaware and Maryland. She describes how they work, noting that they are much like a home-pregnancy test and show results in 30 seconds.

"It's just enough time where someone wouldn't be impatient and go ahead and use," Takeisha Nunez, supervisor of the Louisville Metro Department of Public Health and Wellness syringe exchange program, which hands out the test strips, told Warren.

Opponents of the strips include including three veteran police officers who told Warren that the strips endorse illegal drug use but asked to not be named. Another critic, Dr. Elinore McCance-Katz, assistant secretary for mental health and substance use at the U.S. Department of Health and Human Services, has cautioned that "It is not inconceivable to think that people who are severely addicted will actually use the test strips to seek fentanyl," as a way to get a stronger high.

indeed, Warren reports that people with addictions have told her that they have used the strips to seek a stronger high, while others have told her they use them to avoid fentanyl, "not wanting to die like some of their friends."

Dr. Sarah Moyer, Louisville's health director, told Warren that she researched the use of the test strips before deciding to offer them, telling Warren that "surveys of participants who used test strips showed that more than 70 percent of them decided to change their behavior with the knowledge gained from the test," Warren writes.

Moyer said the health department is first targeting "high-risk" participants, including those just leaving jail or rehab, who are vulnerable to relapse. The department recently ordered 2,000 strips, paying 80 cents a piece for them, Warren reports.

"Fentanyl test strips and naloxone don't increase drug use," Moyer told Warren. "They reduce the harms and deaths from substance-use disorder." Naloxone is a drug that reverses opioid overdoses.

Warren reports that many illicit drug users don't know that fentanyl is being added to drugs other than heroin, and that the health department is working to educate them that they need to use the strips on all illicit drugs.

Further, harm reduction efforts like providing fentanyl strips, Naloxone and access to syringe exchange services provides a touch point for people who have addictions so that when they are ready to seek recovery, they will know where to go for help, Moyer told Warren.

For more information about treatment programs in Louisville and beyond, go to findhelpnowky.org.