Legalizing drug-testing strips will save Texas lives
Thousands of spreadsheet lines clutter my screen, each marking a life lost: a 26-year-old woman from Mesquite, dead on New Year’s Day from the toxic effects of cocaine and fentanyl. A 24-year-old Plano man pronounced dead Christmas Eve from a combination of heroin, fentanyl and methamphetamine. A Houstonian, dead at 17 from the toxic effects of carfentanil, fentanyl and alprazolam.
The repetition only sharpens the sense of loss.
As I comb through these numbers, looking for patterns in tragedy, I imagine the lives of those who have died and the events that might have led to those fateful moments. I think about the Texas families I have met, and my own family and friends, scattered across the state, varied in our politics and identities but united in grief from losing a loved one to a drug-related death. And I wonder how many more people will die before our elected officials take action to help rather than harm those who use drugs.
Several dozen drug-related bills have been introduced in the 88th Texas legislative session, a clear sign that the overdose crisis is on the minds of state leaders. As it should be: More than 5,000 Texans died from an overdose between August 2021 and August 2022. During that same period, deaths involving fentanyl, a synthetic opioid up to 50 times stronger than heroin, increased 558 percent. Drugrelated deaths among 15- to 24-year-olds increased 146 percent from 2019 to 2021.
Among the many proposals to address this crisis, one gaining momentum would allow individuals to check drugs for the presence of lethal substances like fentanyl. Crucially, drugchecking occurs before consumption. Individuals purchasing unregulated drugs can never be certain of what they are getting. A white powder sold as cocaine may contain fentanyl; a pill sold as Adderall may be a counterfeit containing methamphetamine. Drug checking helps fill this information gap.
More information incentivizes safer choices. Individuals who learn their drugs contain fentanyl may reduce their risk of harm by discarding the drugs, using less, changing the route of administration (i.e., snorting instead of injecting) or finding a different seller. For providers, offering drug-testing can create an opportunity to connect clients with other services, including HIV/hepatitis C screening and drug treatment.
Until very recently, drugchecking was relatively unheard of outside of drug-use and harm-reduction circles. But the magnitude of the overdose epidemic has propelled this concept into the mainstream.
Last December, Gov. Greg Abbott stated that he was in favor of legalizing fentanyl test strips, which are strips of paper chemically treated to identify the presence of fentanyl in a small drug sample. They are cheap ($1 to $2 per strip), easy to use and highly accurate.
Drug-checking equipment is currently illegal in Texas and dozens of other states because of expansive definitions of drug paraphernalia that include anything used to “test” or “analyze” a substance. These laws were written decades ago, when drug-checking for user safety was less necessary than it is today.
In the last five years, at least 18 states have updated their laws to legalize drug checking tools, including Oklahoma, Arizona, Tennessee, North Carolina, Wisconsin and West Virginia.
At least 12 of the roughly 18 drug checking-related bills filed in the Texas Legislature are specific to fentanyl. The focus on fentanyl may seem reasonable given how many deaths the drug has caused. But drugtesting capabilities should not be limited to a single substance. The reason is simple: Fentanyl is not the last drug crisis Texas will face.
After decades of relative stability, the illicit drug market is now a rapidly evolving milieu of psychoactive chemicals. Deaths involving other drugs — like xylazine, an animal tranquilizer mixed in with opioids and known as “tranq dope,” and isotonitazene, a type of opioid known as “iso”— are increasing.
Public health agencies and substance-use service providers in other states are operating more advanced drug-testing programs that can detect adulterants like xylazine. Efforts are also underway to develop easyto-use testing strips for newer substances seen on the streets. Drug testing has even won the support of law enforcement officials, many of whom are keenly aware of the drug market’s volatility and agree that drug-checking should not be limited to fentanyl.
Texas will be better prepared for new drug threats by permitting testing for other adulterants in addition to fentanyl. Several bills already filed would achieve this, including SB 868, SB 623, HB 987 and HB 1365. A fentanyl-specific bill, state Rep. Tom Oliverson’s HB 362, is poised to advance out of the House Public Health Committee and could easily be amended to include other adulterants.
This session, Texas lawmakers can grant access to the potentially life-saving power of drug-checking. Let’s not limit this opportunity by focusing on a single substance.