Drug testing strips remain illegal in Texas despite recent rise in overdose deaths


Boram Kim


After the CDC released new data on drug overdose deaths on Wednesday, Texas’s ban on drug testing strips is getting increased attention.

According to the National Center for Health Statistics, more than 100,000 Americans died of drug overdoses in 2021, a 15% increase from the previous year. The rise is attributed to challenges exacerbated by the pandemic: social isolation, lost access to treatment, and the spread of fentanyl, a deadly drug 100 times more potent than morphine.


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Texas witnessed 5,033 drug overdose deaths in 2021, a 19.8% increase from the previous year, which remains higher than the national average.

Under the Texas Controlled Substances Act, drug testing equipment is classified as drug paraphernalia, which makes fentanyl testing strips illegal. Texas lawmakers were unable to get a bill that would have removed criminal penalties for possessing drug testing kits passed last year.

The Biden administration laid out its National Drug Control Strategy last month, which outlines actions to reduce overdoses and deaths from opioids. The strategy will expand access to high impact harm reduction tools like testing strips and naloxone, a medicine that rapidly reverses an opioid overdose.

Harm reduction advocates say making naloxone more widely available and the inclusion of testing kits and clean syringes are critical to the state’s approach and will help save lives.


“Harm reduction is a strategy to keep people alive, to educate people about their overdose risk, to prevent transmissible infections, and to optimize people’s health by treating them with dignity and respect. … We’re losing people in their prime to overdose[s],” said Dr. Kimberly Sue, Assistant Professor at Yale University School of Medicine and Medical Director at the National Harm Reduction Coalition, a non-profit dedicated to bringing harm reduction strategies to scale. 


Testing strips can be used to test drugs, powders, and pills for the presence of illicit compounds. The strips offer an extra measure of protection for people fearing their drugs or medication may be contaminated with fentanyl. Just two milligrams of fentanyl can be deadly. Sue says knowledge of fentanyl presence can inform people to make potentially life saving decisions. 


“The strips are highly effective at detecting the presence of fentanyl in a substance,” said Sue. “Anyone who is buying anything off the street, people think they are buying Oxycodone or people think they are buying Xanax. Those pressed pills can be 100% fentanyl. They can have a little bit of fentanyl. Fentanyl is present in cocaine. … Wouldn’t you want them to know what they’re using is fentanyl?” 


In Harris County alone, fatal drug overdoses increased 52% from 2019 to 2021. County statistics show deaths involving fentanyl skyrocketed by 341% in the same period, from 104 to 459.

Meanwhile, the Travis County Medical Examiner’s Office released 2021 figures that showed drug overdoses were the leading cause of accidental deaths for the first time in a decade. Approximately one-third of overdose deaths were caused by fentanyl.

In response, Travis County Judge Andy Brown said on Tuesday he and his commissioners would consider declaring a public health crisis.


“At the state level, we should legalize fentanyl strips. That’s something that should be available to people in Texas, like it is available to people in New Mexico,” said Brown during a newsinterview for local TV station KXAN.


Brown said he would work with state legislators in next year’s session to eliminate the ban on drug testing strips and invest more in treatment and recovery options. Sue says adopting the national strategies are critical because the increases in fentanyl and stimulant deaths show that drug criminalization policies have not worked.


“I’ve had people who won’t come to the clinic because they have substances on them or they have warrants out for their arrest,” said Sue. “And they won’t access services. … I watched my patients die because of those policies and I watched it happen around the country. It’s very traumatic and difficult to do the work [of] taking care of patients when policymakers make it very difficult for me to provide that care.”