Florida lawmakers decriminalized fentanyl test strips during this year’s legislative session, which should help the state reduce opioid overdoses.
Sen. Tina Polsky’s (D-Boca Raton) Senate Bill 164 passed both chambers of the legislature unanimously, and was recently signed into law by Gov. Ron DeSantis. It legalizes fentanyl test strips, which were previously illegal to possess because they were considered drug paraphernalia.
The Centers for Disease Control and Prevention have endorsed fentanyl test strips as an effective harm reduction strategy. And Florida is joining a growing list of states that have decriminalized them. Governors in 16 states have signed legislation legalizing them since January 2022, bringing the total to 36, as well as the District of Columbia.
Tim Santamour, director of outreach and networking at the Florida Harm Reduction Collective, discussed the impact of SB 164 with State of Reform. The collective is a nonprofit that meets Floridians where they are at through syringe access, overdose prevention, and other healthcare needs.
“We’re a collaborative of community-based organizations working in behavioral health and recovery to eliminate the transmission of infectious disease and harms around substance use. We advocate for money for treatment, whether it be for detox services, other behavioral health services, and (substance use disorder) efforts. We work statewide.”
— Santamour
The organization was launched in December 2019. Its staff includes some individuals who have worked with test strips in the past, although some have been reluctant to do so, Santamour said.
“A lot of people stayed away from them because of their status as drug paraphernalia in the state,” he said.
Several programs the collective works with have expressed excitement in implementing test strip tools, Santamour said. Next steps for implementing the use of test strips includes establishing a statewide buyers’ club for them for community-based programs. The collaborative also plans to educate providers about the use of test strips through its regional meetings and training sessions.
“We’ll be finished with those trainings the first week of August. We will also listen to organizations to develop specific materials to educate people in Florida to use them. We’re hoping to run a statewide naloxone program funded by the state.
We have asked to start including fentanyl test strips when we mail out naloxone, especially for those who have used it. That will get them into the community where they’re needed. We’re hoping the availability of test strips will lead to an increase in the knowledge of referral services.”
— Santamour
The ease of use of test strips largely depends on the situation and location of the individual using them.
“I think it depends on the situation and location of people using them,” Santamour said. “In theory, they’re easy to use for someone who is housed or has a stable place to use them. But for folks who are homeless, and are not using them in a regular location, they’re probably harder to use. Because you need clean water, a measuring spoon, and a number of materials you may not have if you aren’t in a stable place.”
Fentanyl has infiltrated Florida pretty deeply, Santamour said. According to the Florida Medical Examiners Commission, 8,257 Floridians died from accidental drug intoxication in 2021, a 10 percent increase over the 7,575 who died in 2020. Fentanyl was the leading cause of deaths. And Florida, like other states, has seen a switch in drug user preference from a primary use of heroin to fentanyl.
“We’re seeing very little heroin. Very few of the pills on the street are actual pharmaceutical drugs, so it’s something we talk to chronic opioid users about. They already suspect there’s fentanyl in their drugs, so the test strips will be confirmatory for them. We’ve seen studies that show (drug users) are changing their behaviors around substance use.”
— Santamour
The existence of fentanyl in other substances (including adderall, methamphetamine, and cocaine) might surprise users of those drugs, however.
“They’re not suspecting fentanyl to be in those substances, so the strips will make a big difference for them,” Santamour said. “And that’s where we’re thinking we’re going to see the biggest impact, is in recreational drug users who aren’t suspecting fentanyl to be in their drugs.”
Test strips do not show the quantity or potency of fentanyl in drugs, however.
“One disappointment in the bill is it doesn’t allow us to test for how much fentanyl is in the drug,” Santamour said. “That limits the impact of the strips. And it only tests for fentanyl. It doesn’t test for benzodiazepines or xylazine (tranq). There are methods to do that.
A broader bill may have had more impact in that area. We would like to have been able to test for any substance, and the allowance for community-based drug checking as a way of obtaining better information about the drug supply in a given community.”