New Voices: We can prevent fentanyl-related deaths

Opinion editor's note: This article, part of our New Voices collection, was written by a first-time contributor to Star Tribune Opinion. For more information about our efforts to continually expand the range of views we publish, see startribune.com/opinion/newvoices.

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In about the time it takes you to read this letter, there will be at least one preventable death due to opioid overdose. Every 5.5 minutes, someone in the United States dies from fentanyl-related overdose death. But you've probably heard about it — in this publication and on the news. With over 100,000 deaths in 2021, overdose deaths are a leading cause of injury-related death in this country — and coverage of the opioid epidemic is everywhere.

It's not that nothing is being done about this serious issue. President Joe Biden recently announced that he will distribute $1.5 billion to combat the opioid use epidemic, and in the Twin Cities, city officials are exploring ways to combat the rising amount of opioid-related incidents that occur. Even more evidently, the U.S. Surgeon General identified naloxone, the powerful drug used to revive those experiencing overdose, as something that everyone who may come into contact with people at risk for an opioid overdose should carry.

Other initiatives designed to address opioid addiction and support those struggling with substance use are also gaining traction, with different states broaching the issue in unique ways. Communities are calling for constructive, evidence-based and comprehensive transformations of the way we approach addiction and substance use — and there is no time to waste.

So why aren't we using fentanyl testing strips? These small strips of paper which can detect the presence of fentanyl in a number of substances are well-studied and have been proven an effective tool for not only saving lives but positively modifying the behavior of those using substances. Not only that, but the strips are cheap; about a dollar each, compared with Naloxone's average of $40, and aren't prescription — you can even get them on Amazon. They're also 96-100% effective in detecting fentanyl in a substance if used correctly, and easy to use. All you need is to add a small amount of the substance to a cup of water, dip the strip inside the solution, and wait a few minutes to get a result, depending on the strip instructions.

It's not the ease of access, cost or effectiveness that's the issue with fentanyl testing strips: It's the legality. Fentanyl testing strips are illegal in 19 states (not including Minnesota), with many more restricting their distribution or use under drug paraphernalia laws. These laws are not just an active barrier to the use of the strips — they're emblematic of a larger problem with how we approach substance use in this country.

Fears over "promoting" substance use and stigma around drug education remain deeply entrenched in the larger conversations we are having about opioid use, and fentanyl testing strips themselves. Because using the strips comes before any substance is used, they utilize a framework that many are uncomfortable applying: harm reduction. We must accept that drug use will occur, and instead of focusing only on what happens after — an overdose — we must also focus on what happens before.

Fentanyl testing strip use is positive behavior in terms of overdose risk: Using substances with other people around, throwing fentanyl-positive batches away and using fewer fentanyl-positive substances are important patterns seen in those who use fentanyl testing strips. The strips also aren't just for heroin and pills; alternative substances like marijuana can be tested as well, making them a tool that, as legalization increases, the larger population can take advantage of.

As someone who actively distributes fentanyl testing strips to those who need them, I also know another important impact of fentanyl testing strips: They open up a conversation. Not only do they give us the chance to take an essential focus on the "before" of substance use, addressing both the individual and societal causes of substance addiction, but they also allow for literal conversations. The accessibility of fentanyl testing strips allows us to bring them into the public conversation, as I am doing now. But the physical exchange of fentanyl testing strips allows for one-on-one conversations about substance use, resources for addiction support, and considerations for safety that many users may not be aware of.

Peer education is a common strategy in other risk-reducing interventions, like pregnancy prevention, STI awareness and sexual violence awareness. By making fentanyl testing strips more accessible, through legalization and funding for free strips, we can create the same dynamic. Creating an opportunity for those using substances to make that use safer and educate them and others on safety and supportive measures is something we must do. In conjunction with other efforts to fight the opioid epidemic, fentanyl testing strips strengthen our ability to ensure that users and the public are aware, and expand our capacity to provide life-saving education, interventions and support.

Five and a half minutes is all it takes for one more person to lose their life to an opioid overdose. So why not spend 5.5 minutes saving lives — the time it takes to test a substance with a fentanyl testing strip?

Emi Gaçaj, from Minneapolis, is a student at Columbia University and the founder of the Body Org, an organization distributing free wellness products to young people in the Twin Cities.