Rapid tests that can detect the powerful opioid fentanyl may soon become much more available in Tennessee.
Tennessee law considers the tests to be illegal drug paraphernalia. But legislators voted this month to decriminalize them in most cases, in the hopes of preventing overdoses at a time when they are spiking.
Fentanyl test strips work similarly to an at-home pregnancy or COVID test, with a simple set of instructions you can follow at home. You mix the drugs with water, dip a strip in the solution for 15 seconds and then look for lines to appear.
That way, people know what they might be taking, because they often aren’t aware the drugs they’re using contain fentanyl. That has caused a surge in overdoses, both locally and nationally.
In Nashville, more than 700 people died from an overdose last year. That was a 15% increase from 2020, which was already the most fatal year on record, according to the county health department. About three quarters of overdose toxicology reports from 2021 found fentanyl.
The latest numbers from the Tennessee Department of Health show that the highly potent drug is driving an uptick in overdoses statewide, as well. Between 2018 and 2019, overdose deaths involving fentanyl jumped by 46%. Many times, when someone died of an overdose, fentanyl was one of multiple substances in their system.
State prisons, where a disproportionate number of people struggle with a substance use disorder, have also seen a drastic rise in fentanyl-related overdoses. From 2019-2021, drug-related deaths increased more than eightfold. Over 80% of those overdoses involved fentanyl, according to the Tennessee Department of Correction.
“If we can save one life, I think that this bill is worth it, because overdose cases are out of control,” Sen. Raumesh Akbari (D-Memphis) said during a Senate Judiciary Committee meeting in February. “If we can help them at least not take something that could kill them — one pill and it could kill — then that’s what I want to be able to do.”
She and other supporters of the bill (SB 2427 / HB 2177) hope that if users know their drugs are laced, they might toss them, or at least take some precautions, like using a smaller dose.
Growing acceptance of fentanyl test strips, but still some hesitation
Behavioral health experts call this “harm reduction.” The idea is not to encourage people to use drugs, but rather to help them do so safely if they are unable or unwilling to stop. Safe exchanges for drug needles are a common example, which have become more popular in recent years.
Early studies have found the strips are accurate and can change people’s behaviors. When researchers at Johns Hopkins University interviewed drug users in Baltimore, Boston and Providence, “the vast majority were interested in having their drugs checked for fentanyl.” A pilot program in San Francisco found that people who used test strips were likely to alter their behaviors to reduce the risk of an overdose.
As evidence of the tests’ effectiveness grows, multiple states have decriminalized their use, including Arizona, North Carolina, Delaware and Wisconsin. Some health and police departments have started to distribute the tests. The Centers for Disease Control and Prevention and the Substance Abuse and Mental Health Services Administration also announced last year that federal grants can be used to buy fentanyl test strips.
Some Tennessee legislators are still skeptical. They wonder whether people would actually think to test their drugs before taking them — or, worse, if drug dealers would use them as a marketing tool.
“If I’m a drug dealer, I’m going to use this,” Sen. Jon Lundberg (R-Bristol) said at the committee meeting. “‘Look at mine. This is grade-A pure, and I can show it to you.’ I’m concerned we’re going to have the exact opposite effect.”
It would still be illegal for drug dealers to have the tests under the new legislation. Lawmakers also added a sunset clause, which means that the statute would be reassessed in three years. If they don’t think it has helped, they can remove it from the books.
Both the House and Senate have approved the legislation, which now goes to Gov. Bill Lee’s desk. A spokesperson says he plans to sign it into law.