Governor Sununu,

On behalf of the R Street Institute, I would like to share with you our support for House Bill 287, a bill that removes drug testing equipment from the definition of drug paraphernalia in the Controlled Drug Act. The R Street Institute is a public policy research organization focused on advancing free markets and limited, effective government in a number of policy areas, including opioid harm reduction.

As you may know, last year, more than 110,000 people in the United States died of a drug overdose. In New Hampshire, overdoses took an estimated 230 lives by September of 2022, an increase of 14 percent over the prior year. Although all substance use comes with some risks, not all people are willing or able to stop using, and policy that requires abstinence leaves many people behind and at risk for continued health harms. Harm reduction is a pragmatic, evidence-based approach that provides those individuals for whom abstinence is not currently feasible with resources and information to stay alive and as healthy as possible. Therefore, R Street supports harm reduction as an essential complement to existing prevention and cessation efforts. As such, we support HB 287, which would remove life-saving harm reduction tools – xylazine and fentanyl testing equipment – from the state’s definition of paraphernalia.

Due to the illicit nature of many recreational drugs in the United States, there are no safety or quality control mechanisms in place. Inconsistent potency and the fluctuating presence of adulterants can significantly increase risk for overdose, especially when people are unaware of exactly what is in their supply. Since 2015, New Hampshire’s drug supply has been increasingly contaminated by fentanyl – a synthetic opioid that is 50 to 100 times as potent as morphine and has an extremely narrow margin between desired and dangerous effects. More recently, the veterinary tranquilizer xylazine (‘tranq’), has become a growing cause for concern in the state. Xylazine is associated with increased risk for overdose as well as complex, slow-to-heal skin wounds. Furthermore, because it is not an opioid, xylazine does not respond to the overdose reversal medication naloxone.

Fortunately, data indicate that when people are equipped with better information about what is in their supply, they often are empowered to protect their health. Drug checking equipment such as fentanyl test strips (FTS) and xylazine test strips (XTS) can provide that important information by alerting people to the presence of certain adulterants in powder or pills.7 Easy-to-use FTS have low margins of error, and commercially available products detect fentanyl and up to 24 common analogs. While XTS are far newer, they use the same familiar technology, and emerging research indicates they are similarly accurate.

People who use drugs, as well as community-based and public health organizations may use FTS and XTS to check drugs for adulterants, and the strips pose no risks to public safety. Research indicates that tools such as FTS and XTS are desired by people who use drugs, and that having more information about their supply can prompt them to change their behaviors to reduce the risk of overdose and other health harms. In addition, these tools are most useful in places where novel adulterants are on the rise or unstable, both factors that apply to the illicit drug market in New Hampshire.

By removing FTS and XTS from New Hampshire’s definition of drug paraphernalia, HB 287 would reduce barriers to life-saving harm reduction tools and improve people’s ability to make informed, health protecting decisions, thereby saving lives. With the ever-increasing use of contaminates, such as fentanyl and xylazine being found in supplies of illegal recreational drugs, it’s critical that this drug testing equipment is available to the public. For these reasons, we strongly urge you to take favorable action on HB 287 and sign it into law. Thank you for your time and consideration of this important request.

Respectfully submitted,

Stacey McKenna
Senior Fellow, Integrated Harm Reduction
R Street Institute
smckenna@rstreet.org

(Download the letter here.)