Testimony in Support of Allowing Possession, Distribution, and Use of Drug Checking Equipment in New Hampshire
In SUPPORT of permitting the possession and use of drug checking equipment (NH HB 470)
March 19, 2024
Senate Judiciary Committee
Chair Carson and members of the committee,
My name is Stacey McKenna, and I am a senior fellow in Integrated Harm Reduction at the R Street Institute, a nonprofit, nonpartisan think tank focused on advancing limited, effective government in a variety of policy areas, including opioid harm reduction. Last year, the United States overdose crisis took more than 110,000 lives, including approximately 450 New Hampshire residents.[1] R Street acknowledges that some people will always engage in potentially harmful behaviors such as substance use, and that even the best cessation and prevention programs can leave people behind.[2] Harm reduction is a pragmatic, evidence-based approach that saves lives by meeting people where they are and providing tools, education and resources that empower them to make health-positive decisions.[3]
As such, we support HB 470, which would expand New Hampshire’s drug checking permissions beyond fentanyl test strips (FTS) and xylazine test strips (XTS). This would allow harm reduction organizations to more quickly identify and alert community members to novel contaminants in the drug supply, and would reduce the need for this body to repeatedly re-legislate the issue in response to an ever-evolving illicit market.
Due to the illicit nature of many recreational drugs in the United States, there are no safety or quality control mechanisms in place. As in the rest of the country, New Hampshire’s drug supply is increasingly contaminated by fentanyl – a synthetic opioid approximately 50 times as potent as heroin – and xylazine, a veterinary tranquilizer.[4] These drugs can increase risk for fatal overdose, especially for individuals who consume them without knowing.[5]
Drug checking is an important harm reduction intervention that does not pose any dangers to the community, and can empower people who use drugs to change their behaviors in ways that reduce their risk of overdose.[6] Last year, this legislature took an important step in fighting New Hampshire’s overdose crisis when it removed FTS and XTS from the state’s definition of paraphernalia.
Unfortunately, the illicit drug market remains extremely volatile throughout the United States, and novel adulterants continue to emerge in the supply.[7] And while these easy-to-use products can alert people to the presence of the specified adulterants fentanyl in powder or pills, they do not detect other potential contaminants that could worsen or complicate overdose outcomes.[8] By removing “drug checking equipment” more broadly from New Hampshire’s definition of paraphernalia, and by authorizing the use of such equipment, HB 470 would allow for a more comprehensive approach to this life-saving intervention.
For example, public health organizations can quickly adapt to suspicions of a novel adulterant coming to New Hampshire by distributing relevant test strips, without having to await their legislative authorization. Furthermore, this bill would allow relevant organizations to launch point-of-service drug checking programs, which may use test strips, specialized machines, and even apps to identify a wide range of contaminants in the drug supply and alert people to their presence.[9] As with test strips, this information can, in turn, encourage people to take extra precautions to avoid an overdose.[10] In addition, HB 470 would help the New Hampshire legislature stay ahead of the curve when it comes to empowering communities to stay as safe as possible, by not having to return repeatedly to this issue to authorize individual products and technologies as they become available.
By removing drug checking equipment from New Hampshire’s definition of drug paraphernalia, HB 470 would reduce barriers to a range of life-saving harm reduction tools, thereby allowing organizations to adapt swiftly to changing threats, and empowering individuals to make health-protecting decisions. As such, R Street urges your favorable report.
Respectfully submitted,
Stacey McKenna
Senior Fellow, Integrated Harm Reduction
R Street Institute
[1] “Provisional Drug Overdose Death Counts,” National Vital Statistics System, National Center for Health Statistics, Centers for Disease Control and Prevention, March 3, 2024. https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm.
[2] “Harm Reduction,” R Street Institute. Last accessed March 15, 2024. https://www.rstreet.org/home/our-issues/harm-reduction.
[3] “Harm Reduction,” Substance Abuse and Mental Health Administration, April 24, 2023. https://www.samhsa.gov/find-help/harm-reduction.
[4] New Hampshire Drug Monitoring Initiative: Drug Environment Report, 2022; National Institute on Drug Abuse, “Fentanyl DrugFacts,” National Institutes of Health, June 2021. https://nida.nih.gov/publications/drugfacts/fentanyl; Jeff McMenemy, “Fentanyl overdose deaths ‘skyrocketing’ in New Hampshire; first responders issue warnings,” Portsmouth Herald, Oct. 27, 2023. https://www.seacoastonline.com/story/news/2023/10/27/fentanyl-overdose-deaths-skyrocketing-in-new-hampshire/71318063007.
[5] Julie Latimer et al., “Risk of fentanyl overdose among clients of the Sydney Medically Supervised Injecting Centre,” International Journal of Drug Policy, 37, (November 2016), pp. 111-114. https://www.sciencedirect.com/science/article/abs/pii/S0955395916302699; Phillip O. Coffin et al., “Modeling of overdose and naloxone distribution in the setting of fentanyl compared to heroin,” Drug and Alcohol Dependence, 236, (July 1, 2022). https://www.sciencedirect.com/science/article/abs/pii/S0376871622002150; Charles Ingoglia, “This Drug Has Made the Overdose Crisis More Severe,” National Council for Mental Wellbeing, 2024. https://www.thenationalcouncil.org/this-drug-has-made-the-overdose-crisis-more-severe/#:~:text=Much of the information about,undetectable without drug testing equipment; David T. Zhu, “Public health impact and harm reduction implications of xylazine-involved overdoses: a narrative review,” Harm Reduction Journal, 20: 131, (Sept. 12, 2023). https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-023-00867-x.
[6] Nicholas C. Peiper et al., “Fentanyl test strips as an opioid overdose prevention strategy: Findings from a syringe services program in the Southeastern United States,” International Journal of Drug Policy 63 (January 2019), pp. 122-128. https://www.sciencedirect.com/science/article/pii/S0955395918302135?via=ihub.
[7] “What are nitazenes? Emerging group of synthetic opioids may be more potent than fentanyl, study warns,” CBS News Philadelphia, Aug. 29, 2023. https://www.cbsnews.com/philadelphia/news/nitazenes-synthetic-opioids-more-potent-than-fentanyl-study-warns; Christopher P. Holstege, “Nitazenes are a powerful class of street drugs emerging across the US,” The Conversation, Feb. 15, 2024. https://theconversation.com/nitazenes-are-a-powerful-class-of-street-drugs-emerging-across-the-us-222244.
[8] Traci C. Green et al., “An assessment of the limits of detection, sensitivity and specificity of three devices for public health-based drug checking of fentanyl in street-acquired samples,” International Journal of Drug Policy, 77, (March 2020). https://www.sciencedirect.com/science/article/pii/S0955395920300025; Marianne Skov-Skov Bergh et al., “Selectivity and sensitivity of urine fentanyl test strips to detect fentanyl analogues in illicit drugs,” International Journal of Drug Policy 90 (April 2021). https://www.sciencedirect.com/science/article/pii/S0955395920304035?via=ihub.
[9] “What is Community Drug Checking?” Addictions, Drugs & Alcohol Institute, University of Washington, July 27, 2023. https://adai.uw.edu/wordpress/wp-content/uploads/THE_DC_Participant_infosheet_.pdf; “StreetCheck: Community Drug Checking App,” The Heller School for Social Policy and Management, Brandeis University, 2024. https://heller.brandeis.edu/opioid-policy/community-resources/street-check/index.html; Susan G. Sherman et al., “Acceptability of implementing community-based drug checking services for people who use drugs in three United States cities: Baltimore, Boston and Providence,” International Journal of Drug Policy, 68, (April 13, 2019), pp. 46-53. https://pubmed.ncbi.nlm.nih.gov/30991301.
[10] Sherman et al.