Testimony in Support of Increasing Access to Fentanyl Test Strips in Illinois

Testimony from:

Stacey McKenna, Senior Fellow, Integrated Harm Reduction, R Street Institute

In SUPPORT of permitting the possession and use of drug checking equipment (2023 IL HB 3203)

March 7, 2023

House Public Health Committee

Chair Stava-Murray 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 (RSI), a public policy research organization focused on advancing limited, effective government in a number of policy areas, including opioid harm reduction. Last year, the U.S. overdose crisis took more than 110,000 lives.[1] In 2021, 3,013 people in Illinois died of an opioid-involved overdose.^[2] From a public health perspective, it would be ideal if people simply abstained from all use of non-prescribed opioids. However, abstinence-only policies do not work at the population level, and even the best cessation and prevention programs leave people behind. Thus, RSI supports harm reduction as an evidence-based approach that saves lives by meeting people where they are and providing resources, services and education to support their ability to make health-promoting decisions. As such, we support IL HB 3203, which would increase access to a life-saving harm reduction tool—fentanyl test strips (FTS)—by removing them from the state’s definition of drug paraphernalia, permitting their sale in pharmacies and allowing county health departments to distribute them.

Due to the illicit nature of many recreational drugs in the United States, there are no safety or quality control mechanisms in place. The current drug supply is increasingly contaminated by fentanyl—which is up to 50 times as potent as heroin and has an extremely narrow margin between desired and dangerous effects—and related compounds.[3] These drugs significantly increase risk for overdose, especially for individuals who consume them without knowing. In fact, fentanyl and other highly potent synthetic opioids were responsible for 89 percent of Illinois’ opioid-involved overdose deaths in 2021.[4]

Drug-checking equipment such as FTS alert people to the presence of fentanyl and related substances in powder or pills.[5] FTS are easy to use, have low margins of error and commercially available products have been shown to detect not only fentanyl but up to 24 of its most commonly found analogs.[6] The strips do not pose any danger to the community, and research indicates that drug checking can empower people who use drugs to change their behaviors in ways that reduce the risk of overdose.[7]

By removing FTS from its paraphernalia definition and expanding access via pharmacies and public health departments, IL HB 3203 would empower people to protect their health and their lives, even if they are unwilling or unable to stop using illicit drugs at this time. As such, R Street urges your favorable report.

Respectfully submitted,

/s/ Stacey McKenna
Senior Fellow, Integrated Harm Reduction
R Street Institute
[email protected]

[1] Brian Mann, “2022 was a deadly (but hopeful) year in America’s opioid crisis,” National Public Radio, Dec. 31, 2022. https://www.npr.org/2022/12/31/1145797684/2022-was-a-deadly-but-hopeful-year-in-americas-opioid-crisis.

[2] Statewide Semiannual Opioid Report – May 2022, Illinois Department of Public Health, May 2022. https://dph.illinois.gov/content/dam/soi/en/web/idph/publications/idph/topics-and-services/opioids/idph-data-dashboard/Opioid-Report-5_22.pdf.     

[3] Centers for Disease Control and Prevention, “Fentanyl Facts,” U.S. Department of Health and Human Services, Feb. 23, 2022. https://www.cdc.gov/stopoverdose/fentanyl/index.html#:~:text=Fentanyl%20is%20a%20synthetic%20opioid,nonfatal%20overdoses%20in%20the%20U.S.

[4] Statewide Semiannual Opioid Report – May 2022. https://dph.illinois.gov/content/dam/soi/en/web/idph/publications/idph/topics-and-services/opioids/idph-data-dashboard/Opioid-Report-5_22.pdf.    

[5] 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.

[6] Ibid.; 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%3Dihub.

[7] 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%3Dihub.