Jack O’Connor is a States Newsroom Fellow for the summer of 2024. He wrote this article for Iowa Capital Dispatch, which was first to publish it.
After past failed efforts in the Iowa legislature, drug activists believe the next session will deliver legalized fentanyl test strips as support for the movement grows and the drug epidemic continues.
Fentanyl test strips are small strips of paper that can test drugs to see if they contain any fentanyl. Activists argue that by legalizing these strips, lawmakers could save lives by preventing accidental overdoses from fentanyl. Under state law, fentanyl test strips are considered drug paraphernalia and therefore illegal.
The previous effort to include the legalization of fentanyl test strips in a 2023 law fell short but gained some bipartisan support, said the amendment’s author, Democratic State Representative Megan Srivinas of Des Moines. Srinivas and activists are prepping to introduce legislation to legalize the strips next session.
Srinivas said some lawmakers who voted against the amendment worried about bogging down the law with amendments but supported the idea of the amendment.
“The conversations I’ve had around it have left me more optimistic for the future,” Srinivas said.
As of July, fentanyl test strips are only illegal in Iowa, Idaho, Indiana, North Dakota, and Texas.
According to data compiled by The Network for Public Health Law, positive fentanyl detections lead to behavioral changes that reduce the risk of overdose death.
Steps of Hope co-founder Ann Breeding, who created the organization after the death of her son from an overdose involving fentanyl, said fentanyl test strips can save lives and therefore need to be legalized.
“If it saves one life, it matters,” Breeding said.
For 18- to 45-year-olds, the number one cause of death in 2021 was fentanyl overdose, according to data collected by Families Against Fentanyl. The number of fentanyl overdose deaths outnumbered deaths from car crashes, suicides, COVID-19 and all other overdoses combined.
Iowa Harm Reduction Coalition Executive Director Deborah Krauss said Iowa’s apprehension toward fentanyl test strips is having real consequences.
Without legalized fentanyl test strips, it has become much harder to know what’s in the Iowa drug supply, Krauss said.
“We know fentanyl is in our drug supply. We know it’s around,” Krauss said. “We have to go by overdose data because we just don’t have enough data on what the supply is.”
FENTANYL TEST STRIPS, DRUGS, AND STIGMA
The belief that fentanyl test strips will encourage drug use, among other fears surrounding the strips, has complicated advocacy efforts in the state, Breeding said. While no studies have shown fentanyl test strips to increase drug use, Breeding said the overall stigma around the drug epidemic remains.
“There’s a lot of stigma,” Breeding said. “‘They’ve made their choice, let them die. Oh, it’s another one off the streets.’ I’ve heard it all.”
Breeding said her experiences with her son have informed her outlook on fentanyl and people who are opposed to drug harm reduction policies need to listen to those who have lost loved ones to the drug epidemic.
“I think people don’t understand because it’s never happened to them. But I’ve got news. It shouldn’t have to happen to you. It’s time to start listening to everybody who gets it,” Breeding said.
A 2023 national survey conducted by John Hopkins University’s health department revealed about 1 in every 3 people knows someone who has died from an overdose.
Krauss said she’s seen a similar stigma. She added that these test strips give people the opportunity to make choices that could save their lives.
“I think instead of encouraging drug use, I see it as giving someone a more informed decision on the substance that they’re about to ingest,” Krauss said. “When people are able to know the unknown in the substance, people will make better and more positive choices for themselves.”
The fact that fentanyl test strips can prevent a fatal overdose is reason enough to support legalizing them, Breeding added.
“They’re not going to do anything but save lives, period,” Breeding said. “Anyone with a heart would want to save a life.”
Top image: Democratic State Representative Megan Srinivas speaks in support of her amendment to legalize fentanyl test strips during Iowa House debate on a related bill on March 21, 2023. Screenshot from official Iowa House video.