It’s been a little over a year since several organizations throughout the state started giving out free fentanyl test strips in an effort to curb opioid overdoses.
Since then, California has spent hundreds of thousands of dollars distributing the strips to syringe exchange programs across California, including Santa Barbara County’s Pacific Pride Foundation, which alone distributes roughly 200 strips a week. Throughout the past year, the strips have become an increasingly important part of the state’s overdose prevention effort.
Opioid overdoses caused more than 33,000 deaths in the U.S. in 2015 alone, according to data collected by the Centers for Disease Control and Prevention (CDC). The CDC estimates that opioids–ranging from heroin to prescription painkillers–cause nearly 91 overdose deaths in the country each day.
The CDC’s website labels the misuse of opioids as a nationwide epidemic, and the pattern holds true for Santa Barbara County, where data from the Sheriff’s Office shows that opioids caused 65 percent of all overdose deaths in 2016. Those statistics don’t include those who survived opioid overdoses.
And the issue has only been worsened by the growing prevalence of fentanyl, a synthetic opioid that the CDC says mimics the effects of morphine but is 50 to 100 times more potent. Fentanyl, according to the CDC, is often mixed with other drugs–with or without a user’s knowledge. The test strips, according to the California Department of Public Health (CDPH), give drug users a way to find out whether or not their drugs have been laced with fentanyl. Users simply dip a single strip into water containing a small amount of the substance they’d like to test, lay it on a flat surface, and wait for the results.
Synthetic opioid-related deaths increased by 264 percent from 2012 to 2015 in the U.S., according to CDC data.
To combat the crisis, several local law enforcement and government agencies are working to update overdose response protocol, and in April 2017, Sheriff’s Office deputies began carrying Narcan, a brand of naloxone nasal spray used to block the effects of opioids and prevent death during an overdose.
The Pacific Pride Foundation, a nonprofit that offers various youth and LGBTQ-plus education and health programs, started distributing Narcan as part of its syringe exchange program nearly 18 months ago, according to Colette Schabram, executive director of the Pacific Pride Foundation.
Fentanyl test strips followed in June 2017, shortly after several syringe exchange organizations asked the CDPH to begin supplying strips through the California Syringe Exchange Supplies Clearinghouse in May 2017.
The Clearinghouse, which is operated by the North American Syringe Exchange Network through a contract with the CDPH, is funded by the state general fund. It supplies syringe exchange programs across California with various in-kind harm reduction tools, including clean syringes, naloxone, sharps disposal containers, and now, fentanyl test strips.
Each strip costs about $1, including shipping, and as of June 10, the CDPH said $110,000 worth of strips had been distributed to 33 syringe exchange programs across the state.
Although the strips have not been approved by the U.S. Food and Drug Administration, the CDPH said a recent study jointly conducted by researchers at Brown University, Boston Medical Center, and Johns Hopkins University found the strips to be “extremely” accurate in detecting fentanyl in samples of street drugs. The study, which was published in February 2018, also suggested that the strips are unlikely to produce false negative results.
“CDPH believes that the severity of the opioid overdose epidemic and the recently documented increase in fentanyl-involved overdose mortality in California validates this approach to support the health and safety of people who may be at risk of fentanyl exposure or overdose,” the department wrote in an email to the Sun.
“Alongside access to the test strips,” the CDPH wrote, “CDPH is working to increase the number of low-threshold harm reduction services including syringe services and expansion of methadone and buprenorphine, evidence-based treatment for opioid use disorder treatment.”
Since the Pacific Pride Foundation began distributing the strips in June of last year, it’s ordered roughly 2,500 strips, according to the CDPH. Executive Director Schabram said the organization gives out about 200 strips a week between its three sites. Very few clients decline them, she said.
After seeing the popularity and success of Narcan among Pacific Pride’s syringe exchange clients, Schabram said she and other employees discussed other possible solutions.
“And out of those conversations about opioid use in Santa Barbara County,” she said, “we discovered this was sort of the next level need for folks.”
As an organization that runs on a harm reduction model, Schabram said the strips seemed like an obviously beneficial method of saving lives amid the opioid crisis.
“So we’re trying to develop a toolkit to reduce the unintended consequences of an action,” Schabram said. “The opioid crisis is a major concern for the whole nation right now, and we want to be reaching populations that really need this to make better and better decisions.”
Staff Writer Kasey Bubnash can be reached at kbubnash@santamariasun.com.
This article appears in Jul 19-26, 2018.