Harm Reduction - NPX Newsletter Fall 2022

Harm Reduction: The Newest Kid on the Block

By Erin Garrison, PharmD Candidate, OSU 2023

While on rotation back in September, I saw an adolescent patient seeking medication-assisted treatment for her opioid addiction. She elucidated that she may not hang around positive influences to support her recovery, as some of these people still actively use drugs. After having this conversation with her, I encouraged her to take some fentanyl test strips and introduced her to the SOAR Initiative’s app - just one of the free services allowing her direct access to harm reduction strategies. Recovery is not linear, and she was agreeable that harm reduction is important for keeping her friends safe.

The opioid epidemic has been a long battle for Ohio and has only been exacerbated since the eruption of COVID-19. The presence of fentanyl in our community is concerning. Two Ohio State University students passed earlier this year after buying what they believed were study drugs, but were in fact pressed pills made with fentanyl. However, this is not just an issue plaguing students. Overdoses can happen at any age and in all corners of Ohio. Harm reduction tools, such as fentanyl test strips, are crucial to improving awareness and safety as fentanyl becomes increasingly prevalent.

Many people have not heard of fentanyl test strips, including the aforementioned patient. Able to be used by anyone regardless of their recreational drug consumption, these disposable test strips were originally designed for detection of fentanyl in urine drug screens, but have since found their place in testing street drugs for contamination. Just a little residue of the drug and some water is required to test, and results appear within minutes. They are easy and simple to use - so why has no one heard of them? Under the current Ohio Revised Code, fentanyl test strips are considered to be drug paraphernalia. Thankfully, there have been pieces of legislation proposed to decriminalize the strips, like HB456 and SB296. The distinction between these two bills is that the proposed Senate bill will protect any narcotic testing supplies, whereas the House bill only protects the test strips for fentanyl. Nevertheless, this is progress. These bills are still pending in the Ohio Legislature, but that has not stopped statewide entities from promoting the use of fentanyl test strips for harm reduction.

Columbus Public Health, Waterbeds ‘N Stuff, and The SOAR Initiative are just a handful of resources where free test strips are available in the city of Columbus. Caracole in the Cincinnati area has a “harm reduction vending machine” equipped with the test strips, Narcan, and other items for safer injection practices. Various barber shops throughout Cleveland have started carrying strips to offer to their clients. Project White Butterfly (PWB) was started by people in recovery to encourage the use of harm reduction products for safer drug use. From January to November 2021, PWB distributed over 4,500 test strips throughout Cuyahoga county. Families of Addicts services Montgomery county, and they provide test strips, Narcan training, and support group services. Northwest Ohio Syringe Services - operating in the Toledo area - aims to protect the health of people who inject drugs (PWID). They visit local farmers markets to educate and inform, and they offer many of the same services as the other organizations throughout the state.

Fentanyl test strips are a novel way to help ensure the safety and awareness for PWID. They are free and readily accessible throughout Ohio. I keep some in my purse to pass out, and I would encourage all practitioners to do the same and advocate for your patients.