Fentanyl test strips save lives. Why are they still illegal in Texas? | Opinion

Last year, a fentanyl-contaminated batch of crack cocaine killed at least 12 people and led to 70 overdose 911 calls in just 72 hours in Austin. Such a tragedy underscores the gravity of Texas’ overdose crisis and should be a wakeup call to state lawmakers. Fortunately, there are tools — simple test strips that indicate whether a drug is tainted with a dangerous substance like fentanyl — that help people make safer choices when it comes to substance use and reduce their overdose risk. Unfortunately, those tools are illegal in Texas.

But a new piece of legislation, introduced by a Republican state representative, could change this and save countless Texans’ lives.

Illicit drug use has never been completely safe — an unregulated supply means there’s minimal transparency or quality control. But a decade ago, when I was conducting field work with people who used methamphetamine, my participants could assume their supply would be opioid-free. And those using heroin rarely worried that their usual dose would be 50 times stronger than expected.

Now, however, the rise of synthetics has resulted in a market dominated by the highly potent opioid fentanyl, with a roster of novel adulterants — substances added to the drug supply to enhance experience, add weight or improve delivery efficiency — waiting in the wings.

Indeed, recent research from many states, including Texas, found that up to 15% of stimulant samples now contain fentanyl, too. And the animal tranquilizer xylazine has made its way into the Texas supply.

These adulterants in the illicit supply are serious public health threats. People who primarily use stimulants or psychedelics often lack protective tolerance against fentanyl, making them especially vulnerable to an overdose. And, because fentanyl is so potent and fast-acting, even people who have used opioids for decades are at risk. Meanwhile, xylazine complicates overdose because it depresses breathing but does not respond to the overdose reversal medication naloxone.

Checking drugs by using test strips, or more advanced technologies, to test a small amount of a drug for adulterants such as fentanyl or xylazine, can provide people with the information to make safer decisions about their drug use, reducing their overdose risk.

Texas is one of just four holdout states in which possession, free distribution and sale of this life-saving equipment remains a crime.

That glaring legislative gap is likely part of why the state is seeing a smaller decline (about 10 percent) in overdose deaths relative to its neighbors (between 20 and 28 percent) — all of which have authorized some form of drug checking equipment — and the rest of the country.

This is why Texas State Rep. Tom Oliverson, a Republican and an anesthesiologist, has introduced a single, straightforward piece of legislation that could save a lot of lives. His effort is driving home the idea that the overdose crisis warrants pragmatic, health-based solutions, not partisan battles. The illicit drug market is constantly in flux, so saving lives means letting people check for a wide range of potential adulterants, not just the ones we know about. Rep. Oliverson’s bill includes language permitting the possession and distribution of equipment that tests for xylazine as well as fentanyl.

Allowing people who use drugs to possess and community health organizations to distribute fentanyl and xylazine test strips will save lives. Texans who use drugs will be empowered to make safer choices and will have an opportunity to access much-needed health services. The evidence is clear: states should adopt the broadest drug checking legislation allowed by their political climate, and this bill is a massive step in the right direction.