R Street Testimony in Support of NH HB 226, Relative to the use of drug checking equipment

Testimony from:

Robert Melvin, Northeast Region Director, R Street Institute
In SUPPORT of House Bill 226: “Relative to the use of drug checking equipment.”

April 15, 2025

Senate Judiciary Committee

Chairman Gannon and members of the committee,

My name is Robert Melvin, and I am the Northeast region director at the R Street Institute. The R Street Institute (RSI) is a nonprofit, nonpartisan public policy organization. Our mission is to engage in research and outreach to promote free markets, and limited, effective government in a variety of policy areas, including opioid harm reduction. This is why we have a strong interest in HB 226.

While a perfect world would be free of substance use, my organization acknowledges that realistically there are always individuals who will engage in potentially hazardous behavior, and that cessation or abstinence only programs do not work for everybody.^[1] In contrast to a rigid approach that emphasizes abstinence, harm reduction is a judicious strategy to save lives and minimize the harms associated with risky behaviors such as drug use.^[2] By meeting people where they are, educating them, and providing them with tools and resources, we empower them to make less dangerous decisions.^[3] 

HB 226 aims to legalize “drug checking equipment used to inform individuals of whether a substance has been adulterated by the presence of a synthetic opioid, another controlled substance, or undisclosed chemical compound or contaminant,” and authorizes the use of this equipment.^[4] The current proposal expands on a law that was enacted in 2023 that struck from the state “drug paraphernalia” law fentanyl and xylazine testing equipment that was used to check illicit drugs for these contaminants.^[5] This move ensured people who engage in substance use are better able to avoid unintentional overdoses by identifying potentially dangerous adulterants in their supply.  Previously, possession of such equipment was only permissible for individuals who were program participants of syringe exchange programs in New Hampshire.^[6]

Indeed, the 2023 law, coupled with the General Court’s efforts to expand access to harm reduction tools like overdose reversal medication naloxone, has saved lives. New Hampshire has seen a reduction in overdose related fatalities.^[7] But the drug supply continues to change, and New Hampshire lawmakers need to do more to avoid losing these recent gains.^[8]

Heroin and other illegal opioids are inherently risky to consume. However, it is often the compounds that are routinely added to these narcotics unbeknownst to the end user that raise the risk of death and pose challenges for overdose prevention and response.^[9] For the past decade, the U.S. overdose crisis was driven by the addition of the highly potent opioid, fentanyl, to the supply. Recent declines in drug-related fatalities in New Hampshire and elsewhere are largely the result of expanded access to fentanyl-related harm reduction tools, such fentanyl test strips.^[10]

While fentanyl was initially the primary contaminant, we are now seeing a variety of new hazardous substances. These include xylazine, an animal tranquilizer linked to devastating flesh wounds; nitazenes, synthetic opioids significantly more potent than fentanyl; powerful sedatives like benzodiazepines; and a range of harmful industrial chemicals.^[11] 

As a result of the rapidly shifting market, state law needs to be more dynamic in its response and expand the list of drug-checking equipment excluded from the state’s drug paraphernalia law to save lives and reduce risk. This would help mitigate the need for New Hampshire lawmakers to repeatedly legislate the issue with every new contaminant or adulterant that emerges in the illicit drug supply. Doing so will allow harm reduction organizations respond rapidly to new substances compounded with illegal drugs, while bolstering efforts to save lives.

Tools like drug checking equipment are commonly used and have demonstrably saved lives. Research shows that up to 81% of people who inject drugs use fentanyl test strips (FTS), highlighting how essential drug checking has become as a harm reduction strategy.^[12] These resources enable individuals to use more safely—by adjusting their dosage, choosing to use in the presence of others who can administer naloxone or call for emergency help, or, in some cases, discarding contaminated drugs altogether.^[13] The life-saving potential of drug checking is one reason why leading public health organizations, including the American Medical Association, have voiced strong support for harm reduction policies.^[14] 

Opponents might argue that drug checking devices, such as fentanyl test strips, promote drug use by giving users a false sense of security. However, this claim lacks merit and research-based support. Dr. Rahul Gupta, former Director of the Office of National Drug Control Policy, has emphasized that “there is no scientific evidence to support this notion that harm-reduction services like fentanyl test strips somehow encourage drug use.”^[15] In fact, studies and data consistently show that drug checking equipment not only helps mitigate risks but has, in some cases, even discouraged drug use.

With a constantly changing drug supply, communities need tools that are capable of detecting any potential harmful contaminant, not just fentanyl or xylazine. Therefore, it is essential for New Hampshire to broaden its existing drug checking laws to encompass a broader range of drug checking equipment. By expanding the scope of these laws, the state can save lives and allow harm reduction organizations and public health officials to respond more effectively to the ever-evolving opioid crisis. For these reasons, I encourage you to support HB 226.

Thank you,

Robert Melvin
Northeast Region State Government Affairs Director
R Street Institute
rmelvin@rstreet.org 

[1] “Harm Reduction,” R Street Institute. Last accessed January 26, 2025. https://www.rstreet.org/home/our-issues/harm-reduction.

[2] “Harm Reduction,” Substance Abuse and Mental Health Administration, April 24, 2023. https://www.samhsa.gov/find-help/harm-reduction.

[3] Ibid.

[4] New Hampshire General Court, 2025 Legislative Session, House Bill 266, Last accessed April 14, 2025: https://gc.nh.gov/bill_status/billinfo.aspx?id=274&inflect=2 

[5] New Hampshire General Court, 2023 Legislative Session, House Bill 287, Last accessed April 14, 2025: https://gc.nh.gov/bill_status/legacy/bs2016/billText.aspx?sy=2023&id=549&txtFormat=html

[7] “Provisional Drug Overdose Death Counts,” National Vital Statistics System, National Center for Health Statistics, Centers for Disease Control and Prevention, January 15, 2025: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm

[8] Stacey McKenna, “What Policymakers Should Know About the Illegal Drug Supply,” R Street Institute Explainer, Feb. 20, 2025. https://www.rstreet.org/commentary/what-policymakers-should-know-about-the-illegal-drug-supply.

[9] Vanila M. Singh, et al., “The Emerging Role of Toxic Adulterants in Street Drugs in the US Illicit Opioid Crisis,” National Institutes of Health, November 18, 2019: https://pmc.ncbi.nlm.nih.gov/articles/PMC7119254/#:~:text=Mounting evidence suggests that overdoses,illicitly manufactured drugs of abuse.

[10] Centers for Disease Control and Prevention, “CDC Reports Nearly 24% Decline in U.S. Drug Overdose Deaths,” Press Release, CDC Newsroom, Feb. 25, 2025. https://www.cdc.gov/media/releases/2025/2025-cdc-reports-decline-in-us-drug-overdose-deaths.html#:~:text=This is the most recent,month period since June 2020.

[11] U.S. Department of Justice, Drug Enforcement Administration, “The Growing Threat of Xylazine and its Mixture with Illicit Drugs,” DEA Joint Intelligence Report, October 2022: https://www.dea.gov/sites/default/files/2022-12/The Growing Threat of Xylazine and its Mixture with Illicit Drugs.pdf 

Christopher R. Holstege, “Nitazenes are a powerful class of street drugs emerging across the US,” The Conversation, February 15, 2024: https://theconversation.com/nitazenes-are-a-powerful-class-of-street-drugs-emerging-across-the-us-222244

Stephen Liu, PhD, et al., “Trends in Nonfatal and Fatal Overdoses Involving Benzodiazepines – 38 States and the District of Columbia, 2019-2020,” Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, August 27, 2021: https://www.cdc.gov/mmwr/volumes/70/wr/mm7034a2.htm 

Chelsea L. Shover, et al., “Rapid emergence of UV stabilizer Bis(2,2,6,6-tetramethyl-4-piperidyl) sebacate (BTMPS) in the illicit fentanyl supply across the United States in July-August 2024: Results from drug and drug paraphernalia testing,” MedRxiv, September 16, 2024: https://www.medrxiv.org/content/10.1101/2024.09.13.24313643v1 

[12] 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, vol 63, January 2019, pp 122-128: https://www.sciencedirect.com/science/article/pii/S0955395918302135

[13] Alyssa Shell Tilhou, et al., “Differences in drug use behaviors that impact overdose risk among individuals who do and do not use fentanyl test strips for drug checking,” Harm Reduction Journal, Vol 20, Article number 41, March 28, 2023: https://link.springer.com/article/10.1186/s12954-023-00767-0

Maxwell S. Krieger, et al., “Use of rapid fentanyl test strips among young adults who use drugs,” International Journal of Drug Policy, Vol 16, November 2018, pp 52-58: https://www.sciencedirect.com/science/article/abs/pii/S0955395918302469

Susan G. Sherman, et al., “Acceptability of implementing community-based drug checking services for people who use drugs in three United States cities: Baltimore, Boston, and Providence,” International Journal of Drug Policy, Vol 68, June 2019, pp 46-53: https://www.sciencedirect.com/science/article/pii/S0955395919300568 

[14] Andis Robeznieks, “Harm-reduction efforts needed to curb overdose epidemic,” American Medical Association, Overdose Epidemic, November 15, 2022: https://www.ama-assn.org/delivering-care/overdose-epidemic/harm-reduction-efforts-needed-curb-overdose-epidemic

[15] Jan Hoffman, “Fentanyl Test Strips Highlight Rift in Nation’s Struggle to Combat Drug Deaths,” New York Times, October 1, 2022: https://www.nytimes.com/2022/10/01/health/fantanyl-test-strips.html