Louisville’s syringe exchange program is now distributing fentanyl testing strips to its participants, which can detect if drugs like heroin, methamphetamine and cocaine are laced with the powerful opioid that contributes to over 70 percent of fatal overdoses in Louisville.
According to Dave Langdon, the spokesman for the Metro Department of Public Health and Wellness, fentanyl testing strips will now be available to any participants who ask for them at the city’s five syringe exchange sites.
The strips will be also be offered to those “especially vulnerable” to overdoses, such as those just coming out of jail and rehab, or those who have recently switched drug dealers and aren’t sure that their new supply hasn’t been cut with fentanyl.
In addition to distributing free fentanyl testing strips — which cost less than $1 per strip when purchased in bulk — the health department’s syringe exchange sites will now directly give participants naloxone, the drug that can revive the victim of an opioid overdose.
Langdon says that the strips work similar to that of a pregnancy test, as the user dilutes drug residue in water, inserts the strip and waits to see if a line appears indicating that fentanyl or a derivative of the drug is present.
Fentanyl burst onto Louisville’s scene in early 2016, when the health department urgently warned of a spike in fatal overdoses attributed to people using heroin being unaware that it was laced with fentanyl, an opioid that is at least 50 times more potent.
The next three years would bring a dramatic increase in fatal and nonfatal overdoses in Louisville that were driven by fentanyl — increasingly mixed with other drugs like methamphetamine and cocaine — which was rarely present in the illicit drug market only a few years earlier.
According to a study by Johns Hopkins and Brown University last year that surveyed drug users in Baltimore, Providence and Boston, such strips could be effective in alerting users to the presence of fentanyl and altering their behavior.
Up to 84 percent of drug users surveyed indicated having a high degree of concern that fentanyl was present in their drugs, while only one in four stated a preference for drugs cut with fentanyl. Seventy percent of respondents said that knowing fentanyl was present would make them modify their behavior, such as not using the drugs, using them more slowly or changing where they purchased them.
Fatal accidental overdoses in Louisville jumped to 324 in 2016 from 220 a year earlier, spiking again to a high of nearly 400 in 2017. While the Jefferson County Coroner’s office found fentanyl in the toxicology screenings of 11.8 percent of such fatal overdose victims in 2015, that jumped to 42.9 percent the following year and 64 percent in 2017.
Though fatal overdoses trended slightly downward in the first three quarters of 2018, the percentage of victims with fentanyl in their system increased yet again to 71.4 percent.
The distribution of fentanyl testing strips by syringe exchange sites around the country is still relatively new, though health departments in Maryland and Los Angeles have recently begun to do so.
Syringe exchange sites used to give participants a voucher to take to the University of Louisville pharmacy to obtain naloxone, which helps revive those overdosing on opioids, but Langdon says it will now be given directly in order to get more of it into the community.
For the past four years, the city has held naloxone trainings in which the drug was distributed to individuals whose family members were addicted to opioids.
Louisville Emergency Medical Services received 6,688 overdose calls via 911 last year, with 2,287 patients on those runs having received at least one dose of naloxone, a 6.8 decrease from the previous year.