October 15, 2018
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Bangor health organization considers handing out kits to test for fentanyl

Courtesy Health Equity Alliance | BDN
Courtesy Health Equity Alliance | BDN
A New York-based medical supply company sent Bangor-based Health Equity Alliance 60 samples of Rapid Response Fentanyl Test strips, which were created to test urine for fentanyl, a synthetic opioid which can be 50 to 100 times more potent than heroin. The clinic has different plans: they will give them to clients so they can test their drugs for fentanyl.

A Bangor health organization will experiment with handing out urine test kits so substance users can test their drugs for fentanyl, a synthetic opioid driving overdose deaths in Maine.

The experiment, which has received a tepid embrace from health organizations across the country, is meant to curb accidental overdoses. The test kits haven’t yet received Food and Drug Administration approval for this purpose.

Drug dealers often lace heroin and other street drugs with cheap but potent fentanyl, which boosts profit margins but can lead to drug users accidentally ingesting a stronger product than they realize.

Earlier this month, Lochness Medical Inc., a New York-based medical supply company, sent Health Equity Alliance 60 samples of Rapid Response Fentanyl Test strips, which were created to test urine for fentanyl, which can be 50 to 100 times more potent than heroin.

The supplier sent the Canadian-made strips to be handed out for another purpose: so that users can test their drugs before injecting or snorting them, to see if a batch has been laced, according to Maddy Magnuson, HEAL’s harm reduction coordinator.

Users would dip the paper strips in a solution containing drug residue and water, they said.

Because the FDA has not approved the strips for testing drugs, HEAL is concerned with the risk associated with false negatives, Magnuson said. The strips do not indicate the amount or potency of trace fentanyl, either.

That has not stopped some organizations around the country from handing out the strips, and Magnuson has looked to one New York organization, VOCAL, for guidance, they said. Magnuson compared HEAL’s considering the strips to the radicalism of health organizations during the AIDs crisis.

“We would love to have statistics and studies to base our practices on,” they said. “But when it’s not there, we’re doing our best.”

On a single day last month, nine people overdosed across four counties, all suspected of ingesting drugs from the same “bad batch” of fentanyl-laced heroin, police said.

Nobody died, but the string demonstrated fentanyl’s dangerous threat. Last year in Maine, the drug was tied to 247 of the 418 fatal overdoses, killing more people than any other drug. Carfentanil, a synthetic version of fentanyl that is even more potent, killed another five people, according to the Maine attorney general’s office.

Fentanyl’s growing threat has not been met with a proportional response from the government to fund a solution, Magnuson said.

“We want to be doing best practices. But if the government is not working fast enough, we’re not going to be twiddling our thumbs while people are dying,” they said.

But one Maine addiction specialist wondered if the ubiquity of fentanyl would make the test strips pointless.

“Most of the drugs in the state that are used now contain fentanyl,” Portland-based addiction specialist Mark Publicker said. “It doesn’t pass a test with me as being a reasonable or effective way of decreasing overdoses on the basis that we don’t know the sensitivity [of the strips] and it might give people a false sense of security.”

Other front-line organizations have agreed. Insite, a safe-injection clinic in Vancouver, decided against distributing the strips for fear of giving drug users a false sense of security, according to CBS News.

Portland’s India Street Public Health Center acquired a batch of strips a few months ago, but has waited to hand them out to enrollees while staff research “the best way to utilize them,” said Zoe Brokos, the center’s community health promotion specialist.

HEAL is still researching, too, and its staff haven’t decided whether to buy more strips after they hand out the 60 they got for free. That decision will likely hinge on interest from its clients, Magnuson said.

The organization has planned a meeting with clients later this month to gauge interest, and to hand out the strips with caveats.

“I’d love to hear from folks about what they would do with the information. Would it affect their behavior at all? Or would it be just like, ‘Oh, that’s interesting,’” Magnuson said.

Whatever happens, the strips are “a way to open up a dialogue to talk about other overdose prevention practices” and would be doled out with the caution that “this isn’t going to save you,” they said.

HEAL runs the city’s only needle exchange and provides free naloxone, an opioid overdose-reversal antidote, to anyone who asks for it.

Neither are substitutes for treatment, Magnuson said, but they are strategies to reduce the increasingly deadly rise of the state’s drug crisis.

“Our job isn’t to have an agenda for folks. It’s to figure out what they’re interests and needs are and help them make healthier, safer choices,” they said.

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