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These test strips might help prevent fentanyl overdoses, but they’re illegal

An investigator for King County uses a fentanyl test strip in February to demonstrate tools the office uses to test drugs they find at the scene of deaths at the King County Medical Examiner in Seattle.   (Daniel Kim/Seattle Times)
By Jadenne Radoc Cabahug Seattle Times

OLYMPIA — Health officials say fentanyl test strips could help prevent accidental overdoses, but under current law, they’ve been illegal because they fall under the definition of drug paraphernalia.

Lawmakers hope to change that with House Bill 1006, dubbed “Allisone’s Law,” named for a young woman who died of a fentanyl overdose and whose mother, Genevieve Schofield, of Kent, is advocating for the test strips.

The bill passed in the House and is now in the Senate for consideration.

It’s far from clear how making the test strips available to the public will impact the opioid epidemic. Someone looking to take a pill for recreation or to relieve chronic pain would have to know about the potential for fentanyl to be in their drug to test it. Then they’d have to dissolve at least 10 milligrams of a drug in a little bit of water, and put in a strip to see how many pink lines appear. One line is positive; two is negative.

As deaths mount, public health officials and advocates say making these test strips available to the public is an important, if modest, step toward harm reduction. A pilot program in King County giving them out for free shows early signs of promise that they’ll be used.

“I believe … that we’re getting supplies out to the people who desire and need it, especially at this time,” said Brad Finegood, a strategic adviser for Public Health — Seattle and King County.

The U.S. Centers for Disease Control and Prevention reported that over 150 people across the nation die every day from overdosing on synthetic opioids like fentanyl. Locally, fentanyl overdoses killed 700 people in King County last year, and 147 in Snohomish County.

Fentanyl is a synthetic opioid 50 to 100 times stronger than heroin and morphine. The U.S. Drug Enforcement Administration says at least 2 milligrams of fentanyl is considered a lethal dose. Even a tiny amount can prove fatal for an unsuspecting consumer.

Schofield’s daughter, Allisone McClanahan, died in 2021 after unknowingly ingesting fentanyl. McClanahan, who was diagnosed with fibromyalgia, had taken a Percocet from a friend to ease her chronic pain, Schofield said.

McClanahan’s toxicology report showed she had 7 milligrams of fentanyl in her system. Schofield said if her daughter had been aware of the dangers of fentanyl, or knew that taking that pill would have killed her, she wouldn’t have taken it.

Schofield said a test strip might have saved her daughter’s life.

“Allisone, she was everything to me,” Schofield said.

A Senate bill looking to accomplish the same task as Allisone’s Law is sponsored by State Sen. Ron Muzzall, R-Oak Harbor. He said he had a friend whose son unknowingly ingested fentanyl and died.

Muzzall said the effort has bipartisan backing in the wake of the homelessness crisis, which he attributes to substance abuse and behavioral health. (Experts say the high cost of housing is a far larger contributor to homelessness.)

Other states have passed laws or introduced similar legislation to exclude fentanyl strips from drug paraphernalia.

Despite fentanyl test strips being technically illegal, some places in King County already make them available to the public.

As part of a yearlong pilot program, two vending machines dispense the tests for free at Peer Kent and Peer Seattle, organizations that support substance abuse disorder as well as behavioral and chronic health conditions.

Finegood, who is heading the pilot, said he got inspired when reading about fentanyl test strip distribution sites in Nevada. He couldn’t say how much the program’s fentanyl strips have helped, because the county doesn’t track the kits after they’re taken from the machines.

But, a public health spokesperson noted, people are using the test strips. The agency has given out more than 100,000 to date.

Peer Seattle Director Christopher Archiopoli said they’ve had to restock the vending machines at least twice a month since they had it in February 2022.

“I know, just from seeing the amount of it that goes out of the machine every day, and talking to people, that it’s definitely being used, it’s making some impact in the community,” Archiopoli said.

Caleb Banta-Green, a professor of Health Systems and Population Health at University of Washington, said it’s difficult to correlate the distribution of fentanyl test strips with the rate of overdose deaths.

But even if the impact of tools like test strips is modest, so is the cost, Banta-Green said.

“The chance of preventing overdose is worth it,” he said.

Banta-Green likened the value of the test strips to other harm reduction programs, such as offering clean syringes. He said bringing awareness of the danger to drug users has proved to reduce mortality rates. Moreover, people picking up test strips can be connected to other services and resources, he said.

Archiopoli said to make progress, the culture and language around substance abuse need to change.

“We’ve spent the last 40 years shaming people. We label them as junkies, losers and burnouts,” Archiopoli said. ” … And then we expect them to want to be part of our community again. There has to be an understanding that there has to be hope for people to make a change.”

Some businesses in Seattle also offer test strips for free, like Uncle Ike’s Pot Shop.

“It’s a risk I’m willing to take, if it saves one life then it is worth it,” said Ian Eisenberg, co-owner of Uncle Ike’s.

Eisenberg said they have been offering the test strips for a year since fentanyl has become a bigger problem in King County. He said he has lost staff members and friends who unknowingly took fentanyl.

“People are gonna do drugs,” Eisenberg said. “If there’s a way for people to do drugs safer … it’s a good thing.”

Correction: This story was updated to say only a small amount of a pill, not the whole pill, has to be dissolved in water to test it for fentanyl. Furthermore, the story previously misstated that fentanyl test strips reduced mortality rates by 4%. That number was in reference to naloxone.