New Hamilton County Program Distributes Free Fentanyl Detection Strips to Reduce Overdose Deaths

Fentanyl often is laced into illegal substances like cocaine and heroin, and many users don't know if what they're taking has fentanyl in it.

click to enlarge Hamilton County Health Commissioner Greg Kesterman announces the county's free fentanyl test strip program on May 10, 2022. - Photo: Hamilton County YouTube
Photo: Hamilton County YouTube
Hamilton County Health Commissioner Greg Kesterman announces the county's free fentanyl test strip program on May 10, 2022.

Hamilton County now has another weapon in the fight against fentanyl-related deaths.

During the Hamilton County Commissioners meeting on May 10, health commissioner Greg Kesterman announced that county residents now can request free fentanyl test strip kits by texting "FTS" to 22999. The test strips are free, and no name is required to receive them – just an address.

Fentanyl is a legal, potent opioid that frequently causes overdose deaths when misused. It often is laced into illegal substances like cocaine and heroin, and many users don't know if what they're taking has fentanyl in it.

Kesterman said that Hamilton County residents who plan to use illegal substances can first test those substances to see if fentanyl is present, noting that the county's goal is preventing deaths. He said that fentanyl was "extremely deadly."

"The key is that folks use these test strips before using any kind of illegal substance. Obviously it's best that somebody doesn't use the illegal substance, but if somebody has made the purchase, they are definitely planning on using it. By testing, they are able to alter their behavior," Kesterman told commissioners on the United States' first-ever National Fentanyl Awareness Day.

As noted in CityBeat's April cover story about fentanyl, the standard protocol to test a batch of drugs involves dissolving a small amount of the drug in water and dipping a detection strip into it for 15 seconds. The strip then is placed on a flat surface for five minutes, when colored lines will indicate whether or not fentanyl is present. Typically, one line indicates that there is fentanyl in the drug and two lines means there isn’t, but packaging will show instructions and how to determine if the test was valid.

Kesterman said that the mere act of testing drugs for fentanyl can change someone's trajectory.

"Through my team's work over the last several years, we have actually known that 75% of people that use a test strip alter their behavior. They may choose to use with someone else that can help save them should they have a bad reaction to the fentanyl, they might choose not to use it at all, or they might make sure that they have Narcan (brand name of naloxone, a nasal spray used to stop a drug overdose) before using that substance," Kesterman said.

"Obviously our number-one goal 100% of the time is getting people into treatment, but we know sometimes folks are using it (recreationally) and are not going to get access to treatment or not choose to get treatment because they don't feel that they are addicted, so this is another tool to help keep people alive," Kesterman continued.

According to Harm Reduction Ohio, a nonprofit that tracks Ohio drug data, 35.9% of Ohio’s illicit drugs contained fentanyl in the last quarter of 2021 — a 10% increase from earlier in the year. AmandaLynn Reese, director of outreach and engagement for Harm Reduction Ohio, told CityBeat in April that supplies of common party drugs — like cocaine — laced with fentanyl have been sneaking up on those who casually take hits. 
click to enlarge Hamilton County offers free fentanyl test strips via text. - Photo: Allison Babka
Photo: Allison Babka
Hamilton County offers free fentanyl test strips via text.

Fentanyl is tasteless and colorless, with no smell or discernible features, which is why Reese encourages those who use drugs to test their batches before using.

"We know that people are using recreationally and don't know what they're using because they're buying them off the streets. These test strips then can become lifesavers," Denise Driehaus, one of Hamilton County's commissioners, told Kesterman during the meeting. "I have Narcan in my purse but I don't have any test strips, so it's interesting to look at these and see how easy they are to use for someone who maybe got a pill from a friend or something and they need to know what's in that pill."

Kesterman said that when Hamilton County residents text "FTS" to 22999, they will receive three links. One link goes to a form to request fentanyl test strips, one features instructions for using the strips, and one has information about where people outside of Hamilton County can obtain strips via the SOAR Initiative.

CityBeat went through the fentanyl test strip request procedure via text on May 12. The request form asked for an address where the county can mail the test strips; it did not ask for a name associated with that address. Users will need to affirm that they have read the instructions for using the strips.

Fentanyl-laced party drug overdoses have become a rising problem in Cincinnati, Hamilton County and elsewhere in recent years. Officials from Harm Reduction Ohio say that around 5,300 Ohioans died of an overdose in 2021, and 1,497 of those deaths were cocaine related. Data from the Ohio Department of Health on mortality shows that at least 1,083 of those cocaine deaths were caused by laced fentanyl.

Hamilton County is one of Ohio’s top 10 counties for overdose deaths as a result of cocaine, according to data analyzed by Harm Reduction Ohio. Reese told CityBeat in April that at least 15.2% of the cocaine examined by the state’s crime lab contained fentanyl in 2021, so there is no way to know what you’re buying without testing.

The data from Ohio’s crime lab shows an uptick in fentanyl appearing in other drugs right at the onset of the pandemic, jumping from 21.8% to 29.5% in the second quarter of 2020. That number remained steady until the end of 2021, when lacing hit a record high of 35.9%.

“We are seeing it in pressed pills that look very real,” Reese said. “We’re seeing Adderall and Xanax and pain pills of every variety that are laced with fentanyl. Cocaine is often laced with fentanyl, meth is often laced with fentanyl. People don’t know that’s what they’re using. People who have smoked crack-cocaine for 30 years are being introduced to fentanyl totally unaware.” 
In an effort to help reduce overdoses, bar and restaurant owners and managers have been reaching out to Harm Reduction Ohio for Narcan training, and many are making fentanyl detection strips available to customers.

Harm Reduction Ohio offers free naloxone and fentanyl test strips on its website. Participants must complete a training video to place an order. Those who are looking for in-person training and supplies can email CCS at [email protected].

Naloxone and test strips are also available through other local organizations and even pharmacies. Greater Cincinnati HIV/AIDS service organization Caracole has a harm reduction supply vending machine available 24/7 at its Northside headquarters that dispenses naloxone and test strips for free. First-time users need to fill out a survey before getting a 90-day access code. The aforementioned SOAR program will also mail out five free fentanyl test strips via its website

Drug stores such as CVS and Walgreens also dispense naloxone, though it is not free. Many insurance companies will pay for or reimburse people for brand-name and generic naloxone, but those without insurance are on the hook for a $90-$140 charge, pharmacists tell CityBeat.

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