Wondering if there's fentanyl in your cocaine or other drugs? Summit County has a test strip for that

July 15--Street drug users in Summit County have a new way to help them avoid overdosing -- free test strips that show whether fentanyl, carfentanil or their dangerous chemical cousins are in whatever drugs they have purchased.

The strips were originally designed to test the urine of patients prescribed synthetic opioids for pain.

But Summit County Public Health and similar organizations in several cities across the country have started repurposing the strips, hoping to stem the number of people overdosing amid the evolving opioid crisis.

Drug users don't urinate on the strips, made by Canada-based BTNX Inc. They instead mix the residue of the heroin, cocaine, crushed prescription medication, methamphetamine or marijuana with a little water and dip a test strip in the liquid.

In about 15 seconds, the strip changes: One line shows the drugs tested positive for fentanyl or other synthetic opioids; Two lines show a negative result.

Jackie Pollard, assistant director of community health in Summit County, cautions that the test strips aren't guaranteed to be 100 percent accurate since they're not being used as initially intended. Nor do the tests show which synthetic opioid is mixed with the drugs or how much is in there.

Yet if a test strip comes back positive, it gives users information and options: They can not use the drugs at all, use less than they initially intended or use with another sober person standing by with a naloxone kit to reverse an overdose.

In Summit County this week, 27 people sought help in emergency rooms after overdosing.

Two years ago, when synthetic opioid carfentanil first came to Summit County, the numbers were nearly four times that. At that time, heroin users were almost exclusively impacted. Street dealers were secretly swapping out cheap and powerful fentanyl and carfentanil for more expensive heroin.

Now, however, fentanyl has crept into the larger street drug supply.

In April, three women who gathered to celebrate one of their 20th birthdays were found dead of suspected overdoses at a house in Firestone Park. The Summit County Medical Examiner's Office said Friday they are still awaiting toxicology results to determine what caused their deaths.

But investigators suspect the women, not regular drug users, may have snorted cocaine at the party not knowing it was laced with fentanyl.

At the time, Dr. Doug Smith -- a psychiatrist and chief clinical director at the Summit County Alcohol, Drug Addiction & Mental Health Services Board -- said this is the riskiest time in history for any recreational drug use because users never know what they're getting.

Sometimes drug dealers inadvertently cross-contaminate their supplies. Other times, they intentionally spike the drugs they sell with fentanyl.

"What we're hearing is people are buying meth or cocaine because fentanyl (often in heroin) is so deadly," Pollard said this week. "But now we're hearing fentanyl is turning up in those drugs, too, even marijuana."

The fentanyl test strips -- which cost about $1 each -- are being paid for by Summit County Public Health and the ADM Board as part of an evolving plan to help save drug users' lives.

In June of 2016, public health officials opened the county's first needle exchange at its office at 1400 S. Arlington St.

On Wednesdays, drug users can stop by and exchange their old needles for new and also pick up a care package of other items to prevent blood-borne illnesses such as HIV and hepatitis. The package includes bandages, alcohol pads, condoms, lubricant and other items.

In April, the department opened a second needle exchange site at its Fairway location, at 1867 W. Market St., and will soon open a third site in Kenmore. Other needle exchanges are also planned outside the city of Akron with financial help from United Way, Pollard said.

Drug users can remain anonymous for the needle exchange. They're assigned ID numbers.

But if they want a naloxone kit, they must provide a name because the drug is a prescription.

Measuring the success of their efforts is difficult because the goal is to prevent something before it happens.

But Public Health Specialist Angela Genet, who works at the clinics, pointed out one example.

To get a replacement naloxone kit, users must explain what happened to the one they had. In May alone, 20 people reported needing a new kit because they used their old naloxone to reverse an overdose, Genet said.

Many of those who were saved, she said, likely never seek emergency room help.

Beyond that, when users see the same public health workers week after week at needle exchange, they build up a rapport and trust.

"They don't get to go anywhere else and talk about substance abuse but they talk about it with us ... the abscesses, the gritty details," she said.

When users are ready for help, they know they can ask without fear of judgment or trickery, Genet said.

On Wednesday, when workers first offered the fentanyl test strips at the needle exchange, drug users were surprised, Genet and Pollard said.

Public health workers had to explain how they could test any street drug for fentanyl.

"We told them these strips are for their protection," Genet said.

As soon as they understood that, she said, people asked for two or three.

Amanda Garrett can be reached at 330-996-3725 or agarrett@thebeaconjournal.com.

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