Advocates: Fentanyl testing strips are working in Minnesota, but stigma prevents more widespread use

When Mark Wager’s daughter found a bag of the powder on the side of the road on July 14, 2022, she thought it was cocaine. She texted a friend to ask where to get the fentanyl test strips, but her friend didn’t see the message until the next morning.

It was too late. Jessica (Jess) Weiger unknowingly took fentanyl and died of an overdose. She was 39 years old.

Her father and others who have lost loved ones to fentanyl, a powerful synthetic opioid, are left wondering if test strips that show whether the substance contains fentanyl could save lives if more people knew how to get it and how to use it.

Test strips, which the Minnesota legislature made legal in July 2021, are circulating among more drug users, advocates working to combat the opioid epidemic say. But the stigma around fentanyl test strips has prevented some users from testing their medication.

From 2020-21, the number of fentanyl overdose deaths in Minnesota increased from 560 to 834 people, according to the Minnesota Department of Health. Policymakers viewed the test strips as a tool that could help reduce this number, especially among drug users who wanted to avoid fentanyl. To get a positive or negative result from a test strip, a person must dissolve a small amount of the substance in water and dip the strip into the water for 15 seconds before letting the strip lie flat for five minutes. One line on the strip indicates a positive result while two lines indicate a negative result.

The Steve Rumler Hope Network, a nonprofit focused on opioid overdose prevention, education, and advocacy, was among the first organizations in Minnesota to distribute test strips. Since the group began distribution in September 2021, the Stephen Rumler Hope Network has distributed approximately 122,000 tapes throughout the state of Minnesota. That includes nearly 28,000 tapes so far this year.

The organization is putting fentanyl test strips in overdose prevention kits, said Alicia House, executive director of the Steve Rumler Hope Network. Along with the fentanyl test strips, there is also a QR code that people can scan which links to an anonymous survey where people can talk about their usage habits and order more fentanyl test strips.

According to House, 90% of people who report a positive result for fentanyl from fentanyl test strips change their drug use by doing one or more of the following:

• 35% used the substance with a group or with another person
• 33% decided not to use the substance at all
• 32% had naloxone on them while using the substance
• 22% used a smaller dose of the substance

“I think the real potential for preventing overdoses from fentanyl test strips lies in the impact they can have on drug use practices,” House said. “Knowing that their medication contains fentanyl, many individuals exercise caution or do not use the medication at all.”

Advocates at another organization that distributes fentanyl test strips said the strips are very helpful for people who are not looking for fentanyl in their substance of choice.

People who try drugs or don’t use opioids are examples of people who show fentanyl test strips who can be successful, said Justin McNeil, director of participating justice programs at the Minnesota Recovery Connection.

Despite the benefit of the fentanyl test strips, McNeil said he also saw a downside to the strips while working three nights a week at Simpson Housing Services, a homeless shelter network in Minneapolis: People with “full” addictions often use fentanyl test strips to research fentanyl.

MacNeil said harm reduction training and public education about fentanyl are crucial to helping people recover. He added how important it is to erase shyness around using fentanyl test strips.

“I’ve done exercises where people think that reversing an overdose or testing your drugs is empowering, but reversing an overdose is just letting someone live,” McNeil said.

While McNeil believes fentanyl test strips make a difference in the Twin Cities, he believes they are just one tool for preventing deaths and not enough.

One measure he believes will prevent more deaths is the creation of overdose prevention centers, places where people are monitored while they are using their substances. If a person takes an overdose while in an overdose prevention center, there will be immediate attention to reverse the overdose.

Having an overdose prevention center in the Twin Cities would reduce the number of overdoses and help people build confidence so they can have better success making recovery calls, McNeil said.

“If people can go to a place where they feel safe and they won’t be judged on the basis of where they are in their drug use, the chances of them getting better are much higher than what we just go to and tell them ‘number,'” McNeil said.

House and McNeil both talk about the stigma surrounding drug use, saying that many people struggle to access help for fear of being judged or not feeling like they “deserve” help.

House said the conversation to help people who are suffering should start with, “Hey, how do we make sure we keep you alive and safe” rather than telling people, “Don’t use.”

Edward Krombotich, chair of Upper Midwest policy for the National Harm Reduction Coalition, said fentanyl is the drug most commonly used in Minnesota.

“Fentanyl test strips are one solution to a very big problem,” Krumbotich said. “Fentanyl test strips do a great job of analyzing what is in our supply of fentanyl medications, but if we don’t also look at the other types… [drugs] We have a lot of one-sided problem.”

For example, fentanyl can be found in drugs ranging from marijuana to cocaine to methamphetamine, but most people use opioid strips, such as compressed pills and heroin, according to the CDC.

In order to address this, Krumbotich said the goal should be to “bring addiction out of the shadows.” He said some substance users fear imprisonment, so decriminalizing drug paraphernalia will help users be more open about their struggles with addiction.

Krumbotich stressed the importance of dealing with drug users with empathy and meeting with them where they are within healthy limits.

“We all know an addict. We know someone with a substance use disorder,” Krumbotich said. “We have to treat the disease and we have to love the person.”

Since his daughter’s death, Weger has worked with lawmakers and organizations, such as the Steve Rumler Hope Network, to make fentanyl test strips more readily available around the Twin Cities.

Eight months ago, Weiger didn’t know much about fentanyl. Today, he uses his participation in the Steve Rummler Hope Network, such as being part of a public outreach committee, as a way to deal with his grief. He knows more about fentanyl than he ever hoped he would.

“I made a promise to Jessica that I would live a life of wonder, excitement, and the joy of living, and that’s what I was doing in my retirement before July 14th, because that’s what Jess wanted,” Wieger said. “But at the same time, I don’t want other families to suffer this grief.”

Madison Roth is a University of Minnesota journalism student on assignment with MinnPost for the spring 2023 semester.