By PHAEDRA HAYWOOD
The Santa Fe New Mexican
The word fentanyl doesn’t appear anywhere in House Bill 52.
But alarm over deaths caused by the potent synthetic opioid is driving support for the proposed legislation, which would decriminalize the use and possession of test strips used to determine whether the drug is lurking in other substances.
Several people who testified in favor of the bill at a recent legislative committee hearing, including one of its co-sponsors, did so with tears in their eyes, saying their own lives had been touched by the scourge of fentanyl overdoses across the state and nation.
“Fentanyl has become the leading killer of adults ages 18 to 45,” Greater Albuquerque Chamber of Commerce member J.D. Bullington told lawmakers during a recent discussion of the bill.
“When I saw that statistic, I couldn’t believe it,” added Bullington, who has a lobbying firm based in Santa Fe. “I had to look it up for myself and sure enough, fentanyl is now the leading killer of half our adult population. Amid our concerns about gun violence and crime, we must realize that the most prolific killer in our society right now is fentanyl.”
Bullington was one of more than a dozen public officials, health advocates and recovering addicts who expressed strong support for the bill at a recent House Judiciary Committee hearing. They contend it will help slow the rate of people dying from unknowingly overdosing on fentanyl, which is often mixed with other drugs and manufactured to look like narcotic pain medications.
“This bill is absolutely essential to deal with what is a very grave public health emergency,” acting state Health Department Secretary David Scrase told the committee, adding the measure would remove the legal handcuffs preventing the department from distributing the test strips, which are currently classified as drug paraphernalia.
The bill — co-sponsored by Representatives Tara Lujan, D-Santa Fe; Dayan Hochman-Vigil, D-Albuquerque; Christine Chandler, D-Los Alamos; and Sens. Katy Duhigg, D-Albuquerque and Linda Lopez, D-Albuquerque — essentially is a revamp of the 1997 Harm Reduction Act, which developed the state’s needle exchange program, then among the first of its kind.
The legislation is designed to give the Department of Health’s harm reduction program the authority to adjust to an ever-changing substance abuse landscape, Lujan told lawmakers, giving health officials the power to choose which supplies to provide to at-risk communities.
The Controlled Substances Act makes it a fourth-degree felony for New Mexicans to use or possess anything that could be used to “plant, propagate, cultivate, grow, harvest, manufacture, compound, convert, produce, process, prepare, test, analyze, pack, repack, store, contain, conceal, inject, ingest, inhale or otherwise introduce into the human body a controlled substance”.
Hypodermic syringes once fell into that category but were exempted by the passage of the Harm Reduction Act.
House Bill 52 — which would generally exempt any “supplies or testing devices” from the definition of drug paraphernalia — would do the same for fentanyl strips.
The strips are inexpensive testing devices which detect the presence of the fentanyl in other substances. Users can employ the strips at home by dissolving a small amount of a pill or another substance they wish to test in water, then soaking the strip in the solution.
Much like a pregnancy test, a line appears on the test to indicate the presence of fentanyl or one of its many variations.
Evolving solutions for an evolving problem
When the harm reduction program first began 25 years ago, the most pressing need was sterile supplies for intravenous drug users, in hopes of blunting the spread of HIV and Hepatitis C, Department of Health Policy Director Aryan Showers said Thursday.
Since then, Showers said, “We’re continuing to see worse overdoses, but we’re not dealing with the same substances.”
“We went through phases, from heroin to prescription pharmaceuticals, and now it’s this explosion of cheap, really powerful synthetic opioids like fentanyl [and its analogues or variations],” she added.
Fentanyl — estimated to be 100 times stronger than morphine — originally was developed to treat cancer but is rarely used for that purpose anymore.
Instead it has flooded the black market — often disguised as or mixed with something else. It has caused what public health officials say is a problem of epidemic proportions. The drug is more powerful, cheaper and more addictive than many of its predecessors, Showers said.
Even a minuscule dose of the drug can be fatal.
Last year, Showers said, 2,700 people were revived by naloxone — an emergency overdose reversal drug — distributed through state-sanctioned harm reduction programs. Fentanyl, she added, usually prompted the intervention.
According to the Department of Health, about 250 lives could have been saved if it had been able to distribute the testing strips.
If the bill passes, Flowers said, the department would begin distribution of the supplies as soon as possible, hopefully with the help of federal funds earmarked for that purpose.
“We’ve been wanting to do this for a long time,” she said.
Support and concern
The legislation appears to have strong support in the community and on both sides of the aisle.
Scrase said that in addition to the Health Department’s support, state Corrections Department Secretary Alisha Tafoya Lucero said she is behind the bill. And a variety of court officials, including state District Judge Jason Lidyard, First Judicial District Attorney Mary Carmack-Altwies and Chief Public Defender Bennett Baur have spoken in favor of it.
Others who have endorsed the bill include the Drug Policy Alliance, the New Mexico Sentencing Commission, and the National Association of Social Workers New Mexico Chapter, among others.
But the testing strips do have critics.
Andrea Lee — whose 28-year old daughter Amanda Paige Harris died from using fentanyl in Santa Fe County in 2020 — said she’s doesn’t think the strips are effective.
Lee said because fentanyl can clump up in substances it is used to cut or mimic, users would have to be willing to ruin their entire supply to make sure it was safe.
“Fentanyl is not in every portion of the pill,” Lee who lives in Florida, said in a recent phone interview.
“It’s not practical or logical to ask an addict to dissolve a whole pill in water, and lose the whole pill, because you would have to soak the whole pill, “ she said. “They will not mess up their drugs and get rid of their high in order to test and see.”
Besides, she said, her daughter was already addicted to fentanyl and knew what she was taking.
“It’s really honestly not going to help anybody,” she said.
Showers acknowledged the test strips won’t prevent addicts from knowingly taking drugs containing fentanyl. But she said observation has shown having the strips in hand changes people’s behavior, which can save their lives.
They’ll take a drug more slowly, keep naloxone on hand when using or make sure they aren’t alone, Showers said.
“They are employing harm reduction strategies to mitigate their risk,” she added. “Most people don’t actually want to overdose and die.”
Being able to engage substance abusers by providing practical tools to reduce their chances of dying also allows public health officials to build relationships with at-risk populations, Showers said. It also provides points of contact that allows officials to provide other services, including treatment.
“Ultimately, we are trying to provide people with the ability to recover,” she said. “You do that through engaging people, reducing the harms of their addictions … so they aren’t getting diseases while they are using and all the while trying to get them into recovery.”
Will it or won’t it?
New Mexico is one of 10 states that have bills pending in their legislatures that would exclude fentanyl testing strips from the “drug paraphernalia” definition, according to the Department of Health.
Last’s year’s version of the bill died in committee, Rep. Lujan said.
Showers said she’s “fairly confident” the proposed legislation will make it all the way this time, “even within the short time frame”.
The House Health and Human Affairs and Judiciary committees unanimously moved the legislation forward, and House Speaker Brian Egolf said the bill is one of several scheduled to be heard on the floor Saturday.
If the bill clears that hurdle, Showers said, it’s well positioned to be successful in the Senate. If both chambers of the legislature pass the bill, Showers said, she’s certain the governor will sign it in to law.
“We’ve been working on this with the Governor’s Office for a long time,” she said.
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