The strips are currently considered drug paraphernalia under state law.

Hawaii would join others states in making fentanyl test strips legal and widely available if either of two measures moving quickly through the Legislature goes on to become law.

Supporters are encouraged by the bills, which they say can save lives. The test strips give drug users a key tool to know whether the substances they plan to consume are tainted with a powerful synthetic opioid that is increasingly showing up in street drugs, said Nikos Leverenz, grants and advancement manager of the Hawaii Health & Harm Reduction Center.

The House Judiciary and Hawaiian Affairs Committee, chaired by Rep. David Tarnas, moved in that direction Friday by unanimously passing House Bill 573 to legalize the strips. The measure’s next stop is a vote by the full House.

The Senate has been advancing its version of the legislation as well. The chamber’s Health and Human Services Committee passed Senate Bill 671 on Feb. 6, sending the measure on to the Judiciary Committee.

Both bills take fentanyl test strips off the list of what Hawaii law defines as drug paraphernalia. Under current state law, possession of a fentanyl test strip can result in a $500 fine.

Fentanyl test strips can help save lives, but it’s illegal to possess them in Hawaii under current state law. (Courtesy: Kimo Alameda/2022)

Support for changing the law comes from organizations including the state Department of Health, Kauai Prosecutor’s Office, Drug Policy Forum of Hawaii, Hawaii Health & Harm Reduction Center, Hawaii Island Fentanyl Task Force and Community Alliance on Prisons.

“Overdose deaths are a public health crisis,” Kauai Prosecutor Rebecca Like said in her testimony. “We cannot prosecute our way out of this crisis. Legalization of the use of fentanyl test strips is an important step in treating substance use disorder as the public health issue it is, rather than a crime.”

Fentanyl is considered 50 times more powerful than heroin and 100 times stronger than morphine. A tiny amount — comparable to a few grains of salt — is enough to prove lethal. Increasingly, drug cartels are adding fentanyl to heroin, methamphetamine, cocaine and counterfeit pills made to look like Xanax, Adderall, Percocet and Oxycodone.

A recent Los Angeles Times investigation of pharmacies in Northern Mexico catering to U.S. tourists turned up fentanyl-laced pills passed off as legitimate medications. The alarming findings were replicated in a longitudinal study by a team of ethnographic researchers underscoring what experts consider a widening public health crisis.

While counterfeit drugs are not sold at pharmacies in Hawaii, they’re easily obtained on the internet. And statistics indicate fentanyl use is dramatically increasing in Hawaii, with at least 17 fentanyl overdose deaths in Honolulu alone in 2022, according to a report released in October by the Hawaii High Intensity Drug Trafficking Area initiative.

The report says 48 people in Hawaii died from fentanyl in 2021 compared to 28 the year before.

Rep. David Tarnas, who chairs the House Judiciary and Hawaiian Affairs Committee, has pushed forward a bill to decriminalize fentanyl test strips. (David Croxford/Civil Beat/2023)

One person reportedly dies every 11 days on the Big Island from a drug overdose, often involving fentanyl, according to the Centers for Disease Control and Prevention. More than 107,00 Americans died from a drug overdose in the 12 months ending in January 2022.

Of those deaths, 66.5% involved synthetic opioids, primarily fentanyl, according to the CDC.

Given the grim statistics, support for making test strips available is growing in Hawaii.

“Please make it legal for people to be able to test their drugs so they can survive and hopefully one day get help for their drug use. If someone consumes a fatal dose of fentanyl, there is no longer any hope for a chance for a better life,” said Linda Vandervoort in written testimony.

Vandervoort said she works with the unsheltered community in various roles including the distribution of Narcan, a medication used to reverse the effects of an opioid overdose.

Keeping fentanyl test strips – which are easily available for purchase online – illegal simply doesn’t make sense, according to harm reduction experts.

“It would be like making owning condoms illegal,” said Graham Chelius, a doctor on Kauai who treats people with substance use disorder, in written testimony.

Kimo Alameda, head of the Big Island Fentanyl Task Force, says he’s optimistic Hawaii’s politicians will change the law. (Courtesy: Kimo Alameda/2022)

Hawaii is one of about 20 states where test strips are considered drug paraphernalia. In the last year, some 10 states have changed their laws to decriminalize the kits.

Fentanyl test strips work similarly to Covid or over-the-counter pregnancy tests. The user dissolves a small amount of their drug into water and inserts a test strip into the solution. Results appear, typically within five minutes. A single line indicates the presence of fentanyl. Two lines mean a negative result.

The strips, which cost around $1 and can fit into a wallet or purse, are considered a no-nonsense strategy for preventing accidental overdoses. Prevention specialists say overdose-reversing medications like Naloxone, also known as Narcan, should also be widely available.

If Hawaii lawmakers end up decriminalizing fentanyl test strips, the decision could allow new federal funding for overdose prevention to flow to Hawaii. Last September, the Biden administration announced $1.6 billion in funds for communities to address the opioid crisis, including the purchase of fentanyl test strips.

Kimo Alameda, head of the Big Island Fentanyl Task Force, is optimistic that Hawaii lawmakers and the governor will seize the opportunity.

“We are hopeful that the proposed legislation will pass unanimously in both the Senate and the House before going to the governor’s desk for final approval,” Alameda said by email.

The fact that the companion bills are moving is a sign of increased momentum for harm reduction as a tool to address this epidemic, said Alameda, a clinical psychologist and vice president of business development with Hawaii Island Community Health Center.

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