Fentanyl deaths cause alarm, but solutions controversial

In a 2018 photograph, a workforce chief with Iowa Hurt Discount Coalition units up a desk throughout a cellular outreach occasion in downtown Cedar Rapids. The group offers out free naloxone kits, which may reverse an opioid overdose, in addition to threat discount kits that embrace sterile water, cookers, ties, antibiotic wipes, band aids and condoms. (The Gazette)

As Iowa grapples with a dramatic improve in overdose deaths involving fentanyl, some consultants and activists say the best-proven options are at present criminalized within the state.

Advocates of hurt discount — a set of methods to cut back the adverse results of ongoing drug use — say Iowa’s legal guidelines are counterproductive to the aim of reducing overdose deaths and getting folks with substance use issues into remedy.

Democratic Lawyer Normal Tom Miller threw his voice into the dialogue final month, when he known as on the Iowa Legislature to legalize fentanyl check strips, which may check medicine for fentanyl, and develop entry to naloxone, a medicine that may cut back the results of a drug overdose.

Fentanyl is an artificial opioid that’s utilized in medical settings, typically for the remedy of extreme ache. It may be as much as 100 occasions stronger than morphine, that means it takes a a lot smaller quantity to trigger an overdose. The presence of illicit fentanyl, and its involvement in opioid overdoses, has shot up in Iowa lately, main officers to seek for options to the development.

Permitting for testing can be a welcome coverage change, in response to Andrea Weber, a medical assistant professor of psychiatry on the College of Iowa. Weber mentioned legalizing testing strips is “low-hanging fruit” and would enable drug customers who aren’t making an attempt to take fentanyl keep away from consuming lethal quantities.

Fentanyl check strips are at present labeled as paraphernalia below Iowa legislation, which carries a easy misdemeanor cost, punishable by a advantageous of as much as $855 and 30 days in jail.

Debra Krause, director of the Iowa Hurt Discount Coalition, mentioned fentanyl check strips usually are not sufficient to resolve the opioid disaster. She mentioned she desires to see broader deployment of naloxone, a extra sturdy good Samaritan legislation and syringe service packages.

“I’m all the time going to be for the legalization of fentanyl check strips, it’s simply not going to resolve the opiate disaster,” she mentioned. “We’ve been speaking to the legal professional basic and (Iowa Division of Public Well being) for actually 5 years, and we have now the science. Hurt discount has the science and the evidence-based analysis.”

Syringe service packages, also called needle exchanges, are packages that present clear needles to intravenous drug customers to forestall the unfold of illnesses like HIV and hepatitis C. In keeping with the Basis for AIDS Analysis, syringe service packages are authorized by state or native legislation in 39 states. They’re unlawful in Iowa.

Weber mentioned the packages present extra than simply clear syringes for drug customers. They typically supply counseling, evaluations for substance use remedy and testing for frequent bloodborne infections.

Why fentanyl is being talked about now

Officers are sounding the alarm now, partly, as a result of the state has seen a dramatic improve in overdose deaths that concerned fentanyl and in fentanyl seizures by legislation enforcement.

Iowa has one of many lowest drug overdose charges within the nation, however the price has been rising, principally as a result of opioids — deaths went up 34 p.c between 2019 and 2021, in response to the governor’s workplace. Fentanyl was concerned in 83 p.c of the state’s 258 opioid deaths final yr, and drug overdose deaths elevated 120 p.c amongst Iowans below 25 within the final two years.

Fentanyl is commonly present in illicit capsules which are bought on the black market and disguised as actual pharmaceutical medicine like OxyContin and Xanax, officers mentioned. It’s additionally blended into what’s being bought as heroin, cocaine and methamphetamine.

Drugs containing fentanyl usually are not coming from professional pharmacies, however pressed by prison organizations to appear to be pharmaceutical medicine. The fentanyl being present in illicit capsules and substances is made in clandestine labs, Weber mentioned, which suggests the efficiency and purity can fluctuate extensively.

In keeping with knowledge offered by the Iowa Division of Public Security, officers seized greater than 7 kilograms of fentanyl by itself in 127 circumstances final yr. In a whole bunch of different circumstances, officers discovered fentanyl in mixtures with heroin or different medicine. It’s a unprecedented improve from 2018, when the load of fentanyl alone discovered by legislation enforcement was solely about 10 grams in 34 completely different circumstances.

Legislative panorama

Laws has been proposed in earlier years to arrange needle exchanges just like what exists in different states, however none have garnered sufficient assist to get to a flooring vote.

A Senate invoice sponsored by 10 Democrats was proposed final yr, nevertheless it didn’t attain a subcommittee assembly. The same invoice making a pilot program within the Home final yr didn’t get to a subcommittee.

In an emailed assertion, Senate Majority Chief Jack Whitver, R-Ankeny, mentioned a legislation round fentanyl testing kits was value consideration, however he didn’t commit assist for them. He famous that needle exchanges haven’t obtained sufficient assist to advance.

Iowa Home Republicans spokesperson Melissa Deatsch mentioned the caucus was utilizing the time between classes to study extra about what might be completed to curb the rising overdose charges in Iowa.

Gov. Kim Reynolds’ spokesperson, Alex Murphy, didn’t say whether or not Reynolds would assist measures to legalize check strips or arrange syringe service packages, however he pointed to her work to boost consciousness of the deaths in addition to her signing a 2016 legislation that allowed pharmacists to dispense naloxone and not using a prescription.

Reynolds additionally has directed the Division of Well being and Human Providers to incorporate details about fentanyl in an consciousness advert marketing campaign concentrating on youth.

Murphy and Whitver additionally forged blame on the Biden administration’s insurance policies across the southern border that they mentioned allowed for the inflow of medicine introduced in from Mexico.

“That is due largely from failed insurance policies of the Biden administration to not safe our southern borders,” Murphy mentioned.