By Jessica K. Young, Esq.
In May 2023, health officials reported overdose deaths in the United States tied to fentanyl have increased 279% from 2016 to 2021. Individuals who are incarcerated are particularly vulnerable, as the burden of opioid use disorder is disproportionately higher in this population and tolerance generally decreases during incarceration.
Results of the systematic research of publications about fentanyl overdoses during incarceration in PubMed and PsycINFO ranging from 2013-2021 identified that among 179 overdoses, 138 occurred in jails and 41 occurred in prisons across the country. However, a tool to help end the unprecedented overdose deaths in the correctional environment already exists: it is called a fentanyl test strip.
Fentanyl test strips can detect fentanyl in unknown substances as a forensic screening tool. Although reliable, this potentially life-saving item is not currently approved for use in jails for medical screening purposes. The CLIA-waived fentanyl test strips available on the market are FDA-approved for forensic use only (FUO). FUO fentanyl testing is not approved for use related to medical decision-making.
Until the FDA approves the test strips for medical purposes, jails are forced to band-aid the epidemic by stocking Narcan in bulk — and with the increasing trend of mass exposure to fentanyl, multiple doses are required to save the lives of those affected. Some cases have referenced needing 10 doses or more per person to keep the victim awake.
The Centers for Disease Control and Prevention (CDC) noted they are in support of state and community-level fentanyl test strip efforts. In April 2021, the CDC and the Substance Abuse and Mental Health Services Administration (SAMHSA) announced federal funding could be used to purchase the test strips. This purchase approval applies to all federal grant programs, like CDC’s multiyear Overdose Data to Action cooperative agreement, if the purchase of fentanyl test strips is consistent with the purpose of the program.
The FDA needs to approve fentanyl test strips for medical use in corrections. Fentanyl-related overdoses are occurring in correctional facilities with increasing frequency. In addition to the need for improved detection and reporting, immediate efforts to:
- Increase understanding of the risks of fentanyl and how to prevent and treat overdose among correctional staff and residents.
- Ensure widespread prompt availability of naloxone.
- Expand the availability of medications to treat opioid use disorder for people who are incarcerated will save lives.
Currently, there are criminal penalties for possessing drug paraphernalia, including fentanyl test strips. Lawmakers are working to pass a bipartisan bill that is aimed to increase access to fentanyl test strips and help remove the criminalization associated with them. Consider reaching out to your local, state and federal legislators to help support the urgent need of utilizing this tool to decrease deaths caused by fentanyl exposure. There is more than one way to decrease the number of people dying from fentanyl. Fentanyl test strips are one of the options to be able to do this. Let’s try everything we can to stop the staggering number of preventable opioid overdose deaths that are occurring nationwide.
For more information, see:
- CDC’s Efforts to Prevent Opioid Overdoses and Other Opioid-Related Harms
- Fentanyl CLIA waived Stats: A Life-Saving FDA Fix
- Drugs of Abuse Tests
References
CLIA Waived Inc. (n.d.). 14 panel drug test cards.
HealthDay, May 3, 2023. U.S. Deaths Due to Fentanyl Nearly Quadrupled in 5 Years.
Kaplowitz. May 19, 2021. Fentanyl Related Overdose During Incarceration: A Comprehensive Review.
About the author
Jessica K. Young, Esq., CCHP-A, Rule 31 Listed Mediator, is the President and CEO at Advanced Correctional Healthcare, Inc. and has over 18 years of experience in correctional health care and employment law.
