Fentanyl test strips becoming more widely distributed in Metro Detroit

• Fentanyl is a potent synthetic opioid that's a particularly deadly contributor to overdoses.
• Along with opioid overdose reversal medication naloxone, often called Narcan, the testing strips are part of the human-centered harm reduction approach.
• It gives people who use drugs tools to stay safer under the larger umbrella of addressing substance use disorder.

By the numbers: Deaths by opioid drug overdoses in Michigan have dramatically surged this century, from 183 people in 2000 to 2,539 in 2021, per state data.

The latest: New save-a-life stations around Oakland County by the Alliance of Coalitions for Healthy Communities have higher-than-anticipated use, the coalition's harm reduction and recovery support director Steve Norris tells Axios.

• The free boxes placed starting in May are stocked with Narcan, fentanyl test strips, drug disposal pouches and informational resources.
• Around 80% of the stock from 25 boxes has been taken on average — more than the 30% as originally expected. The alliance hears from community engagement efforts that people want more.
• Waterford and Pontiac are having trouble with the drug xylazine — an emerging threat mixed with fentanyl — so those boxes also have xylazine test strips.

The intrigue: The alliance was first looking to set up naloxone vending machines, but realized putting out boxes to distribute free harm reduction resources would be 14 times cheaper ($450 a unit vs. $6,500) and accessible outside, 24/7.

What's next: The alliance plans to set up 36 more boxes over the next two months and 50 more after that. It is looking to collaborate with other groups that want to replicate the project.

Meanwhile, the Detroit Health Department is looking into fentanyl test strip suppliers and sees them as a "priority" for helping prevent overdoses, a spokesperson tells Axios.

• The city plans to distribute them during community outreach starting early next year.

Zoom out: While fentanyl test strips are viewed as drug paraphernalia and still illegal in more than 10 states, Michigan is among a growing number of states embracing their use, Axios' Sabrina Moreno and Shawna Chen report.

Between the lines: Jacob Manteuffel, an emergency medicine specialist with Henry Ford Health who trains staff on opioid use disorder, tells Axios he doesn't see test strips as valuable for opioid users since fentanyl is "essentially in everything already," so a positive reading won't be a surprise. However, the strips can be useful for someone using cocaine or other non-opioid drug, he says.

Context: While some opioid users are knowingly consuming fentanyl because it's what's available, test strips are "vitally important" for people buying substances they don't know have been laced with fentanyl, like cocaine bought at a party, Norris says.

• If a substance tests positive, the person won't necessarily be convinced to throw it away, but "they can use with somebody, go slow, use less, have Narcan" — measures that are more likely to help someone than an ineffective "don't use drugs" policy, David Clayton, HARM:LESS program director for Families Against Narcotics, tells Axios.
• "This is why education needs to be in the forefront of things," Clayton adds.

Editor's note: This story was updated to clarify that Jacob Manteuffel says the test strips can be useful to detect fentanyl in cocaine and other drugs that aren't expected to contain it.