Arizona’s Fentanyl Laws Embrace Reality, Not a Failed ‘War on Drugs’

Opinion: Arizona’s effort to legalize fentanyl test strips and needle exchanges will save lives, unlike previous policies that failed to do so.

Fox News recently reported that Arizona is distributing fentanyl test strips to county health departments to help combat rising drug overdose deaths. So far, the state has distributed the strips in six counties, while Maricopa County is receiving test strips directly from the Centers for Disease Control and Prevention.

It’s a smart decision.

After overdose deaths in Arizona jumped about 48% in the first eight months of 2020 — and rose 32% in Maricopa County in all of 2020 — lawmakers finally decided to adopt the strategy known as ‘harm reduction’.

Harm reduction strategies start from the realistic and nonjudgmental premise that “there never has been, and never will be, a drug-free society”.

Similar to the credo of the medical profession – “First, do no harm” – harm reduction seeks to avoid measures that compound the harms the black market already inflicts on non-medical users and to focus strictly on the goal of reducing the spread of disease and death from drug use.

Bill allows users to test pills for fentanyl

In May 2021, the Legislature passed a bill that removed fentanyl test strips from the state’s list of legally prohibited drug paraphernalia, and Governor Doug Ducey signed it into law.

Fentanyl test strips, made by a Canadian biotech company, were designed for urine drug testing. The Food and Drug Administration has not approved test strips for sale in US pharmacies or other outlets, but harm reduction organizations buy them in bulk and distribute them to intravenous drug users who use “off label” to test heroin, cocaine and other drugs for fentanyl.

Users break a small piece of pill, dissolve it in water, and test it with the strip. If the drug is in powder or liquid form, the test is even easier.

‘Fentazona’: A cheap and deadly drug hijacked Arizona’s opioid crisis

Researchers say the test strips are highly accurate and can detect up to 10 variants of fentanyl that the cartels manufacture and smuggle. They also find that they save lives by getting addicts to consume smaller amounts and/or take a drug more slowly when they detect it contains fentanyl.

Jail is a futile way to stop drug overdoses

That same month, Arizona lawmakers passed and Governor Ducey signed another bill that further amended the state’s drug paraphernalia law, so that harm reduction organizations could enforce “needle service programs” (SSP), also known as “needle exchange” programs.

These programs do more than provide clean needles and syringes to prevent the spread of HIV, hepatitis and other infections. They also provide fentanyl test strips and cleaning supplies, offer HIV and hepatitis testing, and refer people to drug treatment centers.

Syringe service programs are endorsed by the National Institute on Drug Abuse, the CDC, and the American Medical Association. Dr. Jerome Adams, former surgeon general to President Trump, visited Arizona in 2019 to promote PHC.

This wise pivot to harm reduction comes after years of failed efforts to address overdose deaths through prohibition and enforcement.

In 2018, researchers at the University of Pittsburgh reported that the rate of overdose had increased exponentially since the late 1970s, with different drugs dominating at different times.

Now, a new report in the Journal of the American Medical Association predicts the United States could be heading for an even larger wave of overdose deaths.

It’s time for new tactics in the failed war on drugs

All of this is happening despite a 60% decline in opioid prescriptions from 2011 to 2020. Additionally, the Drug Enforcement Administration is imposing quotas on the manufacture of all types of prescription opioids and reducing them year over year. .

In 2019, the reduction in prescriptions led the DEA to announce that less than 1% of controlled substances distributed to retail buyers were diverted. Opioid prescriptions are the wrong target.

There are now reports of the growing presence of nitazenes – synthetic opioids 10 to 20 times more potent than fentanyl – among the illicit drug mix.

This should come as no surprise to anyone familiar with what economists call the iron law of prohibition: “The tougher the enforcement, the tougher the drug.” Drug prohibition incentivizes cartels to create stronger and more potent drugs. More potent forms can be more easily smuggled in and split into multiple portions for sale.

Waging the war on drugs with the same tactics that have failed for the past 50 years and expecting a different outcome is the definition of insanity. Arizona’s recent shift to harm reduction is a welcome step in the right direction.

Jeffrey A. Singer, MD practices general surgery in Phoenix and is a principal investigator at the Cato Institute. Contact him at [email protected].

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