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With overdoses and deaths caused by fentanyl surging several of South Florida’s most prominent elected officials sought a change in state law to legalize inexpensive test strips that can detect its presence, a step they said could save thousands of lives.
Dave Aronberg, the Palm Beach County state attorney; Congressman Ted Deutch, who represents Broward and Palm Beach counties, and state Sen. Shevrin Jones, from South Broward and northern Miami-Dade counties — all Democrats — pushed for the change.
Republicans, who control the Florida Legislature, blocked the legalization effort just 18 hours after dramatic headlines and television coverage of a Wilton Manors spring break house party gone wrong, with six people hospitalized from exposure to fentanyl in cocaine.
Two ended up on respirators. Fentanyl is so potent — 50 times stronger than heroin and as much as 100 times more potent than morphine — that two of the six were stricken when they tried to aid the others.
What happened to the six spring breakers , some of whom were cadets at the U.S. Military Academy at West Point, was cited as lawmakers unsuccessfully argued for the change during a sometimes emotional debate in the Florida House of Representatives on March 11.
State Rep. Kelly Skidmore, a Palm Beach County Democrat, implored her colleagues to examine their priorities.
“If 9,000 dolphins were on the shore dead, or manatees or turtles, man there would be an uprising,” Skidmore said during the debate. “When are we going to wake up? Why do we allow people to die when we know we can save them with one little [change in state law] that takes the fentanyl strips and make them OK to have in your pocket.”
The U.S. Drug Enforcement Administration reports that drug dealers mix fentanyl with other drugs, including, heroin, methamphetamine and cocaine, because of its potency and low cost. The combination increases the chance of a fatal interaction, and the drug users would likely not know the drug is in the mix.
Just a few grains are lethal. While it’s used legally to treat pain, illicit fentanyl is smuggled into the U.S., typically over the Mexican border, according to the DEA. Overdoses can cause respiratory failure leading to death.
But it doesn’t just sicken and kill people who are using drugs. It also gets added to other, seemingly innocuous substances, with deadly results.
Deutch’s nephew Eli died last year after using a legal herbal supplement laced with fentanyl, a loss described by the congressman during an emotion-filled speech on the floor of the U.S. House on the eve of what would have been his nephew’s 21st birthday.
Aronberg said a $1 fentanyl test strip could have saved the young man’s life, and many others.
State statistics for 2020, the most recent year available, show that fentanyl caused 5,302 deaths in Florida, a 63% increase from 2019. A report from the Florida Medical Examiners Commission said fentanyl was responsible for more than double the deaths caused by cocaine in 2020.
In South Florida, there are dozens of fentanyl overdoses every day. In 2000, there was more than one fentanyl-caused death every six hours in the region, with a total of 611 in Broward, 572 in Palm Beach County and 301 in Miami-Dade County.
While the opioid crisis has commanded public attention in recent years, it’s driven by fentanyl, which state statistics show caused, or was present, in 95% of the opioid-caused deaths in 2020.
Strips that can detect the presence of most forms of fentanyl are legal in several states.
The Minnesota Health Department, for example, calls the test strips “a reliable, common-sense means of providing people at risk of fentanyl exposure with more information that can decrease risk of overdose.” As of July 2021, they became legal to distribute and possess in Minnesota.
Florida, however, categorizes the test strips as illegal drug paraphernalia. Removing that designation, thus legalizing the test strips in the state, is the change Aronberg, Deutch and others sought.
“We need to face the reality that, whether it’s kids on spring break trying a substance once, illegal or not, or whether it’s a frequent user, Americans are coming in contact with lethal doses of fentanyl without the tools to know it’s there. Our state’s inaction costs lives,” Detuch wrote on Twitter after the House rejected the move.
Aronberg’s chief assistant drafted the legislative language to make the change. Both he and Deutch reached out to state Rep. Scott Plakon, R-Longwood, the member of the majority party in the House who argued against the legislation.
Opponents said they were troubled by the idea of the government doing something that might be seen as condoning illegal drug use.
“There’s a real philosophical question there, much like providing drug needles to addicts. What are the philosophical implications of that,” Plakon said in a telephone interview. “It does give me heartburn.” He’s referring to a 2019 law that Jones helped pass when he was a member of the House and Gov. Ron DeSantis signed into law which allows counties to offer needle exchange programs to try to curb the spread of HIV and other diseases.
“You’re not putting the stamp of approval on using illegal drugs. You’ve already made it against the law,” Jones said. “You’re trying to make sure that people who are using these drugs, they’re not dying.”
Aronberg also said legalizing the test strips would not encourage people to use drugs who otherwise wouldn’t. “It’s an outdated way of thinking, to think that people with substance abuse disorder are motivated by a moral failing rather than by a brain disease. If you understand substance abuse disorder as a brain disease, then you have to support harm reduction practices,” he said.
Deutch, writing in a series of Twitter posts, cited the case of the West Point cadets: “Fentanyl test strips do not encourage drug use: they empower people to be aware of what substance is really in their possession and to make safe choices…. No parent or public servant, myself included, wants any kid to use cocaine. But if these cadets had been able to access fentanyl test strips, if they had been able to see for themselves that they were about to ingest deadly fentanyl, this story could have been different.”
Aronberg, who has supported increased penalties on dealers, said the fentanyl problem is so severe that it calls for implementing every possible solution. “You can’t arrest your way out of this problem. You need prevention, and a proven and inexpensive prevention are fentanyl test strips.”
Broward State Attorney Harold Pryor offered a similar perspective.
“We don’t condone illegal drug abuse, but context is everything in these types of situations — we don’t see the harm in something that could help members of the community know if what they are ingesting is potentially lethal,” Pyror said via email.
But, said Angela Ventura, director of United Way of Broward County’s Commission on Behavioral Health and Drug Prevention, test strips aren’t a panacea.
“They are not 100% perfect,” she said via email. “There are over 100 different possible analogues of fentanyl and we are not sure if they work for every one of them.”
Ventura said the commission “supports education” but does “not necessarily” recommend their use. “So basically we recommend to someone who is experimenting with drugs just don’t do it. And if someone is dependent or addicted to them to please seek help.”
The Florida Senate approved the legalization of the test strips. But when the measure came before the House on March 11, the last scheduled day of the annual session, Plakon said it should be rejected because the idea had not been vetted and debated in House committees. “It came over to us … with no data, no research, no staff analysis,” he said.
Aronberg, a former member of the Florida Senate, said the argument about a procedure is a smokescreen used when lawmakers don’t want to debate an issue on its merits.
“That procedural argument is always brought out when you don’t want to talk about the real argument. There were other bills that had not been fully vetted in committee, and [the test strips legislation] was vetted in Senate committee,” Aronberg said.
On a voice vote, with no recorded roll call, the Republicans who control the House removed the test strip language from a broader piece of legislation that had passed the Senate. Lawmakers then approved the underlying legislation, which is awaiting action from the governor.
Plakon said someone who wants test strips can obtain them. People with foresight and funds can buy them on Amazon and have them delivered in a day, Plakon said. As an experiment, he said he ordered a single strip for $2.97. A set of 25 costs $25.
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But they’re still illegal in Florida, though Aronberg and Pryor’s spokeswoman said they didn’t know of any Palm Beach or Broward county prosecutions for possessing the strips.
Aronberg said legalization would make them much more widely available, allowing sales at retail pharmacies, and increase the likelihood they’d be used. Agencies in some states promote and distribute the strips.
Plakon, who leaves office this year because of term limits, said supporters can push their case in the 2023 legislative session.
Aronberg said proponents would try again. “We’re going to redouble our efforts. We’re motivated to get it passed next year,” he said. “Floridians will die as a result of the House’s decision.”