By TIM CARPENTER
Kansas Reflector
OLATHE — Crystal Tucker’s 22-year-old son suffered chronic back and chest pain from an old skateboarding accident and decided to buy four oxycodone pills on the black market in an attempt to find temporary relief.
At 11:49 p.m. March 3, 2020, Lantz texted a friend to say the aches were severe and he was desperate for restful sleep. His text said he’d decided to try one of the pills before going to bed.
“The next day I went in to wake him up for work and found that he was completely lifeless,” Tucker said. “I used to be an EMT, so I knew right away it was far too late. We had no idea what happened.”
Tucker said her son didn’t have a drug addiction. She was curious if he had an undiagnosed heart condition. And, she agonized about never securing the right combination of health care to lower her son’s pain to a tolerable level.
“It wasn’t until 12 weeks later that we got the toxicology report that said Lantz died of a fentanyl overdose,” Tucker said. “He only took one pill. One time, one pill.”
Tucker, speaking during a panel discussion Wednesday with Gov. Laura Kelly on the opioid crisis in Kansas, said she appreciated work done to help heal people with addictions. She said more could be invested on the prevention side to make youth and young adults keenly aware drugs could be adulterated by fentanyl — a synthetic drug up to 100 times more potent than morphine and 50 times more potent than heroin.
She urged the Kansas Legislature to decriminalize fentanyl test strips so individuals who choose to take drugs had a tool to shield themselves from accidental poisoning or death. Kansas law recognizes fentanyl test strips as drug paraphernalia, making them out of bounds.
“I have absolutely no doubt that if fentanyl test strips were legal and easily accessible, Lantz would have had them and I know he would have used them,” she said. “If it spares one momma from burying their baby, then it will have been worth it. We’ve got to do something. This epidemic is killing our kids.”
Testing the idea
Kelly, joined for the roundtable discussion by health care, addiction, counseling and research professionals, said urgency of the situation dictated Kansas move ahead with decriminalization of fentanyl test strips.
“We are experiencing an incredible opioid crisis. It has hit Kansas and hit Kansas hard,” the governor said. “Communities across our state are hurting. We must join the many states across the country that have made fentanyl test strips and other tools available to prevent exposure to fentanyl long before it kills.”
She said Senate Bill 174, subject to negotiations by the House and Senate, included language to make test strips accessible. She said the approach had been adopted this year in Mississippi, Georgia and North Dakota — states led by Republican governors.
Douglas County Sheriff Jay Armbrister endorsed the reform idea because it would be a step toward making community members safer from the curse of fentanyl.
“Opponents of this lifesaving policy must ask themselves: Are you afraid these test strips may save a life you disagree with or find little value in saving? Are you willing to stand in front of a mother and tell her that her son’s or daughter’s life was not worth saving?” the sheriff said.
Kevin Kufeldt, clinical director of addiction services at the Johnson County Mental Health Center, said the incidence of opioid addiction among youth entering a residential program had grown from 7% in 2021 to 35% in 2022. The trend in 2023 suggested the figure could escalate to 50%, he said.
He said the state’s harm-reduction strategies ought to include access to fentanyl test strips so people could reasonably test substances for opioids.
“As the rate of opioid-related deaths continues to rise, we owe it to our fellow Kansans to equip them with the necessary tools to make cognizant decisions about their use,” he said. “Fentanyl test strips help a person who uses drugs be more informed, while reducing their risk of overdose and providing them with additional opportunities to seek treatment for their substance use disorder.”
Kufeldt said lawmakers should be open to different strategies because it wasn’t rational to believe a state could arrest and incarcerate its way out of the overdose problem.
Psychosocial issues
Zijun Wang, assistant professor of pharmacology and toxicology at the University of Kansas, said it was important to appreciate the potency of fentanyl. She said a fatal dose of fentanyl was 2 milligrams, perhaps equivalent to no more than 10 grains of table salt.
“It is very important to know that whatever they’re taking is fentanyl free,” Wang said. “That will help them to want to shape their behavior, to be more responsible … for their own lives.”
She said research indicated youth were more likely to engage in risky behaviors because their prefrontal cortex, which controls decision making, had yet to fully develop. Other factors, including genetics, contributed to whether people became addicted to drugs, she said.
Drug addiction should be regarded as a disease rather than some sort of moral failing, she said.
Zahra Nasrazadani, an emergency medical clinical pharmacist at the Salina Regional Health Center, said it didn’t take long for a tainted batch of drugs to leave a mark on the community.
“I can tell you that when there is a bad batch going around we know about it pretty quickly and we start to see those patients in the emergency room,” she said.
She said a comprehensive response would include drug test strips, but also investment in psychosocial services, which would include mental, emotional, social and spiritual needs of patients and families. She said child care could be important to people fighting addiction. Naloxone and other medicines capable of reversing an opioid overdose should be available over-the-counter at no cost, Nasrazadani said.
In addition, she recommended implementation of syringe programs that could serve to draw people in for treatment of infectious diseases and other health challenges.
Building that bridge
Erika Holliday, substance use coordinator in the public health department of the Unified Government of Wyandotte County and Kansas City, Kansas, said influx of black-market pharmaceuticals necessitated legalization of test strips.
“We have youth overdosing more than ever because of counterfeit pills. They go to a party and try a pill to experiment. Now these pills have fentanyl,” she said.
Holliday said allowing health centers to legally distribute test strips would benefit chronic drug users who faced greater likelihood of overdose because manufacturers blend fentanyl with methamphetamine, cocaine or heroin to make the drug concoction more powerful and cheaper to make.
“It would be such a helpful tool,” she said. “Not only save lives, but be a bridge to engage with folks to say, ‘Hey, the health department is a trusting agency. They’re give us these strips to help save our lives.'”
She also said closure of the county’s only in-patient treatment center intensified the challenge of grappling with addiction. More addicts in recovery should be hired to work as counselors because a peer workforce was more effective in connecting with people, she said.