Texas GOP lawmakers warming to opioid harm-reduction policies

AUSTIN, Texas — This article originally appeared in The Texas Tribune.

Texas lawmakers are altering their tune about how to deal with a rising fentanyl disaster within the state forward of the subsequent legislative session beginning in January.

Earlier this month, Republican Gov. Greg Abbott led the best way by popping out in favor of legalizing fentanyl check strips, which assist customers determine whether or not the medication they’re planning on taking comprise the lethal artificial opioid. Abbott beforehand opposed such a coverage however stated the rise in opioid overdose deaths had introduced a “better understanding” that extra wants to be finished by the state to deal with the issue.

“The message from Abbott that he’s willing to support that is huge because that gives the go-ahead to the House and Senate,” stated Katharine Neill Harris, a drug coverage fellow at Rice University’s Baker Institute for Public Policy. “It signals that if we get this passed, it’s not going to necessarily get vetoed.”

Bills to legalize fentanyl check strips, and different related packages like syringe change providers that intention to reduce hurt for these addicted to medication, have been filed up to now, however had been largely authored by Democrats and had little likelihood of changing into regulation in a Republican-dominated Legislature. Many tough-on-crime Republicans have opposed such measures, involved that they permit drug use.

Now, among the Capitol’s most conservative names — like state Sen. Bob Hall of Edgewood and Rep. Tom Oliverson of Cypress— are taking over the case for legalizing fentanyl check strips. And the difficulty is getting assist from prime legislative leaders.

“I believe that recommendations made by the public health committee will receive broad support in our chamber, such as legalizing fentanyl testing strips, encouraging the availability of naloxone and promoting a more centralized and coordinated data collection effort to better inform law enforcement and emergency medical services,” House Speaker Dade Phelan stated in a press release.

Abbott additionally stated he needed to make Narcan, a drug used to reverse opioid overdoses that’s generically referred to as naloxone, extra available throughout the state. First responders and harm-reduction teams that work with individuals who use medication have problem supplying Narcan due to its value — about $125 for a equipment with two doses.

Republican and Democratic lawmakers are working collectively to move harm-reduction measures. That’s been encouraging for drug coverage specialists who’ve been sounding the alarm in regards to the rise of fentanyl within the state for years, however they stated the state nonetheless wants to do extra.

“We are excited about the possibility of legalizing fentanyl testing strips, but that’s one tiny step forward, and we really need to be taking huge strides to get our arms around this crisis,” stated Cate Graziani, co-executive director of the Texas Harm Reduction Alliance.

The proposed coverage modifications come because the opioid disaster continues to batter the nation. Nationwide, the Centers for Disease Control and Prevention reported that greater than 107,000 individuals died from drug overdoses in 2021, the final accessible 12 months. Synthetic opioids had been chargeable for 71,000 of these deaths, they usually had been largely from fentanyl.

In Texas, the CDC predicts that greater than 5,000 individuals died of drug overdoses between July 2021 and July 2022. Overdose deaths involving fentanyl within the state rose 399%, from 333 individuals dying in fiscal 12 months 2019 to 1,662 in fiscal 12 months 2021.

The change from Republican leaders in Austin additionally comes practically two years into Abbott’s unprecedented border mission, Operation Lone Star, which has value the state $4 billion for border safety and despatched hundreds of National Guard members and Department of Public Safety troopers to the border with underwhelming outcomes. One of the operation’s principal objectives is to cease the circulate of medication throughout the border, however fentanyl deaths have elevated within the state in recent times.

“If 50 years of the war on drugs isn’t enough to prove it doesn’t work, then we can look to the past two years,” Graziani stated. “Those strategies aren’t working. We need public health strategies, and we need to stop criminalizing paraphernalia so we can focus on the care.”

Sen. Nathan Johnson, D-Dallas, who filed a invoice for the brand new session to decriminalize strips and different expertise that may assist detect fentanyl, stated the state wants to take swift motion.

“We have a lot of people dying of accidental drug overdoses as a result of taking drugs that they didn’t know contain fentanyl,” he stated. “This affects a lot of people, including college kids, and we, in Texas and nationwide, have suffered devastating overdose losses of life.”

Showing the difficulty’s bipartisan enchantment, Johnson has teamed up with Hall to push the invoice by way of. Similar payments have been filed by Oliverson and Austin Democratic Reps. Sheryl Cole and James Talarico.

“We don’t agree on a whole lot of things, but it does show you that sometimes they’re just the right answers,” Johnson stated.

Hall didn’t reply to a request for remark.

A broader invoice round legalizing fentanyl check strips and different drug paraphernalia filed by Dallas Democrat Jasmine Crockett didn’t get a listening to on the House flooring final session. But with extra lawmakers having constituents affected by the opioid epidemic, a narrower invoice that offers solely with fentanyl testing instruments, and assist from prime Republican leaders, the percentages for passage of this 12 months’s proposals are a lot better.

Marc Levin, a felony justice skilled who has labored on laws in Texas in recent times, stated the change in perspective is “noticeable.”

“It’s not just that opioids have had a significant effect on rural areas, which are represented by Republicans generally, but the connection to China and illegal smuggling across the border — those two things have elevated the issue among Republicans,” stated Levin, chief coverage counsel for the Council on Criminal Justice, a nonpartisan assume tank.

Still, he stated, it’s helpful for lawmakers to reevaluate their previous positions on coverage based mostly on information and new information.

Fentanyl check strips are seen by drug coverage specialists as an necessary device in stopping overdose deaths. Drug customers usually have no idea that the medication they’re taking are laced with fentanyl.

The check strips enable customers to safely be taught whether or not the medication they’ve purchased comprise the harmful drug and head off a doubtlessly harmful overdose.

Drug coverage specialists say that offering the check strips to customers and giving them an opportunity to keep away from deadly overdoses opens the door to a continuum of care that would assist get individuals off medication.

“If you’re out on the street and giving them care packages with Narcan and fentanyl testing strips, that’s an engagement with a health care worker that these people may not [otherwise] be getting,” Neill Harris stated.

In current years, states have moved towards legalizing fentanyl check strips, together with Republican-dominated ones like Wyoming, Nebraska, South Carolina, Alabama and Tennessee.

Some regulation enforcement teams, which have lengthy been resistant, are warming to the legalization of fentanyl check strips as a device within the battle in opposition to opioid deaths.

Jennifer Szimanski, public affairs director for the Combined Law Enforcement Associations of Texas, stated her group is usually supportive of decriminalizing fentanyl check strips however would have to have a look at particular laws.

Others are nonetheless expressing some apprehension.

Kevin Lawrence, govt director of the Texas Municipal Police Association, stated his group remains to be contemplating the concept.

“Our concern is how widespread is it, what kind of controls will there be and what are the repercussions for abuses of this?” he stated.

Neill Harris stated the reticence towards legalizing check strips is analogous to opposition from regulation enforcement to a 2015 regulation that allowed individuals aside from docs to have and deploy naloxone, an opioid-reversing drug. Opponents on the time argued that investing in elevated entry to naloxone may encourage drug use. That regulation additionally granted authorized immunity to an individual who tried to give the drug to somebody they believed to be affected by an opioid overdose.

Narcan is an intranasal type of that drug, and regulation enforcement officers at the moment are clamoring for the state to make it extra available to them. That’s after years of schooling from specialists have taught police throughout the state how straightforward the drug is to use, how efficient it’s in saving lives and the regulation’s protections for first responders who use it to strive to reverse an overdose.

“We need to get Narcan in the hands of more police officers,” Szimanski stated. “We’ve had members reach out in the last few months if there’s any way CLEAT can provide Narcan because their administrations are not providing it.”

Another model of naloxone is cheaper, costing between $1 and $25 a unit — however that should be injected, requiring extra coaching.

This 12 months, a federally funded state-run program out of the UT Health San Antonio School of Nursing that offered free Narcan ran out of funds midway by way of the 12 months.

The program was additionally a sufferer of its personal success. So many teams had grow to be depending on it without cost Narcan that it couldn’t fulfill all of the requests it obtained. In 2023, this system, referred to as “More Narcan Please,” is limiting teams to 48 models per order and emphasizing the necessity to get the lifesaving drug immediately into the arms of these most affected.

Graziani with the Texas Harm Reduction Alliance stated she desires to see extra particulars about Abbott’s plan for making Narcan extra available. Some states have prioritized getting the drug within the arms of regulation enforcement, however some drug coverage specialists say it’s simpler to get Narcan within the arms of drug customers, their relations or harm-reduction teams that immediately work together with drug customers since these are the individuals probably to have an interplay with an individual experiencing an overdose.

Graziani additionally stated she desires to know extra in regards to the state’s plan to disperse the drug equitably to make sure that it will get to rural areas which have much less assets to purchase Narcan, and to hurt discount teams like hers which have direct contact with customers. Having Narcan in faculties and universities can be an necessary a part of the battle, she stated.

“We would love to see a plan in place that prioritizes community-based distributions,” she stated, including that naloxone wants to be “ubiquitous.”

Abbott can be pushing for stiffer penalties for individuals who knowingly promote medication laced with fentanyl.

“I want it to be categorized as murder for someone to knowingly provide a fentanyl-laced pill to someone who ingests it and dies,” he stated earlier this 12 months.

Drug coverage specialists oppose such a transfer and say it’s a continuation of “war on drugs” methods that haven’t labored up to now.

“Our drug supply is more deadly now than ever because we continue to double down on those prohibitionists or tough-on-crime policies, and we know that through research, increasing criminal penalties does nothing to decrease drug use,” Graziani stated.

Levin stated the coverage proposal is “well-intentioned” however has problematic unintended penalties.

“The biggest concern that I’ve seen with other states is that while it is intended to go after drug kingpins, most of the people who have been prosecuted have been family members or other people who were there at the time of the overdose,” he stated.

Studies have proven that with a rise in “drug-induced homicide” prosecutions in jurisdictions that move these legal guidelines, the speed of overdose deaths truly goes up. In an evaluation in Wisconsin, 90% of the individuals prosecuted on these costs had been pals, kin or low-level drug sellers promoting to assist their very own drug use. In one other in New Jersey, 25 of the 32 such prosecutions had been pals of the deceased who didn’t usually promote medication.

Experts say lawmakers ought to as a substitute concentrate on policies pushed by public well being analysis. They say the hassle to decriminalize fentanyl check strips ought to increase past that drug to cowl different doubtlessly harmful substances. Drug traffickers are already utilizing different substances to improve the facility of road medication, and legalizing check strips just for fentanyl may depart customers prey to different medication.

“What I would like to see is the legalization of any drug-checking tools or technology that are used for reducing risk,” Neill Harris stated.

Experts are additionally pushing for different modifications, just like the legalization of syringe change packages, which swap out used syringes for brand new ones to forestall drug customers from contracting ailments, and modifications to the state’s “overdose Good Samaritan” regulation, which protects from arrest or prosecution an individual who requires emergency assist — however has steep necessities for individuals to obtain that safety.

The Good Samaritan regulation doesn’t defend individuals who have felony drug costs on their felony information or who’ve referred to as for emergency assist in the final 18 months. Both necessities would rule out a lot of drug customers or their households.

“We understand that regardless of someone’s history, they need to be able to call [for help],” Graziani stated. “It’s punishing the person who might die because someone around them has a [criminal] history.”

Abbott has not indicated assist for both of these coverage concepts, which makes their passage by the Legislature much less seemingly.

But drug habit specialists say they may proceed to push for a extra holistic method to combating the nation’s opioid overdose epidemic in Texas.

“Narcan access and even fentanyl testing strips are steps in the right direction, but we’re going to need more than that to address this,” Neill Harris stated. “We sort of need everything. We need to throw the kitchen sink at this.”

The Texas Tribune is a member-supported, nonpartisan newsroom informing and interesting Texans on state politics and coverage. Learn extra at texastribune.org.

Disclosure: CLEAT, Rice University, the Baker Institute for Public Policy and UT Health San Antonio have been monetary supporters of The Texas Tribune, a nonprofit, nonpartisan news group that’s funded partially by donations from members, foundations and company sponsors. Financial supporters play no function within the Tribune’s journalism. Find a complete list of them here.