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Decriminalize Drug-Checking Technologies in Pennsylvania to Prevent Overdose Deaths

Jack Spades / CC BY
Journal of Science Policy & Governance | Volume 17, Issue 02 | October 12, 2020

Second Place Winner

Policy Memo
:
Decriminalize Drug-Checking Technologies in Pennsylvania to Prevent Overdose Deaths

Kyla Mace (1,5,7), Wisberty J. Gordián-Vélez (2,5,7), Aerin Wheeler (3,5-7), Victor Acero (2,5-7), Emily Cribas (4-7)
  1. Perelman School of Medicine at the University of Pennsylvania, Pharmacology Graduate Group, Philadelphia, PA
  2. University of Pennsylvania, Department of Bioengineering, Philadelphia, PA
  3. University of Pennsylvania, Department of History and Sociology of Science, Philadelphia, PA
  4. Perelman School of Medicine at the University of Pennsylvania, Cell and Molecular Biology Program, Philadelphia, PA
  5. University of Pennsylvania, Penn Students for Sensible Drug Policy, Philadelphia, PA
  6. University of Pennsylvania, Penn Society for Psychedelic Science, Philadelphia, PA
  7. University of Pennsylvania, Penn Science Policy and Diplomacy Group, Philadelphia, PA
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https://doi.org/10.38126/JSPG170210
Keywords: drug overdose; fentanyl test strips; drug-checking technologies (DCTs); people who use drugs (PWUD); Pennsylvania Controlled Substance, Drug, Device, and Cosmetic Act

Executive Summary: Drug-checking technologies (DCTs), such as fentanyl test strips, prevent fatal overdoses caused by the adulteration of drugs. DCTs are currently classified as illegal drug paraphernalia in Pennsylvania (PA), but the recent and significant rise in fentanyl-related overdoses has prompted the PA House and Senate to propose exempting fentanyl test strips from the definition of drug paraphernalia. While fentanyl is currently the leading drug adulterant, other substances may be used to alter drugs. Therefore, we argue that broader reform is required to protect Pennsylvanians against all potential drug adulterants. We recommend that the PA House and Senate Judiciary Committees work to amend the PA Controlled Substance, Drug, Device, and Cosmetic Act to exempt all DCTs from the definition of drug paraphernalia. This proactive intervention will save countless lives by preventing adulterant-related overdoses.

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References

  1. American Medical Association. 2020. “Issue Brief: Reports of Increases in Opioid-Related Overdose and Other Concerns during COVID Pandemic,” 7.
  2. An Act amending the act of April 14, 1972 (P.L.233, No.64), known as The Controlled Substance, Drug, Device and Cosmetic Act, further providing for definitions., H.B. 1741, P.A. General Assembly, Regular Session 2019-2020 (P.A. 2019)
  3. An Act amending the act of April 14, 1972 (P.L.233, No.64), known as The Controlled Substance, Drug, Device and Cosmetic Act, further providing for definitions., S.B. 886, P.A. General Assembly, Regular Session 2019-2020 (P.A. 2019)
  4. Azpiri, Jon. 2020. “Vancouver Sees Spike in Overdose Deaths amid COVID-19 Crisis.” Global News, April 1, 2020. https://globalnews.ca/news/6763146/vancouver-sees-spike-in-overdose-deaths-amid-covid-19-crisis/
  5. Bonds, Anita, Mary Cheh, Jack Evans, Vincent Gray, David Grosso, Kenyan McDuffie, Phil Mendelson, et al. 2017. Opioid Abuse Treatment Act of 2017.
  6. Bush, Melinda, Julie Morrison, Patricia Van Pelt, Robert Peters, Sue Rezin, Laura Fine, Mattie Hunter, et al. 2019. Needle and Hypodermic Access.
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  8. DEA Philadelphia Division. 2018. “The Opioid Threat in Pennsylvania.” DEA.
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  10. Walid F. Gellad, Adam J. Gordon, Chung-Chou H. Chang, and Julie M. Donohue. 2017. “Medication-Assisted Treatment and Opioid Use Before and After Overdose in Pennsylvania Medicaid.” JAMA 318 (8): 750. https://doi.org/10.1001/jama.2017.7818
  11. Goldman, Jacqueline E., Katherine M. Waye, Kobe A. Periera, Maxwell S. Krieger, Jesse L. Yedinak, and Brandon D. L. Marshall. 2019. “Perspectives on Rapid Fentanyl Test Strips as a Harm Reduction Practice among Young Adults Who Use Drugs: A Qualitative Study.” Harm Reduction Journal 16 (1): 3. https://doi.org/10.1186/s12954-018-0276-0
  12. Kuo, Yong-Fang, Mukaila A. Raji, and James S. Goodwin. 2019. “Association of Disability With Mortality From Opioid Overdose Among US Medicare Adults.” JAMA Network Open 2 (11): e1915638. https://doi.org/10.1001/jamanetworkopen.2019.15638
  13. Leslie, Douglas L., Djibril M. Ba, Edeanya Agbese, Xueyi Xing, and Guodong Liu. 2019. “The Economic Burden of the Opioid Epidemic on States: The Case of Medicaid.” The American Journal of Managed Care 25 (13 Suppl): S243–49.
  14. NDEWS. 2018. “National Drug Early Warning System.” Percentage of Methamphetamine Deaths That Also Involved Fentanyl in Five SCS. 2018. https://ndews.umd.edu/feature/percentage-methamphetamine-deaths-also-involved-fentanyl-five-scs​
  15. Nolan, Michelle L., Sindhu Shamasunder, Cody Colon
  16. Berezin, Hillary V. Kunins, and Denise Paone. 2019. “Increased Presence of Fentanyl in Cocaine-Involved Fatal Overdoses: Implications for Prevention.” Journal of Urban Health 96 (1): 49–54. https://doi.org/10.1007/s11524-018-00343-z
  17. OverdoseFreePA. 2018. “Death Data Overview.” OverdoseFreePA. 2018. https://www.overdosefreepa.pitt.edu/know-the-facts/death-data-overview/
  18. Philadelphia Department of Public Health. 2020. “Non-Fatal Overdose - Clinical Sites.” Philadelphia Department of Public Health - Health Information Portal. 2020. https://hip.phila.gov/DataReports/Opioid/NFOClinicalSites
  19. Power, Mike. 2020. “40 Americans Are Dying Every Month From Taking This New, Legal Opioid.” Vice, March 12, 2020. https://www.vice.com/en_us/article/wxebjb/40-americans-are-dying-every-month-from-taking-this-new-legal-opioid?utm_campaign=sharebutton
  20. Premier, Inc. 2019. “Opioid Overdoses Costing U.S. Hospitals an Estimated $11 Billion Annually.” Premier, Inc. Newsroom. January 3, 2019. https://www.premierinc.com/newsroom/press-releases/opioid-overdoses-costing-u-s-hospitals-an-estimated-11-billion-annually
  21. Sherman, S.G., J.N. Park, J. Glick, M. McKensie, K. Morales, T. Christensen, and T.C. Green. 2018. “FORECAST Study Summary Report.” Johns Hopkins Bloomberg School of Public Health. https://americanhealth.jhu.edu/sites/default/files/inline-files/Fentanyl_Executive_Summary_032018.pdf
  22. The Controlled Substances, Drugs, Device, and Cosmetic Act. 1972. Pa. C.S. Vol. 35.
  23. Vancouver Coastal Health. 2017. “Drug Checking at Insite Shows Potential for Preventing Fentanyl-Related Overdoses.” Vancouver Coastal Health. May 15, 2017. http://www.vch.ca/about-us/news/news-releases/drug-checking-at-insite-shows-potential-for-preventing-fentanyl-related-overdoses
  24. Zibbel, Jon, Jennifer Howard, Sarah Duhart Clarke, Abigail Ferrel, and Sarita Karon. 2019. “Non-Fatal Opioid Overdose and Associated Health Outcomes: Final Summary Report.” U.S. Department of Health and Human Services, September, 33.
  25. Zibbell, Jon E., Arnie P. Aldridge, Dennis Cauchon, Jolene DeFiore-Hyrmer, and Kevin P. Conway. 2019. “Association of Law Enforcement Seizures of Heroin, Fentanyl, and Carfentanil With Opioid Overdose Deaths in Ohio, 2014-2017.” JAMA Network Open 2 (11): e1914666. https://doi.org/10.1001/jamanetworkopen.2019.14666

Kyla Mace is a graduate student in the Pharmacology Graduate Group at the University of Pennsylvania with a research background in the neurobiology of substance use disorders. She holds a B.A. in Psychology from the University of North Carolina, Chapel Hill.
 
Wisberty J. Gordián-Vélez is a PhD candidate in the Bioengineering Graduate Group at the University of Pennsylvania studying neural tissue engineering approaches to treat neurodegenerative disease. He holds a B.S. in Chemical Engineering from the University of Puerto Rico, Mayagüez Campus.
 
Aerin Wheeler is a graduating senior at the University of Pennsylvania studying Public Health and Neuroscience. Her research interests include health disparities, healthcare delivery, and community medicine.
 
Victor Acero studies tissue engineering and traumatic brain injury as a PhD candidate in the Department of Bioengineering at the University of Pennsylvania. He holds a B.S. in Engineering Science from the Pennsylvania State University.
 
Emily S. Cribas is a PhD candidate in the Cell and Molecular Biology Graduate Group at the University of Pennsylvania studying host-pathogen interactions in the gut. She holds a B.S. in Biochemistry and Molecular Biology and Psychology minor from Penn State.
 
Acknowledgements
The authors are grateful for the contributions of Shannon Wolfman, Jake Hoffman, Stephen Mell, and Erin Reagan from the University of Pennsylvania in preparing this manuscript.


DISCLAIMER: The findings and conclusions published herein are solely attributed to the author and not necessarily endorsed or adopted by the Journal of Science Policy and Governance. Articles are distributed in compliance with copyright and trademark agreements.

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