Author Topic: "An Experiment Helps Heroin Users Test Their Street Drugs For Fentanyl" - NPR  (Read 2208 times)

Offline CrazyLegs (OP)

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http://www.wnyc.org/story/an-experiment-helps-heroin-users-test-their-street-drugs-for-fentanyl/

In the day room at St. Ann's Corner of Harm Reduction, which runs a needle exchange program in the Bronx, a group of guys are playing dominoes and listening to salsa music while they wait for lunch. And Van Asher, one of the staffers in charge of "transactions" — that means he gives out needles — is talking up his latest idea for how to keep the users here safe.

He wants to tell them what's really in their stash.

"If you're doing dope," he says to one client, "we'll give you a test strip so you can test and see if there's fentanyl."

Fentanyl is a synthetic opioid that is "similar to morphine but can be 50 to 100 times more potent," according to the National Institute on Drug Abuse. Increasingly, drug dealers have been using fentanyl to cut their heroin supply — which can be lethal for users. By using the same simple test a doctor would use to check for fentanyl in a patient's urine, Asher is now giving drug users in the Bronx a way to quickly find out what's in their syringe before they inject.

"I know what I'm getting is the raw," one client tells Asher, implying he knows his drugs are pure.

"That's what you think!" Asher tells him. "But how do you know? Are you buying it from, like, the FDA?" The client laughs.

Asher is the data manager here: He makes sure the Centers for Disease Control and Prevention and local health departments get the information they need about the drugs taken by the people who come here. But he started this project more out of his own feeling of desperation about the community he serves than out of a desire for official data collection.

He says the number of overdose deaths in the last year has been so overwhelming, he's tried to stop counting them. But the New York City Department of Health and Mental Hygiene says drugs killed more than 1,300 people in 2016 — the highest number on record. And public health officials say that rise has been driven, in large part, by fentanyl.

As Asher says, "You see someone, you go: 'I'll see you tomorrow.' And you never see them again."

Which is why he and St. Ann's Corner recently ordered a bunch of fentanyl test strips from Canada and started handing them out. The idea is that giving users information about what they're using could empower them make a better choice. If they know there's fentanyl in the mix, maybe they'll inject the drug more slowly. Maybe they'll use in a safer place. Maybe they won't use at all.

Now, Asher is working with needle exchanges around the country who are trying the same sort of thing. Dr. Alexander Walley, the director of the addiction medicine fellowship program at Boston Medical Center, has been tracking the use of these test strips since the idea first got started last year, at a needle exchange in Vancouver, called Insite.

"From what I've heard ... even when they know they're going to be positive for fentanyl, the experience of somebody testing their drugs and seeing that it's fentanyl has an impact," Walley says. "It really encourages them to use more safely."

Insite, which is funded by the Canadian government, is also the only "safe injection" site in North America. That means there's a key difference between what's happening there, and what's happening at needle exchanges in the U.S. In Canada, whether or not a user's drugs test positive for fentanyl, he or she can stay at Insite and inject under a nurse's supervision, which increases the chances that an otherwise lethal overdose could be reversed.

Walley thinks about these test strips the same way he thinks about a fire extinguisher or a seat belt: as a precaution. He's interviewed heroin users, and says while some users tell him they like fentanyl, and some don't, "the majority of people are agnostic. Because the people we interview, they have a daily opioid use disorder — and what they really care about is not being in withdrawal."

"At the end of the day," he continues, "I think giving people knowledge about what they're putting in their body is probably a good thing more than a bad thing."

But will these test strips help users in the Bronx avoid an overdose? Asher says the only way to know is to give them out and study what happens next.

His project is still very much a work in progress. Asher says that he's been giving out about 10-15 test strips a day, and is starting to run low. Each strip costs about a dollar, and the budget at St. Ann's, which is funded primarily by the city and state departments of health, is tight. Asher has tried handing out surveys with the strips, to figure out which brands might be more dangerous, or what a tainted batch might look like. But it's hard to get users to report back.

One thing he's already learned: Fentanyl has become a big part of the local drug supply in the Bronx. One user, Vincente Estepa, says all but one of the bags of heroin he tested came up positive for fentanyl.

When asked whether that will change the way he uses, though, he says no.

"At the end of the day an addict is an addict, Estepa says. "It's stronger! If it makes me feel the euphoria, I'm going to go for it."

Estepa says dependence on the drug means constantly looking to avoid "E." That stands for "empty," he explains — when the physical symptoms of opioid withdrawal kick in. And avoiding withdrawal can mean taking risks.

Using heroin has already taken a lot from him. Estepa has lost his job. He's homeless. But he's still alive. The people running this project want to keep it that way.

-------------------------------------------

Just another note -- I'm pretty sure if you listen to the audio, the actual radio piece, you'll hear the employee of the BRONX facility responsible for testing mention that FIVE OUT OF SIX tests come back as POSITIVE for FENTANYL.  Most people don't even know what they're using -- they just think "it's fire dope," when the truth of the matter is that many of these people are actually using fentanyl.



"All change, and time’s arrow, point in the direction of corruption. The experience of time is the gearing of the electrochemical processes in our brains to this purposeless drift into chaos as we sink into equilibrium and the grave.”

Offline Thoms

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This is fucking rad. Maybe one day my county will turn more into California and less into fucking Texas or some shit. Fucking nut balls. Then maybe we will open a NX. I think the testing strips are a great idea the only problem is that everyone will be hot.
Fear and self loathing in thoms.

Offline MoeMentim

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It's about time.  This'll probably never happen envision a time when the consumer market drives the producers to produce more pure/clean drugs.  a dream from a harm reduction standpoint but i never expected to smoke legal pot in my lifetime & I'm twisting up a joint of that right now...

Offline CrazyLegs (OP)

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This'll probably never happen envision a time when the consumer market drives the producers to produce more pure/clean drugs. 

Well, looking at it from a certain perspective, this has actually already happened... And it's called fentanyl.  The emergence of fentanyl as a cutting/substituting agent in the heroin market has basically brought to the market a stronger product that is "pharmaceutically pure" (or the opposite - impure, if you're only looking for heroin), and in many cases is the same price or *cheaper*, since a lot of these dealers were sourcing their fentanyl in bulk from east Asia at very low prices relative to what un-cut heroin sells for on the illicit market.

So what you end up with is a classic case of healthy competition leading to a buyers' market. 
"All change, and time’s arrow, point in the direction of corruption. The experience of time is the gearing of the electrochemical processes in our brains to this purposeless drift into chaos as we sink into equilibrium and the grave.”

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i think more people would want to stay away from fent than would seek it out.  i want nothing to do with the stuff - short legs, fast tolerance & the danger.

Offline traplord69

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I think it comes down to the fact that there is a lot of shitty dope out there, and insert fent as a cut, so its mixed with actual heroin and gives what may be sub par dope an extra kick, this is pretty obvious.  In that sense I do understand the desire.  If its between bad dope, or bad dope with a fent kicker that gives you a nice rush and then still the decent legs of some ok dope, it sort of makes it attractive.  I agree though, I would want nothing to do with a straight fentanyl bag.  It's obviously still a huge health hazard as its basically impossible for a lay person to correctly distribute fent in the microgram range into bags that are 30-100mg of dope/cut.

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Yup, i also want nothing to do with any fent analog or any of that carfentanyl shit theyre bringing in as heroin.  Mainly cause fentanyl, like patches, never gave me any euphoric feeling whenever i tried it. Sure it took away the w/ds but it didnt scratch that itch for me, and i had what, 4-5 25mcg gel patches that i tried using.  I feel like its better for pain relief and youd od before you got that good feeling. Its just too clean of an opioid to be abused

And the street fent/carfent is even worse.  I still believe it was carfent that i oded on last july, same time as all the confirmed carfent ods around my area in ohio.  I was normally doin half gram shots several times a day for almost a year after i relapsed from 2 yrs clean, and this day i got some new grey chunk that just looked odd.  It was a really light chunk, had no weight like a normal chunk that size, and when i pulled it up into the rig it didnt have a lot of color or taste that im used to for a half of a half sized shot. I actually thought dude gave me some weak shit.

I did it and before i even got the tie barely loose i remember feeling damn this is actually some bomb shit, then wake up strapped in the ambulance.  I went out with nothing else, no xanax, or anything but that shot i did, and i know i was doin double that of real good shit from a major city.

That carfent and even fent is so strong, and a dose is so small that theres a huge possibility for hot spots where one speck can be lethal if juan and jose in south america decided to not stir or mix the shit long enough. When one dealer has 20 custys od in an evening, somethin aint right

Offline theSWPK

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If you're IV'ing dope, you,really probably going to shoot it up anyway. Maybe ppl will learn to titrate their doses?
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