Florida lawmakers this spring passed a new law, recently approved by Gov. Ron DeSantis, that decriminalizes fentanyl test strips.

Fentanyl test strips are an effective, cheap and easy-to-use tool that can detect fentanyl, a powerful opioid, in street drugs. They can’t detect the amount or potency, but experts say they can still save lives.

But there’s a catch with what the new law — celebrated by lawmakers on both sides of the aisle — does and does not do.

SB 164 does decriminalize those $2 paper strips for detecting fentanyl, but it leaves out testing tools capable of detecting other controlled substances.

That includes xylazine, a powerful veterinary tranquilizer with serious side effects that’s increasingly being laced into street drugs, such as fentanyl, unbeknownst to the person buying.

Also known as “tranq” or “tranq dope,” xylazine is a non-opioid tranquilizer that’s not recommended for human use.

In humans, xylazine can cause dangerously low blood pressure, difficulty breathing, sedation, as well as serious skin wounds and necrosis — the rotting of skin tissue.

Left untreated, necrotic skin ulcerations may require amputation. Mixed with fentanyl, the combination can be lethal.

Mixed with the powerful opioid fentanyl, xylazine can increase the risk of fatal drug overdose.

The U.S. Centers for Disease Control and Prevention urges people who use street drugs to avoid using alone — you need someone to be there in the event that you accidentally overdose.

The federal agency also encourages testing street drugs for xylazine and fentanyl.

Advocates for harm reduction say that testing recreational drugs for fentanyl or for xylazine can help users make an informed decision about whether to use a drug or abstain.

This is true not just for people with addiction, or the millions of Americans with a clinical substance use disorder, but for anyone who acquires drugs through less than legal means.

But finding tools to test drugs for xylazine in Florida isn’t so simple, or without risk.

The criminalization of harm reduction practices

Tools for testing drugs, also known as drug-checking equipment, are illegal to possess, use, or sell in Florida — as they are in a number of states.

That’s because they’re classified under decades-old state statutes as a form of illegal “drug paraphernalia.”

Under Florida law, drug paraphernalia refers to any item used to “plant, propagate, cultivate, grow, harvest, manufacture, compound, convert, produce, process, prepare, test, analyze, pack, repack, store, contain, or conceal a controlled substance.”

Prior to July 1 of this year, that included fentanyl test strips.

Fentanyl remains the most common drug detected in Floridians who’ve died of a drug overdose, followed by cocaine and meth, according to state data for 2022.

Fentanyl is legally prescribed as a painkiller, but it’s also manufactured illegally, and it’s those illicit forms of fentanyl that are responsible for the majority of U.S. fentanyl overdose deaths.

Unlike legal forms of fentanyl, illicit forms aren’t regulated. There’s no quality control.

Fentanyl is also super potent. It’s 50 times more powerful than heroin, and can be deadly in small amounts for those who don’t use it frequently and chronically.

That’s a serious danger for people, including teens and young adults, who recreationally use drugs who take it by accident.

Fentanyl has been found in counterfeit pills sold on the street, as well as drugs like cocaine, meth and marijuana. It has permeated the supply of other illicit opioids like heroin.

It’s been on the radar of Florida lawmakers for years. And a spike in overdose deaths during the COVID-19 pandemic only increased the urgency for lawmakers to take action.

Over 107,000 people in the U.S. died of drug overdose in 2022 alone — a record high. Two-thirds of those deaths involved fentanyl and chemically similar substances known as analogs.

Opioid overdose deaths in Orange County, Florida slightly dipped last year, but local elected officials are reluctant to let their guard down and celebrate the downward trend just yet.

Fentanyl’s proliferation in the street drug supply is still a concern. Plus, other dangerous contaminants are entering the supply, too, like xylazine.

And unlike opioids, xylazine is not affected by naloxone — a drug also known as Narcan, that’s capable of reversing an opioid overdose.

A problem in Orange County

A study published last June found that xylazine has been detected in 36 states, including Florida.

The Orange County Sheriff’s Office held a press conference in June to raise awareness about the drug, and Florida state officials have also sounded the alarm.

“In 2021, xylazine was the 11th-most frequently identified drug in the FDLE crime labs,” said Eli Lawson, special agent of the Florida Department of Law Enforcement, in April. “In 2023, so far, it is the sixth-most frequently present drug in processing drug-related evidence statewide.”

“Since 2021, our FDLE crime labs across the state have logged 1,090 cases of xylazine being present in processed evidence,” Lawson added. “This growing challenge is serious.”

Data from the state’s medical examiner’s office shows xylazine was involved in at least 218 deaths in Florida last year, up from 112 reported deaths in 2021.

Orange County sheriff John Mina shared in June that xylazine has been linked to at least three overdose deaths in Orange County so far this year, and two deaths last year.

“We can’t stress how important this is to let our residents and visitors know the dangerous effect of xylazine in our community,” said Mina.

The drug has generally been found in the form of a white, off-white, brown or purple powder, a FDLE spokesperson told Orlando Weekly.

But Tim Santamour, director of the Florida Harm Reduction Collective, told Orlando Weekly that unless you have a way to test your drugs — with commercially available xylazine test strips, for example — there really aren’t any ways to know whether there’s xylazine in your drug supply.

If you’re buying street opioids, you might feel groggier or more sedated from opioids laced with xylazine, Santamour said. That’s because xylazine, like opioids, is a depressant.

But drug-checking tools for xylazine — including test strips, similar to those that test for fentanyl — aren’t widely available in Florida, as far as Santamour knows.

At least not for the general public.

Some law enforcement agencies do have access to tools, used in labs or at street stops, that can check for xylazine — for the prosecution of drug-related offenses.

Santamour says there’s not a lot of communication about their detection of drugs in local communities in real time.

“That information could be released to the public, or at least to the Department of Health, you know, immediately,” said Santamour.

“That would go a long way to informing people who use drugs what’s out there, and what they should be looking out for,” he added. “It would also help folks that are doing wound care in hospitals and emergency rooms, so they know what to expect ahead of time.”

A missed chance?

This year wasn’t the first time Florida lawmakers considered decriminalizing drug checking equipment, and an earlier effort would have gone further.

In 2022, Florida Democratic lawmakers launched a broader proposal to decriminalize all drug-testing equipment, including but not limited to fentanyl test strips.

Other lawmakers weren’t biting.

So, then-Democratic Rep. Andrew Learned filed an amendment to a separate controlled substances bill that would, like this year’s bill that passed, decriminalize fentanyl test strips only.

The GOP-controlled legislature, however, shot it down at the last minute. Critics worried that it could encourage drug use (a claim that’s not backed up by research).

“There’s a real philosophical question there, much like providing drug needles to addicts,” former Sen. Scott Plakon, a Republican, told the Sun Sentinel at the time. “It does give me heartburn.”

This year’s proposal was watered down to make it more palatable for skeptics.

The bill’s language specified that only drug testing equipment for detecting fentanyl would be removed from the state’s legal definition of illegal “drug paraphernalia.”

Later, the bill language was amended to clarify that this only applied to testing tools that aren’t capable of identifying the “quantity, weight or potency” of a controlled substance.

Orlando Weekly reached out to the two Democratic lawmakers who sponsored this year’s measure — Florida Rep. Christine Hunschofsky and Florida Sen. Tina Polsky — to ask if they regretted not pushing for a broader decriminalization proposal.

Rep. Hunschofsky did not respond to two emailed requests for comment.

An aide for Sen. Polsky informed us that Polsky is out of the country for the rest of the month, and wouldn’t be available for an interview.

But back in January, when Hunschofsky first filed her bill in the House, the lawmaker told Orlando Weekly that the narrowly tailored language was intended to increase the bill’s chance of passing.

She wasn’t wrong.

Its eventual passage was a rare, bipartisan victory this session, with Democrats and Republicans agreeing on little else of substance.

“Unfortunately when it comes to the supermajority Republican Legislature, working in an incremental way with harm reduction programs is the only way to get things through,” Orlando Rep. Anna V. Eskamani — who co-sponsored the fentanyl test strip bill— told Orlando Weekly over email.

Decriminalizing other types of drug-checking equipment, she added, “should absolutely be a priority next legislative session.”

Florida isn’t the only state to tailor its language to only apply to fentanyl test strips. It’s also not the only tool or strategy out there that can help address the problem of accidental overdose.

State lawmakers, particularly the GOP, have in recent years moved to further crack down on people who deal fentanyl by, for instance, enhancing criminal penalties for fentanyl trafficking.

Most illicit forms of fentanyl are smuggled into the U.S. from Mexico, through legal ports of entry.

Focusing on criminal penalties for trafficking, however, is a point of concern for some drug policy advocates, who see it as a perpetuation of the United States’ “War on Drugs.”

It’s a “repeat of failed law enforcement practices of the past,” said Santamour.

“I think we saw that with the crack [cocaine] crisis that increased penalties did not stop, or did not curtail the availability of crack,” Santamour said. “That’s not going to stop fentanyl from entering the communities.”

What it’s going to do, he said, is punish low-level drug dealers — street-level drug dealers — who “have no idea of knowing” what’s all in the drugs they sell.

The Florida Harm Reduction Collective, he added, was “neutral” about the move to decriminalize fentanyl test strips.

It’ll be helpful for people who use drugs recreationally, particularly non-opioids, Santamour said.

But for people who use street opioids like heroin multiple times a day to stave off distressing withdrawal symptoms, the strips won’t be of much use.

Fentanyl has contaminated the street opioid supply in recent years. For many of those who chronically use street opioids, it’s already just assumed there will be some amount of fentanyl in them.

“We know it’s beneficial for some communities,” said Santamour, of the move to decriminalize fentanyl test strips. “But it wasn’t equally beneficial for all communities.”

Still, he adds that being able to do the bare minimum of checking drugs for xylazine without facing potential misdemeanor or felony charges under state law could be helpful moving forward.

“It allows folks to make different decisions around those substances,” he said. “And that could include not using, and seeking alternatives such as detox, treatment, MAT [medication-assisted treatment], you know? Something else besides continuing to use.”

The White House recently rolled out its own plan to address the “emerging threat” of xylazine mixed with fentanyl — a potentially lethal combination — on a federal level.

Orange County Sheriff’s Office officials, for their part, admitted they don’t think the issues they’re seeing with fentanyl or xylazine are going to go away any time soon.

“It’s not a fad,” said OCSO Captain Darryl Blanford. “This is a growing trend that’s probably gonna be here for a few years.”

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