The vending machine outside Caracole, an HIV/AIDS prevention organization in Cincinnati, isn’t for a midday snack.
Instead of chips or soda, it holds what director of prevention Suzanne Bachmeyer believes is an assortment of life-saving supplies.
“These are our test strips,” she said as she opened up the vending machine’s door on a summer day. “We do them kind of a la carte, so if people want them they can just vend a pack.”
Three years ago, the state of Ohio decriminalized these testing strips that can detect the presence of fentanyl, a potent synthetic opioid. That move led to wider distribution in the state, and Bachmeyer says the testing strips’ prevalence has helped reduce overdose deaths.
“It allows individuals to protect themselves and people in their community,” Bachmeyer said.
Over the last few years, Ohio public health groups have invested heavily in these testing strips, hoping to prevent fatal overdoses. But, now, they will likely become harder to get: The federal government agency that helped pay for them says it will no longer fund substance use testing strips.
A shift away from harm reduction
The federal Substance Abuse and Mental Health Services Administration (SAMHSA) doles out grants to Ohio for overdose prevention. But in April, the administration sent out a letter to health departments, saying those SAMHSA funds can no longer be used to purchase or distribute substance use testing strips.
It’s part of a larger priority shift from the Department of Health and Human Services. Secretary Robert F. Kennedy Jr. spoke at a press conference in Michigan last month.
“Ignoring addiction doesn’t work. Harm reduction doesn’t work,” Kennedy Jr. said in Clinton Township, Mich. during an announcement of a federal drug addiction and homelessness program in June.
SAMHSA did not respond to a request for an interview, but in that April letter, it said that harm reduction efforts are incompatible with federal law and “facilitate illicit drug use.”
“Addressing the addiction and overdose crisis is a top priority for the Administration, HHS, and SAMHSA,” the letter read. “To finally bring an end to this crisis and achieve the Great American Recovery, it is essential that the use of federal funding is aligned to common-sense public health strategies that focus on prevention, treatment, and long-term recovery.”
A prevention tool
Ohio State researcher Janet Childerhose disagrees with the administration’s stance on substance use testing strips. She’s studied the link between fentanyl testing strips and risk reduction behaviors.
“I understand the inclination to assume that if we take harm reduction supplies and tools away from people who are using that we're going to dissuade them from using,” she said. “What we know from the evidence and from other kinds of public health interventions is that simply is not true.”
Rather, she said, testing strips help address an increasingly complex and deadly drug supply.
In 2023, fentanyl was involved in more than three fourths of unintentional drug overdose deaths in Ohio, often in combination with other drugs, according to the Ohio Department of Health.
“People are ingesting a supply that is unknown to them. It's not regulated. It is adulterated with lots of different things. They don't know what the amount is,” she said. “Basically, people are sitting ducks.”
It’s not just researchers who see the value in fentanyl testing strips. For years, the federal government explicitly sanctioned their purchase with SAMHSA grants – including in a letter from the Trump administration last July.
Impact on Ohio orgs
The Ohio Department of Health’s Project DAWN has relied on SAMHSA funds to distribute testing strips free of cost.
The ODH declined an interview. But in a May email, Project DAWN officials told Ohio community groups that the department could no longer provide them testing strips.
“We are actively reviewing the updated guidance with our state and federal partners to determine the best path forward and to identify possible alternative funding sources,” the Project DAWN email obtained by The Ohio Newsroom read.
Tonja Catron, the executive director of the statewide SOAR Initiative, says it’s been a devastating blow to her overdose prevention organization.
“We can’t buy anything that keeps people who use drugs safe,” Catron said.
With fewer funds available, she says her organization has had to slow its distribution. They have prioritized giving strips directly, and only, to people who use drugs.
The statewide nonprofit Harm Reduction Ohio distributed over a million drug testing strips last year. Executive director AmandaLynn Reese estimates the organization will only be able to distribute a quarter of that this year.
“Everyone from your school nurse to your person who is injecting substances, living in an encampment, wants these supplies. And now, at a dollar a piece, how is that sustainable for a nonprofit?” Reese said.
Both organizations say they’re worried about the community that has relied on testing strips.
“I do not think that it’s gonna stop drug use in Ohio,” Catron with the SOAR Initiative said. “If their long-term goal is recovery – if that's what the government wants – that person is never gonna be alive long enough to make it there.”
For now, the groups say they are distributing what they have left and hoping community fundraising and private grants can help them restock.
